Team Job Planning - How to do it…

Ann York and Steve Kingsbury

2010

Team Job Planning in CAPA p 85-

89

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

Job planning: Blank Diaries

Mon Tue Wed Thu Fri

Psychiatrist Am Choice

Pm Partnership

Free

SW Am Tier 2

Pm Specific

Admin

Psychologist

Am Non clinical

Pm Team meeting

Systemic Am

Pm

Team Meeting

Mon Tue Wed Thu Fri

Psychiatrist Am Choice

Pm Partnership

Free

SW Am Tier 2

Pm Specific

Admin

Psychologist

Am Non clinical

Pm Team meeting

Systemic Am

Pm

Admin Time

Mon Tue Wed Thu Fri

Psychiatrist Am Choice

Pm Partnership

Free

SW Am Tier 2

Pm Specific

Admin

Psychologst Am Non clinical

Pm Team meeting

Systemic Am

Pm

Specialist and specific time

Mon Tue Wed Thu Fri

Psychiatrist Am Choice

Free = 3 Pm Partnership

Free

SW Am Tier 2

Free = 6 Pm Specific

Admin

Psychologst Am Non clinical

Free = 4 Pm Team meeting

Systemic Am

Free = 7 Pm

Other Commitments

Mon Tue Wed Thu Fri

Psychiatrist Am Choice

Free = 2 Pm Partnership

Free

SW Am Tier 2

Free = 4 Pm Specific

Admin

Psychologst Am Non clinical

Free = 4 Pm Team meeting

Systemic Am

Free = 4 Pm

Free sessions for Choice and Core Partnership work

Mon Tue Wed Thu Fri

Psychiatrist Am

2 Pm

SW Am

4 Pm

Psychologist Am

4 Pm

Systemic Am

4 pm

TEAM TOTAL

= 14 sessions

Per week

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

1.30 pm

3 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

Mon Tue Wed Thu Fri

Psychiatrist Am

Pm

SW Am

Pm

Psychlgist Am

Pm Ch

Systemic Am

Pm Ch

TOTAL TEAM CAPACITY

= 4 Choice appointments per week

TOTAL TEAM DEMAND

= 4 Choice appointments per week

What is the capacity for Core Partnership in the job plans? p 88-89

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 sessions 10Team meeting 1YOT 1Systemic Therapy clinic 1LAC consultation 1Management 1Admin 1Choice 1

Remaining Core sessions 10 – 7 = 3

Core Partnership new clients per quarter 3 x 3 = 9

Mon Tue Wed Thu Fri

Systemic Am

Pm CH

Team Core Partnership CAPACITY per 13 week quarter

Mon Tue Wed Thu Fri

Psychiatrist Am

Free = 2 Pm

SW Am

Free = 4 Pm

Psychlgist Am

Free = 3 Pm Ch

Systemic Am

Free = 3 Pm Ch

Team Core Partnership CAPACITY per 13 week quarter

Mon Tue Wed Thu Fri

Psychiatrist Am

2 x 3 = 6 Pm

SW Am

4 x 3 =12 Pm

Psychlgist Am

3 x 3 = 9 Pm Ch

Systemic Am

3 x 3 = 9 Pm Ch

TOTAL TEAM CAPACITY

= 36

new Core Partnerships per quarter

Why? 97-103

Why 3?

In 13 weeks each clinician is there for 11.25 weeks (leave etc) So for each half day in their diary they do 11.25 half days per

quarter In each half day they can do 2 appointments So over the quarter they can do 11.25 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

AndWe know this number works for most UK CAMHS teams

ButIf your session average is more than 7 or you can only do 1 appointment in a half day e.g for LDThe 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 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)