Team Job Planning - How to do it… Ann York and Steve Kingsbury 2010.

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Team Job Planning - How to do it… Ann York and Steve Kingsbury 2010

Team Job Planning in CAPA p  Each individual has a job plan that describes their work in various ways  Combined to form a team job plan  Useful to managers and clinicians as describes predicted activity  Can show effects of losses  Contains activity for clinicians  Based on “do-able”numbers

Job plans include… Supporting work: admin, management, CPD Other: consultation, YOT, LAC

You need to work out 1. What is everyone doing at the moment? ie. current job plans 2. How many Choice sessions need to be added to those job plans to match referrals? 3. What is the capacity for Core Partnership in the job plans? 4. Managers: is the team in balance? 5. Do job plans need reviewing?

Assumptions 1. All referrals that you accept will be guaranteed a Choice appointment within 6 weeks of referral 2. Only 2/3 of those having Choice will continue into Core Partnership work 3. Families and young people who have Core Partnership work need an average of 7.5 appointments 4. You can offer two appointments in a 3.5 hour session / half day 5. Out of 52 weeks of the year, only 45 are actually worked 6. You will design job plans according to what is currently being done

Step 1 What is everyone doing at the moment?

Job planning: Blank Diaries MonTueWedThuFri Psychiatrist AmChoice PmPartnership Free SW AmTier 2 PmSpecific Admin Psychologis t AmNon clinical PmTeam meeting Systemic Am PmPm

Team Meeting MonTueWedThuFri Psychiatrist AmChoice PmPartnership Free SW AmTier 2 PmSpecific Admin Psychologis t AmNon clinical PmTeam meeting Systemic Am PmPm

Admin Time MonTueWedThuFri Psychiatrist AmChoice PmPartnership Free SW AmTier 2 PmSpecific Admin Psychologst AmNon clinical PmTeam meeting Systemic Am PmPm

Specialist and specific time MonTueWedThuFri Psychiatrist AmChoice Free = 3 PmPartnership Free SW AmTier 2 Free = 6 PmSpecific Admin Psychologst AmNon clinical Free = 4 PmTeam meeting Systemic Am Free = 7 PmPm

Other Commitments MonTueWedThuFri Psychiatrist AmChoice Free = 2 PmPartnership Free SW AmTier 2 Free = 4 PmSpecific Admin Psychologst AmNon clinical Free = 4 PmTeam meeting Systemic Am Free = 4 PmPm

Free sessions for Choice and Core Partnership work MonTueWedThuFri Psychiatrist Am 2 Pm SW Am 4 Pm Psychologist Am 4 Pm Systemic Am 4 pm TEAM TOTAL = 14 sessions Per week

Step 2 How many Choice sessions need to be added to the Job Plans?

Team Job Planning Example Anywhere CAMHS...  4 full time staff (4 FTE)  4 referrals per week

How many Choice appointments need to be added to those job plans? All accepted referrals are offered a Choice appointment  Number of referrals per week (that are accepted) = 4  They need 4 Choice appointments. HOW?  Each staff member can do 2 Choice appointments in one 3.5 hour session / half day 1.30 pm 3 pm

Decide who will do Choice Think skills not profession or seniority  Good at engagement- to service and not clinician  Facilitator with expertise  Knows local services  Can communicate best practice  Confident but not overconfident

Choice Clinics MonTueWedThuFri Psychiatrist Am Pm SW Am Pm Psychlgist Am PmCh Systemic Am PmPmCh TOTAL TEAM CAPACITY = 4 Choice appointments per week TOTAL TEAM DEMAND = 4 Choice appointments per week

Step 3 What is everyone’s capacity for Core Partnership

What is the capacity for Core Partnership in the job plans? p Calculate capacity for each clinician  Count free sessions in job plan for Core Partnership work  Multiply by 3 (Partnership Multiplier)  This is number of new Core Partnership clients each clinician will take on in a period of 13 weeks

Andrew Down, systemic therapist Total sessions10 Team meeting1 YOT1 Systemic Therapy clinic1 LAC consultation1 Management1 Admin1 Choice1 Remaining Core sessions 10 – 7 =3 Core Partnership new clients per quarter3 x 3 = 9 MonTueWedThuFri Systemic Am PmPmCH

Team Core Partnership CAPACITY per 13 week quarter MonTueWedThuFri Psychiatrist Am Free = 2 Pm SW Am Free = 4 Pm Psychlgist Am Free = 3 PmCh Systemic Am Free = 3 PmPmCh

Team Core Partnership CAPACITY per 13 week quarter MonTueWedThuFri Psychiatrist Am 2 x 3 = 6 Pm SW Am 4 x 3 =12 Pm Psychlgist Am 3 x 3 = 9 PmCh Systemic Am 3 x 3 = 9 PmPmCh TOTAL TEAM CAPACITY = 36 new Core Partnerships per quarter

Why? Why 3?  In 13 weeks each clinician is there for weeks (leave etc)  So for each half day in their diary they do half days per quarter  In each half day they can do 2 appointments  So over the quarter they can do x 2 = 22.5 appointments  Each family and young person averages 7.5 appointments  This means that the 22.5 appointments divided by 7.5 appointments = 3 children and young people And We know this number works for most UK CAMHS teams But If your session average is more than 7 or you can only do 1 appointment in a half day e.g for LD The multiplier will be less

How many fixed appointments does Andrew offer? ie how much of his diary has he given up? 2 Choice appointments a week 9 new Core Partnership appointments over 13 weeks

How does he plan his work? Tue am Fri

Step 4 Is the team in balance?

Step 5 of 5: is there enough capacity? TOTAL TEAM CHOICE DEMAND = 4 Choice appointments per week TOTAL TEAM CORE PARTNERSHIP CAPACITY = 36 per quarter Choice demand and capacity are matched... TOTAL TEAM CHOICE CAPACITY = 4 Choice appointments per week New Core Partnership Demand is provided TOTAL TEAM CORE PARTNERSHIP DEMAND = 35 per quarter 66% will need Core Partnership 4 x 13 x 0.66 =35

Reasons for Choice-Partnership Imbalance  Too many referrals  Too many referrals accepted  Transferring a high % from Choice High need Not full choice “all need help”  Choice taking too large a slice of core Long choice durations than planned for  Shirking  Lack of monitoring  Vague job planning: low core% of whole service  Vacant posts  Long average core partnership durations  Less than 2 appointments per session

Summary  Choice activity based on referrals (remember to flex…)  Core Partnership based on job plans  The number is 3  Admin time based on core activity  Job plans should be reasonable based on what you and the team NEED to do  Shift to Team Job Planning and activity  May or may not be in balance

Core service Percentage It is useful to know what % of the service is given to all Choice and Core Partnership WHY?  40% is the realistic ceiling;  this is challenging and needs excellent clinical and managerial leadership WE FIND: 40% in Choice and Core Partnership works for most teams: This could be... 40% for Choice and Core Partnership work 35% Specific work (i.e. 75% of time is in clinical work) 25% in supporting work e.g. management, CPD etc

Flexing your Choice capacity  Each week count the number of referrals accepted for Choice  Add the number of accepted referrals from last week who have not yet opted in (they may yet come)  Then count the number of vacant Choice in the next 6 weeks.  If there aren’t enough find some more…

How could a rural service deliver CAPA?  A rural service example: Single clinician Long travel times Lots of local relationship work Many settings Short contact durations (minutes)