Impact of a fast-track assessment clinic on waiting times and non-attendance rates for new referrals to a community mental health centre

Abstract

Aims and method: A new fast-track assessment (FTA) clinic was established by a community mental health team (CHMT) in South-East London. Previously, those who responded to an opt-in letter were offered an appointment with a duty worker or at an out-patient clinic. In the new system, all routine referrals are booked into a single fortnightly clinic staffed by two doctors and two to three other CMHT staff with post-clinic discussion of all cases (2-6 min per case). A total of 100 consecutive referrals before the introduction of the FTA clinic were compared with 100 following the introduction. Results: The interval between receipt of referral to first appointment offered was reduced from 55 to 18 days and to actual assessment from 71 to 26 days. Eighty-four referrals to the FTA were offered a first appointment date that was within 21 days of receipt of a referral, compared with four before the introduction of the FTA. These differences were highly significant. There was a trend for more patients to attend for assessment after the FTA clinic was introduced (79 compared with 68). Clinical implications: This simple re-engineering of the assessment process within a CMHT has achieved its objective of reducing waiting times to first assessment appointment. It also appears to have reduced the number of referrals that do not result in an assessment.