A Team Away Day – Xmas version!

Today we had one of our team away days. These are part of the full CAPA model and should occur at least 4 times a year (see the 11 components). A key part of away days are that they are not set by management but that the content is devised by and delivered by the team – I thought it might be interesting to post about today.

We started with a warm-up. We thought it might be good to do something appreciative so we each took a piece of paper, wrote our name on the bottom, and passed it to our left. We then all wrote an appreciative comment or comments about that person, folded the paper over – so no-one could see what was written — and again passed it to our left. Eventually the pieces of paper returned to their owners. It was quite moving to see what had everyone had written.

Then, up till coffee, we talked about the recent GP audit and thought about ways we could improve the referral process, let them know about the good things we were doing and reflected on the choice letters. The plan is to then meet with the local GP lead and think it through with them.

After coffee, up till lunch, we looked at the CYP-IAPT measures for every session monitoring and tried some out. These changes are going to be HUGE but in the end i think really good.

After lunch we thought about shared decision making and young peoples experience of the service. We thought both about how to make our clinic rooms more welcoming and what posters or positive messages we wanted on the walls. We then went on to think about a user experience project about how young people and their families experience the choice letter.

Tea came and then we had an exercise where we walked round the room looking at 6 Xmas pictures (snowman, mistletoe, Rudolf, present, tree, scrooge) and choose the one we thought best represented our view of the CYP-IAPT process. After we’d all selected we talked in the round why we’d picked them. After that we reflected on the hopes and fears we had written down 3 months ago. Interesting to find we had moved on and were maybe more positive and working together as a team.

Finally to cool down, we had a Xmas quiz run rather madly by Simon. A fun end to a really good day of working together.


CAPA-ccino and other beverages…

We visit and hear about lots of teams who say they are doing CAPA but when we look closely they are doing some but nowhere near all of the 11 CAPA components. Our experience is that this CAPA-lite model really doesn’t work very well! In fact this was a key finding of the Mental Health Foundation of English CAMHS and CAPA, that there were many partial implementations often due to myths about CAPA (MHF report).

At a recent conference a delegate suggested that we should call such a service not CAPA-lite but CAPA-ccino! It has less coffee, is covered with a frothy top and suggests it is more substantial than it is.

More extreme even was when we came across a service that said they were dong CAPA and had merely converted their first appointment into triage, called it Choice and nothing else! As another delegate suggested this should be CAPA Zero.

So if you think your service is meant to be doing CAPA but it isn’t a full and satisfying double espresso, check out the self rating scale…

A CAPA limerick

I have to credit Andrew, a systemic therapist, in my team for this…

Said a CAMHS statistician / clinician
“To end waiting lists is my mission.
With a partnership quota
We’ll be lean – like Toyota !
My ambition will come to fruition.”

Excellent and had to post it!


CAPA travels to Canada!

Warm people, cold weather. Cars that stop to let you cross. Experts in clearing snow (we could learn a thing or two here!). We had a wonderful time running CAPA training in Halifax, Nova Scotia 26 Nov to 1st Dec.

We were very excited when Sharon (Clark) from IWK invited us to run CAPA training at the Chocolate Lake Hotel.  No Willy Wonka in sight though! Day 1-2 was for clinicians and 3 for managers and others from the Province. Sharon had heard of CAPA from one of their clinicians who had worked in a CAPA team in New Zealand. The world is a very small place it seems!

IWK is the main provider of mental health services in Nova Scotia. We were struck by their enthusiasm about the service transformation CAPA can bring. The current services, although developed in good faith, are no longer able to provide responsive, quick access that they crave. Anxiety about their waits to non-urgent appointments had felt overwhelming until now…

The wonderful Maureen MacDonald, Health and Wellness Minister, opened the first day and we were struck by her resolute commitment to the project. She is a fantastic champion for children’s mental health- her praise for the hard work of the staff was particularly welcome. Then the day spurred on, tailored to people’s needs as we went. We talked about a focus on what people want, how to offer choices and let go when enough has been done. We were filmed (will we ever dare watch this!) and interviewed by a news journalist from the Chronicle Herald.

In Day 3 we worked with paediatricians, child and adult mental health practitioners, managers and the Department of Health. We focused on different viewpoints and system-free CAPA. How does CAPA help the service user, manager, clinician, administrator and funder? Everyone took something away.

Breakfast with the psychiatrists (the biggest plate of pancakes you ever did see!), bring and share supper at Sharon’s on Tuesday evening and a Q&A lunch before we went. A packed visit. Can’t wait to hear how things go for Nova Scotia!

Thank you for having us! We loved being with a new ‘family’.