CAMHS Wales Trust Report: North East Wales NHS Trust

Introduction

This is a Health Board summary report of data entered for the 20010 CAMHS Mapping Wales exercise. The exercise is an internet data collection exercise that creates an inventory of teams that deliver NHS-funded Specialist CAMHS, and a summary of expenditure on Specialist CAMHS for children and young people in Wales. Caseload data for teams supplying Tier 2 and 3 functions is drawn from 1st to 26th March 2010 and from 1st October 2009 to 31st March 2010 for Tier 4 teams. The census day for all teams was 1st March 2010. Data was reported on the mapping website between February and April 2010.

The website is managed by a team of staff at Durham University who have been commissioned by the Welsh Assembly Government to carry out the mapping of NHS-funded Specialist CAMHS in Wales.

1 Service Summary

This table summarises the number of teams and whole time equivalent (WTE) staff in post on 30th November. The total service costs include only the direct costs of the team staff and the facilities within which they work. This is the 2008/09 budgeted cost of the team. Caseload data is drawn from a sample period of 17th November to 14th December 2008 for teams supplying Tier 2 and 3 functions and from 1st June to 30th November 2008 for Tier 4 teams.
Service Number of teams mapped Total Staff (WTE) Total service costs1 Total Caseload2 Services Edited This Year
Flintshire ASD Service 1 3.500 220320 15 1
Flintshire Early Intervention Service (EIS) Team 1 8.900 368672 197 1
Flintshire Tier 2 / 3 CAMHS 1 18.350 794879 239 1
Wrexham CADDS 1 9.050 421856 120 1
Wrexham Tier 2 / 3 CAMHS 1 21.850 809033 232 1
Total
5 61.650 2614760 803 5
  1. As reported by providers
  2. From geographical breakdown

2 Team staff and non-staff costs

Staff costs are the total salaries plus employers' contributions for staff working in the team and non-staff costs include travel, training, drugs, equipment etc. which is directly attributable to the team. This is the 2008/09 budgeted cost of the team staff and non-staff costs.

Service Team staff costs Team non-staff costs
Flintshire ASD Service 207854 12465
Flintshire Early Intervention Service (EIS) Team 350943 17726
Flintshire Tier 2 / 3 CAMHS 750623 44255
Wrexham CADDS 395885 25970
Wrexham Tier 2 / 3 CAMHS 754995 54036
Total
2460300 154452

3 Local or wider teams

A local team is one that has been commissioned to serve a defined local area. These local areas are usually made up of a single or small number of LHBs. Almost all children and young people using a local team will come from this area but it is acknowledged that local teams occasionally have clients from further afield. A wider than local team routinely serves a population of more than one LHB. A service-wide team routinely serves the whole catchment population of the whole service. These teams deliver a service to a wider than local area but one that is very well defined. A Wales-wide team provides a national service.
Service Number of teams mapped Local team Wider than local team Service-wide team Wales-wide national service.
Flintshire ASD Service 1 1 - - -
Flintshire Early Intervention Service (EIS) Team 1 1 - - -
Flintshire Tier 2 / 3 CAMHS 1 1 - - -
Wrexham CADDS 1 1 - - -
Wrexham Tier 2 / 3 CAMHS 1 1 - - -
Total
5 5 - - -

4 Partners in service provision

The organisation making the mapping return is recorded as the principal health provider of the teams. This table lists all the other agencies who contribute to the provision of the teams.
Service Number of teams mapped Other Welsh NHS trust Local Authority CVS agency Independent sector
Flintshire ASD Service 1 1 - - -
Flintshire Early Intervention Service (EIS) Team 1 - 1 - -
Flintshire Tier 2 / 3 CAMHS 1 1 - - -
Wrexham CADDS 1 1 - - -
Wrexham Tier 2 / 3 CAMHS 1 1 1 - -
Total
5 4 2 - -

5 Settings of main base

The main base is the location where the majority of the team is physically based. The team's administrative support would also normally be based here.
Service Number of teams mapped Hospital - DGH Hospital - Psychiatric Hospital - community Primary healthcare team premises that include GP surgeries Primary healthcare team premises (not including premises for GP surgeries) Community-based clinic Other community facility School Social Services Education services premises (not school) Voluntary (third sector) premises Patient/Client's Own Home Other
Flintshire ASD Service 1 - - - - - 1 - - - - - - -
Flintshire Early Intervention Service (EIS) Team 1 - - - - - 1 - - - - - - -
Flintshire Tier 2 / 3 CAMHS 1 - - - - - 1 - - - - - - -
Wrexham CADDS 1 1 - - - - - - - - - - - -
Wrexham Tier 2 / 3 CAMHS 1 1 - - - - - - - - - - - -
Total
5 2 - - - - 3 - - - - - - -

6 Regular outreach setting

The outreach bases are locations in which the team regularly operates. That is it delivers a service from this setting (including participation in team meetings) at least once a month.
Service Number of teams mapped Hospital - DGH 1 Hospital - Psychiatric 1 Hospital - community 1 Primary healthcare team premises that include GP surgeries 1 Primary healthcare team premises (not including premises for GP surgeries) 1 Community-based clinic 1 Other community facility 1 School 1 Social Services 1 Education services premises (not school) 1 Voluntary (third sector) premises 1 Patient/Client's Own Home 1 Other 1
Flintshire ASD Service 1 - - - - - - - 1 - 1 - 1 -
Flintshire Early Intervention Service (EIS) Team 1 - - - 1 - 1 1 1 - - 1 1 1
Flintshire Tier 2 / 3 CAMHS 1 - - - - - - - - - - - - -
Wrexham CADDS 1 - - - - - - - 1 - - - 1 -
Wrexham Tier 2 / 3 CAMHS 1 - - - - - - - - - - - - -
Total
5 - - - 1 - 1 1 3 - 1 1 3 1
  1. Number of service with this base as a regular outreach setting

7 Age range of service users

This tables shows the lower and upper age limits for teams. Note: a "-" here will denote no lower/upper age limit.
Service Number of teams mapped 0-4 5-9 10-15 16 17 18 19-25 Services for 16 and 17 year olds1 Proportion of services for 16 and 17 year olds2
Flintshire ASD Service 1 1 1 1 1 1 - - 1 100.0%
Flintshire Early Intervention Service (EIS) Team 1 1 1 1 1 1 1 1 1 100.0%
Flintshire Tier 2 / 3 CAMHS 1 - 1 1 1 1 - - 1 100.0%
Wrexham CADDS 1 - 1 1 1 1 1 - 1 100.0%
Wrexham Tier 2 / 3 CAMHS 1 - 1 1 1 1 - - 1 100.0%
Total
5 2 5 5 5 5 2 1 5 100.0%
  1. Number of teams which provide services for all 16 and 17 year olds irrespective of school or occupational status
  2. Number of teams which provide services for all 16 and 17 year olds irrespective of school or occupational status as a proportion of all teams

8 Caseload by age

The age profile of the team caseload worked with in the sample period.
Service 0-4 5-10 11-15 16 17 18 19-25
Flintshire ASD Service 3 11 1 - - - -
Flintshire Early Intervention Service (EIS) Team 20 66 42 5 5 1 58
Flintshire Tier 2 / 3 CAMHS - 39 123 36 34 6 1
Wrexham CADDS - 47 44 12 10 5 -
Wrexham Tier 2 / 3 CAMHS - 33 138 33 25 3 -
Total
23 196 348 86 74 15 59

9 Team provision for learning disability/impairment

Revision were made to questions in 2008/09 to reflect developments in the ways in which impairments and disabilities of learning are described and defined functionally. Thus, a person who has a learning impairment is a person whose problems with learning are sufficient to impair their progress in one or more areas of their life or their enjoyment of their life. Learning disability refers to the experiences and capabilities and enjoyment of life of people who problems with learning go beyond impairment such that they could result in substantial and lasting functional and educational limitations that amount to disability of at least mild severity. In the past, in some services, the distinctions between the various levels of impairment and disability have been related to IQ (i.e. sometimes, severe learning disability has been described as a person having an IQ of 69 or lower). Now, much greater emphasis is placed on the degree of impairment or disability in relationship to particular person's lives rather than their IQ. Therefore, it is for clinical members of the team to determine the distinctions between the levels of disability that are described above.

Service Services for children with mental disorders who also have a learning impairment1 Services for children with mental disorders who also have a mild learning disability1 Services for children with mental disorders who also have a moderate learning disability1 Services for children with mental disorders who also have a severe learning disability1
Flintshire ASD Service 1 1 1 1
Flintshire Early Intervention Service (EIS) Team - 1 - -
Flintshire Tier 2 / 3 CAMHS 1 1 1 -
Wrexham CADDS 1 1 1 1
Wrexham Tier 2 / 3 CAMHS 1 1 1 -
Total
4 5 4 2
  1. Number of teams that selected this

10 Teams delivering tier 2 functions

The functions of Tier 2 include assessments and interventions that form the first line of specialist services. Thus, most outpatient and community services that are provided by Specialist CAMHS deliver the functions of Tier 2. Specifically, General or routine generic outpatient services are NOT Tier 3 functions.
Service Team or team member provides on-call response1 Works collaboratively with teams delivering tier 4 functions1 Advises on design, delivery and evaluation of universal and selective services1 Supports specific services eg YOTs and LAC services1 Trained staff provide first-line specialist assessment and interventions1 Ensures children receive timely and coordinated services1 Specialised services for sensorily impaired children and young people1
Flintshire ASD Service - - - - - - -
Flintshire Early Intervention Service (EIS) Team - - - - - - -
Flintshire Tier 2 / 3 CAMHS - 1 - 1 1 1 -
Wrexham CADDS - - - - - - -
Wrexham Tier 2 / 3 CAMHS - 1 1 1 1 1 1
Total
- 2 1 2 2 2 1
  1. Tier 2 teams only

11 Tier 2 team: selective health promotion programmes and indicated early intervention programmes

Note: indicated programmes are intervention programmes that are made available to children and young people who have an assessed need for that intervention

Service Designs, delivers and evaluates selective health promotion programmes1 Designs, delivers and evaluates indicated early intervention programmes1
Flintshire ASD Service - -
Flintshire Early Intervention Service (EIS) Team 1 1
Flintshire Tier 2 / 3 CAMHS - -
Wrexham CADDS - -
Wrexham Tier 2 / 3 CAMHS - -
Total
1 1
  1. Number of teams that selected this

12 Teams delivering tier 2 functions support for tier 1

Service Provision of training 1 Provision of advice 1 Provision of formal and informal consultation 1 Provision of PMHW 1 Non-specialist and Specialist CAMHS working together to plan the delivery of care for individual children and young people? 1
Flintshire ASD Service - - - - -
Flintshire Early Intervention Service (EIS) Team 1 1 1 1 1
Flintshire Tier 2 / 3 CAMHS 1 1 1 - 1
Wrexham CADDS - - - - -
Wrexham Tier 2 / 3 CAMHS 1 1 1 1 1
Total
3 3 3 2 3
  1. Number of teams that selected this

13 Teams delivery tier 3 functions

There are several reasons why children and young people and their families may require access to services that deliver the functions of Tier 3. Tier 3 functions include delivering a variety of very specialised clinics, teams that deliver specialist forensic mental healthcare, day-care services, intensive community care, home treatment and early intervention services for young people who have a psychosis, special units in schools, foster care and social services-led specialised family intervention centres, and teams that accept referrals for more intensive assessment and intervention with children and young people who have particular problems (e.g. family therapy clinics, ADHD clinics, ASD clinics etc). Teams that deliver the functions of Tier 3 may be composed of staff drawn from a variety of different agencies. The work requires high levels of skill in planning, delivering and coordinating, targeted care and intervention programmes. Usually, children and young people are referred to teams that deliver the functions of Tier 3 by staff in teams that deliver the functions of Tier 2.
Service Team provides an emergency, rapid response and on-call service1 Works collaboratively with teams delivering tier 4 functions1 Works with lower tier CAMHS1 Trained staff provide second-line specialist assessment and interventions1 Ensures children receive timely and coordinated services1 Contracted specialist support for regional specialist children's services1 Provides specialist peripatetic forensic MH outpatient services1 Tier 2 first-line outpatient services in addition to the functions of tier 31 Advises on design, delivery and evaluation of universal and selective services1 Specialised services for sensorily impaired children and young people1
Flintshire ASD Service - 1 1 1 1 - - 1 - -
Flintshire Early Intervention Service (EIS) Team - - - - - - - - - -
Flintshire Tier 2 / 3 CAMHS - - - - - - - - - -
Wrexham CADDS - 1 1 1 1 - - - - -
Wrexham Tier 2 / 3 CAMHS - - - - - - - - - -
Total
- 2 2 2 2 - - 1 - -
  1. Tier 3 teams only

14 Teams delivering tier 3 functions: intensive home treatment/outreach

Service Number of children that can be supported at any one time Number used in 6 months 1st June to 30th November Number of children that can be supported at any one time Number used in 6 months 1st June to 30th November
Flintshire ASD Service - - 3 1
Flintshire Early Intervention Service (EIS) Team - - - -
Flintshire Tier 2 / 3 CAMHS - - - -
Wrexham CADDS 8 6 - -
Wrexham Tier 2 / 3 CAMHS - - - -
Total
8 6 3 1

15 Tier 3 support to tier 2

Service Provision of training Provision of advice Provision of formal and informal consultation
Flintshire ASD Service 1 1 1
Flintshire Early Intervention Service (EIS) Team - - -
Flintshire Tier 2 / 3 CAMHS - - -
Wrexham CADDS 1 1 1
Wrexham Tier 2 / 3 CAMHS - - -
Total
2 2 2

16 Services providing alternatives to inpatient care

Service Intensive home treatment Day services Early intervention Other intensive outreach
Flintshire ASD Service - - - 1
Flintshire Early Intervention Service (EIS) Team - - - -
Flintshire Tier 2 / 3 CAMHS - - - -
Wrexham CADDS - - - 1
Wrexham Tier 2 / 3 CAMHS - - - -
Total
- - - 2

17 Day care

None reported

18 Intensive home treatment

Service Number of children that can be supported at any one time Number used in 6 months 1st June to 30th November
Flintshire ASD Service - -
Flintshire Early Intervention Service (EIS) Team - -
Flintshire Tier 2 / 3 CAMHS - -
Wrexham CADDS 8 6
Wrexham Tier 2 / 3 CAMHS - -
Total
8 6

19 Intensive outreach

Service Number of children that can be supported at any one time Number used in 6 months 1st June to 30th November
Flintshire ASD Service 3 1
Flintshire Early Intervention Service (EIS) Team - -
Flintshire Tier 2 / 3 CAMHS - -
Wrexham CADDS - -
Wrexham Tier 2 / 3 CAMHS - -
Total
3 1

20 Services delivering tier 4 functions

These teams provide highly specialised interventions including inpatient psychiatric services for children and adolescents. Choose one from the following list that best fits the majority of each team's commitment.

None reported

21 Inpatient bed and placement capacity

This table shows both the number of available and commissioned beds on 17th November 2008. The number of beds available takes into account the needs of patients, for example if you have a young person requiring constant observation and therefore additional nursing staff your actual capacity may be reduced. The number of commissioned beds is the fully funded permanent bed capacity; i.e. you have a formal contract with commissioner(s) for this number of beds. This number should stay the same year on year unless there are expansions or reductions in the formal contract.

None reported

22 Tier 4 support to tiers 2/3

None reported

23 Teams providing assessment functions

How often teams provide the following clinical assessment and management functions.
Service Number of teams mapped Initial clinical assessment 1 Care Programme Approach (CPA) 1 Education Act (statement) 1 For purposes of court proceedings 1 Management of mental health crisis 1
Flintshire ASD Service 1 1 - 1 1 1
Flintshire Early Intervention Service (EIS) Team 1 1 - - - 1
Flintshire Tier 2 / 3 CAMHS 1 1 1 1 1 1
Wrexham CADDS 1 1 - 1 1 1
Wrexham Tier 2 / 3 CAMHS 1 1 1 1 1 1
Total
5 5 2 4 4 5
  1. Number of teams that selected this

24 Interventions provided by teams

What types of intervention are offered within the team. This refers to what is done, and not whether members of the team are explicitly qualified to provide these interventions.
Service Number of teams mapped Tier Advice and information 1 Structured Parenting Programmes 1 Play Therapy 1 DBT 1 Pharmacological (prescribing, monitoring and review of medication) 1 Behavioural therapy 1 Drama therapy 1 Art therapy 1 Family therapy 1 Music therapy 1 Psychotherapy 1 Cognitive behavioural therapy 1 Individual psychological therapy 1 Group psychological therapy/group work 1 Counselling 1 Interpersonal skills training 1 Systemic approaches 1 Other (please specify) 1
Flintshire ASD Service 1 3 1 1 - - 1 1 - - - - - 1 - 1 1 1 1 1
Flintshire Early Intervention Service (EIS) Team 1 2 1 1 - - - 1 - - - - - 1 1 1 1 1 1 1
Flintshire Tier 2 / 3 CAMHS 1 2 1 - - 1 1 1 - - 1 - - 1 1 1 1 1 1 1
Wrexham CADDS 1 3 1 1 - - 1 1 - - - - - 1 - 1 1 1 1 1
Wrexham Tier 2 / 3 CAMHS 1 2 1 1 - 1 1 1 - - - - - 1 1 1 1 1 1 1
Total
5 2 5 4 - 2 4 5 - - 1 - - 5 3 5 5 5 5 5
  1. Number of teams with skills available in team and used

25 Outcome measures used by teams

Measures used to assess outcomes (administered at time of entry into the service and at 6 months later or at case closure) in at least one part of the service.
Service Number of teams mapped SDQ for parents : Yes start of treatment SDQ for parents : Yes at 6 months SDQ for parents : Yes at case closure SDQ for parents : No SDQ for children : Yes start of treatment SDQ for children : Yes at 6 months SDQ for children : Yes at case closure SDQ for children : No CHI-ESQ for parents : Yes start of treatment CHI-ESQ for parents : Yes at 6 months CHI-ESQ for parents : Yes at case closure CHI-ESQ for parents : No CHI-ESQ for children : Yes start of treatment CHI-ESQ for children : Yes at 6 months CHI-ESQ for children : Yes at case closure CHI-ESQ for children : No CGAS for practitioners : Yes start of treatment CGAS for practitioners : Yes at 6 months CGAS for practitioners : Yes at case closure CGAS for practitioners : No HoNOSCA : Yes start of treatment HoNOSCA : Yes at 6 months HoNOSCA : Yes at case closure HoNOSCA : No
Flintshire ASD Service 1 - - - 1 - - - 1 - - - 1 - - - - - - - - - - - 1
Flintshire Early Intervention Service (EIS) Team 1 - - - 1 - - - 1 - - - 1 - - - 1 - - - 1 - - - 1
Flintshire Tier 2 / 3 CAMHS 1 - - - - - - - - - - - - - - - - - - - - - - - -
Wrexham CADDS 1 - - - - - - - - - - - - - - - - - - - - - - - -
Wrexham Tier 2 / 3 CAMHS 1 - - - - - - - - - - - - - - - - - - - - - - - -
Total
5 - - - 2 - - - 2 - - - 2 - - - 1 - - - 1 - - - 2

26 Team provision of training

Types of training are offered by the team
Service Number of teams mapped Ad hoc/one off training Sessional input to a training course including lectures and workshops Regular component of a training course Provide accredited training course Provide education supervision for progress trainees Examining including acting as external examiner and work on exam boards Other input into education design policy and research
Flintshire ASD Service 1 1 1 1 - 1 - 1
Flintshire Early Intervention Service (EIS) Team 1 1 1 1 1 1 1 1
Flintshire Tier 2 / 3 CAMHS 1 1 1 1 - 1 - 1
Wrexham CADDS 1 1 1 1 - 1 - 1
Wrexham Tier 2 / 3 CAMHS 1 1 1 1 - 1 - 1
Total
5 5 5 5 1 5 1 5

27 Where teams input training

Service Number of teams mapped Health Education - Schools Education - HEI Professional body Social services Other Childrens Services Independent/private sector
Flintshire ASD Service 1 1 1 - 1 1 - -
Flintshire Early Intervention Service (EIS) Team 1 1 1 1 1 1 1 -
Flintshire Tier 2 / 3 CAMHS 1 1 1 - 1 1 - -
Wrexham CADDS 1 1 1 - 1 1 - -
Wrexham Tier 2 / 3 CAMHS 1 1 1 1 1 1 - -
Total
5 5 5 2 5 5 1 -

28 IT access and use

Service Total Staff (headcount) Number with access to HOWIS Number with access to and use HOWIS No access HOWIS Number with access to Computerised clinical notes Number with access to and use Computerised clinical notes No access Computerised clinical notes Number with access to Activity statistics Number with access to and use Activity statistics No access Activity statistics
Flintshire ASD Service 8 9 5 - 9 3 - 9 2 -
Flintshire Early Intervention Service (EIS) Team 10 10 10 - - - 10 10 5 -
Flintshire Tier 2 / 3 CAMHS 29 28 28 - - - 28 28 6 -
Wrexham CADDS 14 13 13 - - - 13 13 2 -
Wrexham Tier 2 / 3 CAMHS 34 34 34 - 34 10 - 34 5 -
Total
95 94 90 - 43 13 51 94 20 -

29 Staff by professional group

Whole time equivalent (WTE) staff in post in the team at 30th November 2008. Note: Only health staff who are managed by CAMHS have been included. Health staff managed by paediatric services should have been excluded.
Service Nurses Doctors Clinical Psychologists Educational Psychologists Social Workers Psychotherapists CAF OT Family Therapists Other Qual Therapist Other Qualified Other Unqual PMHW Managers Admin
Flintshire ASD Service 1.700 0.100 1.300 - - - - - - - - - 0.100 0.300
Flintshire Early Intervention Service (EIS) Team - - 1.500 - - - - - - - - 5.000 - 2.400
Flintshire Tier 2 / 3 CAMHS 3.200 1.600 2.200 0.100 0.800 0.300 - - 3.500 1.600 0.400 - 0.250 4.400
Wrexham CADDS 5.300 0.100 1.200 - - - - - - - - - 1.250 1.200
Wrexham Tier 2 / 3 CAMHS 5.900 1.400 2.700 - 0.600 - - - 3.800 - - 1.000 0.250 6.200
Total
16.100 3.200 8.900 0.100 1.400 0.300 - - 7.300 1.600 0.400 6.000 1.850 14.500

30 Staff headcount by professional group

Headcount of staff in post in the team at 30th November 2008.
Service Nurses1 Doctors1 Clinical Psychologists1 Educational Psychologists1 Social Workers1 Psychotherapists CAF1 OT1 Family Therapists1 Other Qual Therapist1 Other Qualified1 Other Unqual1 PMHW1 Managers1 Admin1
Flintshire ASD Service 3 1 2 - - - - - - - - - 1 1
Flintshire Early Intervention Service (EIS) Team - - 2 - - - - - - - - 5 - 3
Flintshire Tier 2 / 3 CAMHS 5 3 3 1 1 1 - - 5 3 1 - 1 5
Wrexham CADDS 8 1 2 - - - - - - - - - 1 2
Wrexham Tier 2 / 3 CAMHS 8 3 5 - 1 - - - 6 - - 2 1 8
Total
24 8 14 1 2 1 - - 11 3 1 7 4 19
  1. Headcount in post

31 Profession of origin of PMHW

PMHW are staff who are specifically employed as specialist CAMHS workers providing an interface between tier 1 and specialist CAMHS. This table shows the professional background of PMHWs.
Service PMHW1 Nurse Clinical psychologist Educational psychologist Social worker Occupational therapist Other
Flintshire Early Intervention Service (EIS) Team 5 1 2 1 2 - 1
Wrexham Tier 2 / 3 CAMHS 2 - - - 1 - 1
Total
7 1 2 1 3 - 2
  1. Headcount in post

32 Staff vacancies by professional group

The whole time equivalent (WTE) funded vacancies in the team at 30th November 2008.
Service Nurses1 Doctors1 Clinical Psychologists1 Educational Psychologists1 Social Workers1 Psychotherapists CAF1 OT1 Family Therapists1 Other Qual Therapist1 Other Qualified1 Other Unqual1 PMHW1 Managers1 Admin1
Flintshire ASD Service 1.000 - - - - - - - 0.500 - - - - -
Flintshire Early Intervention Service (EIS) Team - - 1.000 - - - - - - - - - - -
Flintshire Tier 2 / 3 CAMHS - 0.500 - - - - - - - - - - - -
Wrexham CADDS - - - - - - - - 0.500 - - - - -
Wrexham Tier 2 / 3 CAMHS - 0.500 1.000 - - - - - - - - - - -
Total
1.000 1.000 2.000 - - - - - 1.000 - - - - -
  1. Funded vacancies (wte)

33 Caseload summary

Caseload data for teams supplying Tier 2 and 3 functions is drawn from 17th November to 14th December 2008 and from 1st June to 30th November 2008 for Tier 4 teams. The census day for all teams was 30th November. In addition to caseload the number of consultations the team carried out in the sample period are recorded. For the purposes of the CAMHS mapping, a consultation requires a clinician from a Specialist CAMHS to provide clinical advice or information for which they can be held accountable. This will usually infer that a record of the consultation will be recorded by at least one party.
Service Local Caseload Wider Caseload Total Caseload1 Consultations
Flintshire ASD Service 15 - 15 -
Flintshire Early Intervention Service (EIS) Team 197 - 197 84
Flintshire Tier 2 / 3 CAMHS 239 - 239 47
Wrexham CADDS 120 - 120 131
Wrexham Tier 2 / 3 CAMHS 232 - 232 83
Total
803 - 803 345
  1. From geographical breakdown

34 Waiting time for new cases seen in sample period

The number of new cases first seen during the sample period by the team and duration of wait to see the team. The duration of the wait is the interval between the date of receipt of a referral and the date on which Intervention begins or is initiated (ie an assessment that results in a decision that a person should be offered an intervention or a programme of different interventions but in which intervention or a part of it has not started should remain on the waiting list until intervention commences). As regards this mapping exercise, intervention alone is not considered to be an intervention unless the person concerned is discharged as requiring no additional intervention from the service. Thus, if the clinical assessment is that intervention is required in any case, that case cannot be taken off the waiting list solely on the basis of an assessment having begun or having taken place. It is for clinicians to state if intervention has commenced or not. In the case of 'Did Not Attends' (DNA) or cancellations, the wait is from the most recent DNA or cancellation.
Service <=4 weeks 1 >4 weeks but <=16 weeks 1 >16 weeks but <=26 weeks 1 >26 weeks but <=39 weeks 1 >39 weeks but <= 1 year 1 > 1 year 1
Flintshire ASD Service - 1 3 1 - 4
Flintshire Early Intervention Service (EIS) Team 164 23 - - - -
Flintshire Tier 2 / 3 CAMHS 32 7 - - - -
Wrexham CADDS 2 - 4 - - -
Wrexham Tier 2 / 3 CAMHS 11 20 5 - - -
Total
209 51 12 1 - 4
  1. Number of new cases

35 Caseload waiting at the end of the sample period

The total number of cases waiting to see the team at the end of the data collection period and the duration of their wait to date. These are the cases for whom a referral has been accepted by the team but which have not yet been seen. The duration of the wait is from receipt of the referral to the end of the sample period (15th December 2007). In the case of 'Did Not Attends' (DNA) or cancellations, the wait is from the most recent DNA or cancellation.
Service <=4 weeks 1 >4 weeks but <=16 weeks 1 >16 weeks but <=26 weeks 1 >26 weeks but <=39 weeks 1 >39 weeks but <= 1 year 1 > 1 year 1
Flintshire ASD Service - 6 8 14 3 10
Flintshire Early Intervention Service (EIS) Team 7 3 - - - -
Flintshire Tier 2 / 3 CAMHS 17 7 - - - -
Wrexham CADDS 4 4 6 - - -
Wrexham Tier 2 / 3 CAMHS 32 58 8 - - -
Total
60 78 22 14 3 10
  1. Number of cases waiting this long for treatment

36 Duration of treatment of cases

This is reported for all cases identified in the total caseload question. This is measured from the point at which the case was accepted onto a team members caseload, in other words at the end of the waiting list.
Service <=4 weeks 1 >4 weeks but <=16 weeks 1 >16 weeks but <=26 weeks 1 >26 weeks but <=39 weeks 1 >39 weeks but <= 1 year 1 > 1 year 1
Flintshire ASD Service 9 2 2 1 1 -
Flintshire Early Intervention Service (EIS) Team 60 78 23 14 6 6
Flintshire Tier 2 / 3 CAMHS 64 54 35 14 6 27
Wrexham CADDS 11 61 20 6 6 16
Wrexham Tier 2 / 3 CAMHS 55 38 56 27 32 24
Total
199 233 136 62 51 73
  1. Number of cases with this duration of treatment

37 Caseload by gender

The gender profile of the team caseload worked with in the sample period.

Service Caseload: male1 Caseload: female1
Flintshire ASD Service 14 1
Flintshire Early Intervention Service (EIS) Team 92 105
Flintshire Tier 2 / 3 CAMHS 112 127
Wrexham CADDS 74 44
Wrexham Tier 2 / 3 CAMHS 132 100
Total
424 377
  1. From age profile

38 Caseload by ethnic group

The ethnic profile of the team caseload worked with in sample period. If the ethnicity is not known, the young person, or the child's principal carer, should be asked to identify the ethnicity of the child by asking which ethnic group listed best describes him or her. The choice of whether the child/young person or parent should answer depends on whether the child/young person is competent to do so.
Service White: British White: Irish White: Any other white background Mixed: Mixed white and black Caribbean Mixed: Mixed white and black African Mixed: Mixed white and Asian Mixed: Any other mixed background Asian or Asian British: Indian Asian or Asian British: Pakistani Asian or Asian British: Bangladeshi Asian or Asian British: Any other Asian background Black or Black British: Caribbean Black or Black British: African Black or Black British: Any other black background Other Ethnic Groups: Chinese Other Ethnic Groups: Any other ethnic group Not stated
Flintshire ASD Service 14 - - - - - - - 1 - - - - - - - -
Flintshire Early Intervention Service (EIS) Team 143 - - - - - - - - - - - - - - - 54
Flintshire Tier 2 / 3 CAMHS 237 1 1 - - - - - - - - - - - - - -
Wrexham CADDS 119 - - - - - - - 1 - - - - - - - -
Wrexham Tier 2 / 3 CAMHS 227 1 3 1 - - - - - - - - - - - - -
Total
740 2 4 1 - - - - 2 - - - - - - - 54

39 Primary presenting disorder

Everybody's Business provides for the distinctions between disorders and problems. People who have disorders are those who satisfy the criteria of ICD10. If referred children and young people do not have disorders, please classify their problems as externalising or internalising problems. The mapping exercise bases its categories on ICD classifications.
Service Hyperkinetic disorders Emotional disorders Conduct disorders Eating disorders Psychotic disorders Substance misuse Habit disorders Autistic spectrum disorders Developmental disorders Other disorder Not possible to define disorder Externalising mental health problem Internalising mental health problem Deliberate self harm Bullying - recipient Bullying - perpretator Violence to others Other problem Not possible to define problem
Flintshire ASD Service 2 1 1 1 1 1 1 15 1 1 1 1 1 1 1 1 1 2 1
Flintshire Early Intervention Service (EIS) Team 13 26 14 2 2 3 2 7 2 4 2 52 81 4 1 1 1 5 4
Flintshire Tier 2 / 3 CAMHS 60 136 6 7 6 4 2 3 2 22 4 1 1 1 2 2 2 22 4
Wrexham CADDS 1 1 1 1 1 1 1 60 62 1 1 1 1 1 1 1 1 1 1
Wrexham Tier 2 / 3 CAMHS 89 97 5 10 11 2 7 5 2 7 1 1 2 10 2 2 2 1 1
Total
165 261 27 21 21 11 13 90 69 35 9 56 86 17 7 7 7 31 11

40 Number of presenting disorders

Service 1 disorder 2 disorders 3 disorders 4 disorders 5 disorders More than 5 disorders
Flintshire ASD Service 11 3 1 - - -
Flintshire Early Intervention Service (EIS) Team 62 58 37 13 - 17
Flintshire Tier 2 / 3 CAMHS 149 75 15 - - -
Wrexham CADDS 54 46 20 - - -
Wrexham Tier 2 / 3 CAMHS 88 67 52 12 3 -
Total
364 249 125 25 3 17

41 Cases referred with ASD as the primary problem

Service Referred with autistic spectrum disorder (ASD) as the primary problem Referred with autistic spectrum disorder (ASD) but not as the primary problem
Flintshire ASD Service 15 -
Flintshire Early Intervention Service (EIS) Team 3 3
Flintshire Tier 2 / 3 CAMHS 2 4
Wrexham CADDS 44 -
Wrexham Tier 2 / 3 CAMHS 3 38
Total
67 45

42 Referrals

Referrals received and accepted by the whole team in the sample period.

Service Total number of referrals received by the team in the sample period Total number of referrals accepted by the team in the sample period
Flintshire ASD Service - -
Flintshire Early Intervention Service (EIS) Team 69 69
Flintshire Tier 2 / 3 CAMHS 38 38
Wrexham CADDS 9 9
Wrexham Tier 2 / 3 CAMHS 56 37
Total
172 153

43 Referrals for ASD

The number of referrals of children and young people who are thought to have an ASD (this will not necessarily have been confirmed at this stage), and therefore differs from the question on the number of cases with an ASD identified as the primary presenting disorder.

Service Primarily referred for help with the diagnosis or management of an ASD Referred as a consequence of having a co-morbid mental disorder
Flintshire ASD Service 15 -
Flintshire Early Intervention Service (EIS) Team 3 3
Flintshire Tier 2 / 3 CAMHS 2 4
Wrexham CADDS 44 -
Wrexham Tier 2 / 3 CAMHS 3 38
Total
67 45

44 Caseload learning impairment, learning disability and ASD

These questions have been added this year. The definitions used by staff to select between the four levels of impairment or disability should reflect recent policy developments in the ways in which impairments and disabilities of learning are described and defined functionally.

Thus, a person who has a learning impairment is a person whose problems with learning are sufficient to impair their progress in one or more areas of their life or their enjoyment of their life.

Learning disability refers to the experiences and capabilities and enjoyment of life of people who problems with learning go beyond impairment such that they could result in substantial and lasting functional and educational limitations that amount to disability of at least mild severity. In the past, in some services, the distinctions between the various levels of impairment and disability have been related to IQ (i.e. sometimes, severe learning disability has been described as a person having an IQ of 69 or lower). Now, much greater emphasis is placed on the degree of impairment or disability in relationship to particular person's lives rather than their IQ. Therefore, it is for clinical members of the team to determine the distinctions between the levels of disability that are described above.

Service Children or young people who have a learning impairment (not including an ASD) Children or young people who have a mild learning disability (not including an ASD) Children or young people who have a moderate learning disability (not including an ASD) Children or young people who have a severe learning disability (not including an ASD) Children or young people who have an ASD
Flintshire ASD Service - - - 1 6
Flintshire Early Intervention Service (EIS) Team 6 7 4 - -
Flintshire Tier 2 / 3 CAMHS 3 1 4 - 1
Wrexham CADDS - - 47 - 73
Wrexham Tier 2 / 3 CAMHS 15 3 1 - 4
Total
24 11 56 1 84

45 Caseload acute or chronic

The number of children and young people who were referred because they were thought to have or who were later discovered to have a problem or disorder that is thought to be related to acute or chronic psychosocial distress or trauma after them being directly or indirectly affected by abuse, disaster, major incident or accident.

Service Related to a single event or incident (e.g. a traffic accident single episode of abuse etc) Related to possible recurrent repeated or habitual abuse
Flintshire ASD Service - -
Flintshire Early Intervention Service (EIS) Team 1 7
Flintshire Tier 2 / 3 CAMHS 8 37
Wrexham CADDS - -
Wrexham Tier 2 / 3 CAMHS 14 34
Total
23 78

46 Caseload special characteristics

The number of cases within the team direct caseload with the following characteristics:

Service Children currently 'looked after' by their local authority (excluding S26 cases) Children in contact with a YOT in last year Children receiving inpatient mental health services provided in security (Medium secure) Children who are subject to secure orders under Section 26 of Children Act
Flintshire ASD Service - - - -
Flintshire Early Intervention Service (EIS) Team - 1 - -
Flintshire Tier 2 / 3 CAMHS 27 18 1 -
Wrexham CADDS 4 8 - -
Wrexham Tier 2 / 3 CAMHS 14 13 1 -
Total
45 40 2 -

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