RQIA Independent Review of Child and Adolescent Mental Health ...

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RQIA Independent Review of Child and Adolescent Mental Health ...

increased.

The trust reported an

increase in referral rate

over the last number of

years. The review team

estimated the combined

DNA and CNA rate for the

Belfast Trust is 26 per cent

(South Eastern is 16 per

cent). The DNA first

appointment rate was

estimated at nine per cent

for Belfast and 24 per cent

for South Eastern.

In the validation visits staff

expressed concern that

treatment and follow up are

compromised by waiting list

pressures.

Staff reported that there is

reduced follow on

appointments, due to

CAPA, and increase in sign

posting. Concern that

treatment follow ups are

comprised by waiting list

pressures of (CSR)

The trust reported the

highest referral rate and

indicated that this has

increased year on year.

The review team

estimated the combined

DNA and CNA rate for

the Northern Trust is six

per cent. The DNA first

appointment rate was

estimated at 25 per cent.

The focus group

indicated that the current

target waiting time of

nine weeks has reduced

opportunity for service

development: (e.g.

setting up a group

service) and has reduced

opportunities for further

training and

development.

The trust reported that

CAMHS will have links

with a wraparound

service for Looked After

Children (LAC) which is

being developed by

appropriate referrals.

Clinical referral co-ordinators

have established a good

interface with GPs to ensure

a seamless pathway.

Referrals can be categorised

as emergency, urgent and

routine, whilst some referrals

are signposted to other

services. The trust reported

an increase in referrals year

on year.

The DNA rate is six per cent

for new assessments (first

appointments). The total

DNA/CNA rate is 25 per

cent.

The focus group described

"impact of targets as having

potential to create a bottle

neck in follow on

appointment" and advised

that it may ultimately have

an impact on quality and

treatment.

The trust reported that the

Choice and Partnership

Approach (CAPA) principles

and appropriate access to

services.

Referrals can be classed as

emergency, urgent and

routine.

The trust reported having a

60 per cent increase in

referrals. The review team

estimated the combined

DNA and CNA rate for the

Western Trust is 31 per

cent. The DNA first

appointment rate was

estimated at 15 per cent.

Independent reviewers

raised a concern regarding

the trusts lack of planning

for a potential resource

implication, following the

introduction in January

2010 of an extended

service for 16-18 year olds.

The trust introduced the

CAPA Model in 2007 to

assist in the management

of referrals.

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