Making New Ways Work for US NHS Ayrshire and Arran

1. Making New Ways Work for USNHS Ayrshire and Arran Andrew Smith Clinical Operations Manager

2. What we had • A single point of triage • Daily triage of all referrals • All cases assessed in 18 weeks • Passed back in to 3 locality teams • An electronic record that cant give us data • No way of identifying/recording what treatment was being delivered except by care plan • No accurate way of recording assessment( as defined by New Ways • No way of recording identified need

3. What we did • In the shadow period using New Ways definitions • We looked at how we record waiting lists • We examined the present waiting lists • We looked at how we would re-design the way we collected the data in the teams • Decide how we would collect the data more accurately and usefully

4. Outcome We had two waiting lists..1 for tier 2 and 1 for tier 3.. We had been using different starting points, and there was no reason for this ..stopped this

5. outcome • …we found that, in our figures, we had been recording cases passed from one discipline to another for treatment. And the waiting time had been getting recorded from initial assessment, even if they had been getting seen for months • stopped this

6. How/What Data was collected • Staff filled in monthly stats forms looking at how many face to face contacts were undertaken • This was then processed using the original referral date as starting point for tier 3, and the assessment date for tier 2 • Data was produced by discipline specific input • We had monthly feedback..and we know the data was not helpful

7. We decided • With help, to train all staff in new ways compliant definitions • Design a template to capture as many of the points as we thought reasonable • Collect the figures weekly • Define not only treatment , but the 1st treatment choice by expanding on the Gen 18 definitions in the document • Re-design the weekly meeting structure to initially focus on collecting these figures

8. New Ways of Reporting Information

9. Definitions of Treatment - This is deemed to be when:- • The commencement of a planned programme of intervention delivered by an appropriately qualified clinician designed to address agreed treatment goals is undertaken. OR ~ • 2. Initiation of a coordinated treatment plan. OR – • 3. Commencement of a specialist assessment, which will typically be multi-disciplinary, for • example Eating Disorder/ADHD. • DESCRIPTION CODE • Assessments • Assessment- Child/Young Person A-CYP • Assessment - Parent/Carer A-PC • Assessment - Family A-FAM • Assessment - Functional A-FUN • Assessment - Paediatrics Self Harm A-PSH • Assessment - Paediatrics Liaison A-PL • Assessment - Out of Hours A-OUH • CLINICAL PATHWAYS ASSESSMENT • ADHD ADHD-A • Eating Disorder ED-A • ASD ASD-A • Psychoses PS-A • Other-Specify O-A • Specialist Medication SM • PSYCHOLOGICAL THERAPIES • Interpersonal Psychotherapy IP • Behavioural Therapy BT • Cognitive Behaviour Therapy CBT • Dialectical Behavioural Therapy DBT • Brief Solution Focused Therapy BSFT • Psychodynamic Psychotherapy PP • Systemic and Family Therapy SFT • Humanistic/Integrative Therapy HIT • EMDR EMDR • NLP NLP • Social Learning Theory based Parental Management Training PMT • Problem Solving Skills Treatment PSST • Guided Self Help GSH • Relaxation Training RT • Motivational Enhancement Therapy MET • Social Intervention SI • Occupational Intervention 01 • Educational Intervention EI • Speech and Language Therapy SLT • Other O

10. Results • We can now accurately produce RTT Data using the definitions. • We can now accurately produce • Workload demand- discipline specific • Capture the full range of assessment work • 1st clinical direction treatment • Include the full range of what we do in the data