Tower Hamlets CAMHS Triage Team Process Overview

Tower Hamlets Front
Door/ Triage Team
Dr Rebecca Adams, Consultant in Child and Adolescent
Psychiatry
Dr Olivia Kneen, Clinical Psychologist/ Triage Lead
Key aims of Triage/ Front Door
Improve client experience by making contact with
clients in a more timely manner and providing
information
Reduce waiting list for initial assessment
Improve our DNA rates
Eliminate lengthy process of LRP and be more
responsive to incoming referrals by having more
weekly meetings
Screen for risk more effectively
Allocate to the right clinician/ team at front door
Reduce the amount of cases allocated for internal
transfer
Embed a Thrive Framework to allocations (short term
vs longer term)
Overall Task/ Mission Statement
To triage or provide a welcome call to all
referrals to TH CAMHS within 2 weeks
and signpost to the appropriate service
within or outside of CAMHS on a triage/
consultation basis.
Triage Process 1
1. All incoming referrals will be screened for risk by Duty
 Duty to initiate any initial liaison required (e.g. more key referral
information needed)
2. Referral taken to next triage meeting (x3 per week) to be allocated
to one of three outcomes:
Definitely appropriate
                     Allocate and welcome call
Definitely not appropriate           
   NTO letter sent out
Triage Required 
                                Triage clinician to 
  
  
                                       conduct triage assessment
Triage Process 2
3.Triage clinician conducts either welcome call or triage
assessment (telephone/ face to face) / liaison with professional
network:
4.Discussion in next triage meeting –
 Possible Outcomes:
Accepted for Tier 3 CAMHS –  allocated to brief or long term
work
Recommendations made/ signposted to relevant self help
material or to other organisations and then closed to Tier 3
CAMHS
Triage Process 3
5. Triage clinicians to feedback outcome of triage assessment/ liaison
to family
and complete relevant letter updating outcome to referrer and family (to be sent out
by admin)
6. Admin to send out first assessment letters on basis of allocation
CAMHS Tower Hamlets
CAMHS 
Duty Team
 – Duty clinician
screens referral for risk, urgency and
appropriateness and immediate liaison
Referral received and logged on RIO by admin
E&B Team x2 :
-Brief Intervention
-Longer term work---
Eating disorders
Emergency/
Urgent Self Harm
:
A&E or clinic
 
Allocations / Triage
Meeting (x3 per
week)
First Liaison
Max: 3 weeks
MDT Pathway
 
Meeting
s
Discuss and Review Care Plan and Goals
Discharge
Neurodevelopmental
Team
:
ASD, ADHD, LD
Bipolar and Psychosis
 
Team
(and ultra high risk)
Parent Training
CYP IAPT Groups
advice/signpost/
discharge
 Conduct Team
Assertive Outreach
Assessment &
Treatment
Book forwards 
for
-Routine assessment
-Urgent assessment
(Time specified)
London Borough
Tower Hamlets
team
Internal referral:
             -specific therapy
             - co-worker
CAMHS in
Social Care
CC
CAMHS Triage – Clinicians contact families to
triage/ welcome to service/ further liaison
Not accept
Time frames
Every newly referred young person/family to receive a
telephone call within 2 weeks.
Aim for all initial assessments to be conducted within 5
weeks (target reached in April 2016)
Changes to Allocation Process
Emotional & Behavioural Pathway
We will allocate to either :
    SHORT TERM - “First steps” (up to 6 sessions)
    or
    LONGER TERM (6 sessions plus)
This is in line with the THRIVE Model of care and this will
aim to improve throughput through the service
THRIVE MODEL
 
Results of Triage transformation:
Initial results for triage – very encouraging:
Wait times reduced to 5 weeks for initial assessment (achieved
by April 2016)
Decrease in DNA rates
Increase in client satisfaction with front door process
1. Waiting time for first
appointment significant reduced
2. DNA Rates Down
Despite referrals steadily rising
What next for Front door TH?
Service hubs/ drop in to be trialled in outreach
settings (Emmanuel Miller Centre, Spotlight
Youth Centre etc.) to improve accessibility
Embedding text messaging as routine prior to
first assessments
Discussion
Any thoughts/ questions/ feedback?
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Tower Hamlets CAMHS Triage Team is focused on improving client experience by efficiently screening referrals, conducting triage assessments, and allocating cases to the appropriate clinicians. The team aims to reduce waiting times, improve response rates, and enhance risk screening processes. Their mission is to triage all referrals within 2 weeks and signpost to suitable services. The triage process involves risk screening, allocation meetings, welcome calls, and liaison with professional networks. Feedback is provided to families and referrers through detailed letters. Overall, the team strives to ensure timely and effective support for children and adolescents in need of mental health services.

  • CAMHS
  • Triage Team
  • Mental Health
  • Child Psychiatry
  • Process Overview

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  1. Tower Hamlets Front Door/ Triage Team Dr Rebecca Adams, Consultant in Child and Adolescent Psychiatry Dr Olivia Kneen, Clinical Psychologist/ Triage Lead

  2. Key aims of Triage/ Front Door Improve client experience by making contact with clients in a more timely manner and providing information Reduce waiting list for initial assessment Improve our DNA rates Eliminate lengthy process of LRP and be more responsive to incoming referrals by having more weekly meetings Screen for risk more effectively Allocate to the right clinician/ team at front door Reduce the amount of cases allocated for internal transfer Embed a Thrive Framework to allocations (short term vs longer term)

  3. Overall Task/ Mission Statement To triage or provide a welcome call to all referrals to TH CAMHS within 2 weeks and signpost to the appropriate service within or outside of CAMHS on a triage/ consultation basis.

  4. Triage Process 1 1. All incoming referrals will be screened for risk by Duty Duty to initiate any initial liaison required (e.g. more key referral information needed) 2. Referral taken to next triage meeting (x3 per week) to be allocated to one of three outcomes: Definitely appropriate Definitely not appropriate Triage Required Allocate and welcome call NTO letter sent out Triage clinician to conduct triage assessment

  5. Triage Process 2 3.Triage clinician conducts either welcome call or triage assessment (telephone/ face to face) / liaison with professional network: 4.Discussion in next triage meeting Possible Outcomes: Accepted for Tier 3 CAMHS allocated to brief or long term work Recommendations made/ signposted to relevant self help material or to other organisations and then closed to Tier 3 CAMHS

  6. Triage Process 3 5. Triage clinicians to feedback outcome of triage assessment/ liaison to family and complete relevant letter updating outcome to referrer and family (to be sent out by admin) 6. Admin to send out first assessment letters on basis of allocation

  7. CAMHS Tower Hamlets Referral received and logged on RIO by admin CAMHS Duty Team Duty clinician screens referral for risk, urgency and appropriateness and immediate liaison CCCAMHS Triage Clinicians contact families to triage/ welcome to service/ further liaison First Liaison Not accept Allocations / Triage Meeting (x3 per week) advice/signpost/ discharge Emergency/ Urgent Self Harm: A&E or clinic CAMHS in Social Care Book forwards for -Routine assessment -Urgent assessment (Time specified) Conduct Team Assertive Outreach Assessment & Treatment E&B Team x2 : -Brief Intervention -Longer term work--- Eating disorders Neurodevelopmental Bipolar and PsychosisTeam (and ultra high risk) London Borough Tower Hamlets team Max: 3 weeks Team: ASD, ADHD, LD MDT PathwayMeetings Discuss and Review Care Plan and Goals Discharge Parent Training CYP IAPT Groups Internal referral: -specific therapy - co-worker

  8. Time frames Every newly referred young person/family to receive a telephone call within 2 weeks. Aim for all initial assessments to be conducted within 5 weeks (target reached in April 2016)

  9. Changes to Allocation Process Emotional & Behavioural Pathway We will allocate to either : SHORT TERM - First steps (up to 6 sessions) or LONGER TERM (6 sessions plus) This is in line with the THRIVE Model of care and this will aim to improve throughput through the service

  10. THRIVE MODEL

  11. Results of Triage transformation: Initial results for triage very encouraging: Wait times reduced to 5 weeks for initial assessment (achieved by April 2016) Decrease in DNA rates Increase in client satisfaction with front door process

  12. 1. Waiting time for first appointment significant reduced 2. DNA Rates Down Despite referrals steadily rising

  13. What next for Front door TH? Service hubs/ drop in to be trialled in outreach settings (Emmanuel Miller Centre, Spotlight Youth Centre etc.) to improve accessibility Embedding text messaging as routine prior to first assessments

  14. Discussion Any thoughts/ questions/ feedback?

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