About the CYPMH Referral System Management Tool

NHS England and NHS Improvement have developed the CREST to support with the planning and commissioning of children and young people’s mental health services. Through inputting some basic information, the CREST enables systems to review how available capacity serves the demand on the service.

This straightforward approach to demand and capacity modelling makes the concept accessible to everyone. The outputs can be utilised in many different areas, including supporting operational planning, improvement in waiting times and developing new service pathways.

One of the many benefits of the CREST is the ability to combine the modelling of both community and inpatient services, providing opportunities for all system stakeholders to collaboratively consider the children and young people's mental health provision across their population.


The concept for the CREST was the creation of the Children and Young People's Mental Health Programme Team. The key principle was to provide a tool for those working within children and young people's mental health services which offered an evidence based approach to strategic and operational planning. 

The original organisations commissioned to develop the tool along with their roles were:
  • SCW CSU (Lead organisation providing leadership, project management, co-ordination and data access);
  • Oxford Healthcare Trust (providing clinical oversight);
  • Healthcare Decisions Ltd. (providing modeling approach, tool design, and software implementation) (Reporting to the NHSE Steering Committee)

Since its formation, the CREST has been through several transformations. During 2019/20, NHS South, Central and West CSU partnered with the team to develop the current format. The latest version provides an efficient and accessible approach to modelling, maximising the outputs and reflecting the current needs of those working in this specialist field.

October 2014

NHS England commissioned SCWCSU, Oxford Healthcare Trust, and Healthcare Decisions Ltd. (HCD) to develop a tool to support planning within commissioning of CYPMH services

October 2014

June 2015

'Beta' version 1.0 of Excel tool developed and released by HCD

May 2016

Version 2.0 of Excel tool released based on user-testing and feedback

May 2016

August 2017

Version 3.0 released by HCD. This was the first online version of the tool

June - September 2019

Discovery Phase

Gathering User feedback, User Focus groups & design workshops

June - September 2019

October 2019

Alpha Phase

SCW begin work on redeveloping V2 online tool, Testing assumptions and options for addressing issues

January 2020

Private Beta Phase

Private Beta Phase tool release for limited testing / user - focus group

January 2020

March 2020

Public Beta Phase

Tool released Early as public Beta to support planning for covid 19 global pandemic