Applying Lean to CAMHS

Start stop by tungphotoChild and Adolescent Mental Health Services (CAMHS) are under pressure. Despite investment in the UK in recent years, demand often seems to outstrip supply. This may be because increased resource brings rising expectations, and higher referral rates.

An excellent presentation by Ian Dufton, a Child and Adolescent Psychiatrist, provides good evidence that Lean approaches can be applied to CAMHS. I’ll return to some of the detail in the presentation in future posts, as it has great examples of Lean techniques.

In this post, I want to concentrate on some of the cultural issues raised by Ian Dufton. He notes that an initial exercise in value stream mapping lead to no further activity for over a year. Changes in organisational support, and in local leadership, were necessary prerequisites to further work, he suggests.

This chimes with other work. Individuals can make changes in their work place, but buy in from an organisation seems to make change much more likely, and easier to sustain. Dufton also notes the importance of early success, with an early Rapid Process Improvement Workshop (RPIW) resulting in a reduction in drug costs that was nationally recognised. This is likely to have increased the credibility of the process, and encouraged willingness to at least give it ‘the benefit of the doubt’.

Do you agree that organisational support is important? What might let you start work on Lean improvements?

Image courtesy of tungphoto at

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