Evaluation of a Waiting List Initiative in a Child and Adolescent Mental Health Service

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The aim of the study was to evaluate Initial Assessment (IA), a new system for managing referrals. The system is designed to: reduce waiting times, reduce ‘did not attend’ (DNA) rates, and improve multi-disciplinary team working and team morale, compared to the existing referral procedure.


A comparison was made between a child mental health service using IA and a second centre using the existing system over a 6-month period, based on administrative records, a child functioning measure, staff and user questionnaires.


The Initial Assessment system was associated with a significantly shorter average waiting time for the first appointment (9 weeks) and a lower DNA rate (10%) in the intervention centre. The populations seen under the new and existing systems were similar in terms of the severity of cases. Staff reported a positive impact overall on team working and team morale, despite a reported individual increase in time pressure; users reported acceptance of the system.


Findings suggest that the increase in team morale and support from colleagues associated with the new system may have mediated against any negative impact of the increased time pressure. Substantial cost savings to the NHS are indicated.

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