Implementation!

Just got back from presenting on the 2nd day (as well as a workshop) of a launch conference for the Scottish HEAT strategy. This is about incr4easing efficiency and access across all mental health. It was interesting to hear that CAPA is in play effectively in some service and others are just about to start. Lots of change…

However the really exciting thing was that we got to hear Karen Blase talk. She is leading researcher on implementation science in the real world ie what actually helps change and new programs work. Not only was she a great speaker, relaxed, knowledgeable and funny but said really good stuff. I was reassured that lots of the CAPA stuff we do is in line with the science – we’ve just learnt this from the 500+ teams we’ve worked with but there was also stuff to learn.

I think the sound bite knowledge was that you needed 1. Values ( as everything inst on a flow chart and you need to know how you decide), 2. a clear set of practices [eg the CAPA CRS], 3. these practices operationalised ie what you have to actually do and 4. direct feedback and coaching on those practices. It came to me that we need to talk more about teams doing this re Choice if their implementation is going to go well.

She also talked about values based management – i dream of this!!

HwattFinally it was neat to be @ Herriot Watt university as the first small talk Ann and I did on all this was there just over 9 years ago!!

Advertisements

Our tour down under!

Ann and I have been very privileged recently to do a couple of weeks work in New Zealand and Australia around CAPA. We spent three days in Auckland working with the Werry Center (NZ’s excellent CAMHS change organization) including one day’s masterclass with CAPA champions from cross the country. Then we flew to Wellington, met with the local Adult mental health team in their service (great to visit actual buildings and staff) followed by a CAPA conference for the whole DHB (organization). After that we flew to Sydney briefly and on to Orange (160 miles west and inland of Sydney) doing two workshops there – one for staff and another for clinical leads, planners, clinical directors etc. After flying back to Sydney we had a day off on the Wednesday and then two metropolitan conferences in the city.

So much to talk about but for me the highlights were:

  • the positive feedback from the Christchurch team about how CAPA had increased their team cohesion so they had been able to provide a service through the difficulties and been able to flex choice capacity in responses to waves of referral demand. Humbling experience to hear about them, their situation and their efforts.
  • the discussions with adult consumer advisers (service users) about what they would like the initial appointment to be called. They said they really did not like “First Assessment” as they did not want to be “Assessed” not did they like that the service was counting already! The loved “Choice” as “we wold love to be really able to feel that we had a choice”
  • turning up to Wellington airport to discover our booked flight to Sydney did not exist!
  • the size of some of the patches in the Orange area and especially so further inland, The size of Germany with only 100K people in them. And the challenges of the lone workers in these patches were enormous and their resilience was extraordinary.
  • cycling round the Manly dam cycle track on a hire mountain bike. This was not for beginners to advanced as advertised. Very scary for me anyway!
  • the energy of the Sydney metro conferences
  • and finally arriving at Sydney to come home to discover that our return flights had been unbooked by the airline as we had missed the non-existent plane!

We plan to be back in a year maybe. Thanks to all and to Ann for sharing it all with me.

Steve

CAPA implementation and leadership

Question: The issue of who should lead CAPA within our teams is currently being discussed as is the issue of what the tasks of a CAPA lead actually are in the first year. We are uncertain whether our leadership model should be based on one person or indeed whether carefully differentiated tasks should be delegated to a small number of people within each team. We do not have an overarching team leader and this is not something that is currently up for debate. Moreover, we need to ensure we have the appropriate CAPA leads to take us through this first year

Steve and I advise that teams have a CAPA leadership team of manager, CAPA clinical lead and Admin lead. The main tasks in the first year are to keep things on track – and this means monitoring what is going on, checking Away days have supportive content, reviewing job plans, co-ordinating any service audit that is happening etc.

The clinical lead role can rotate of course, and this can be helpful so that the ownership is not located within one person. The skills and knowledge needed are enthusiasm and knowledge about CAPA and ability to work with others to take it forward. All the actual work – such as job planning, audit can be delegated within the team.

Ann