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

AIMS AND METHOD A new fast-track assessment (FTA) clinic was established by a community mental health team (CHMT) in SouthEast 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 postclinic 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 to18 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 21days 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.