Case Study - South East CAMHS

South East CAMHS Tier 4 Services

The Scenario

  • The CReST team supported a demand & capacity modelling pilot across the South East region from October 2020 to April 2021.
  • Using retrospective admission activity from 2018/19 – 2020/21, and modelling a variety of different scenarios, CReST indicated an overall deficit in CAMHS Tier4 bed capacity in the SE region
  • In the SE region, bed occupancy levels have been consistently high, over 95%. The modelling was based on 10 beds for every 100,000 population of CYP 0/19 years old, as indicated in the national CAMHS Accelerated Bed Plan.
  • The CReST modelling identified a bed deficit.

Modelling Assumptions

  • Scenarios ranging from 98% to 85% bed occupancy were modelled, at regional, Provider Collaborative, and specialty level across the SE region
  • Modelling was initially based on admission activity data, rather than referrals and part-year 2020/21 data was extrapolated so surge demand since COVID-19 pandemic therefore was not included. Later re-modelling using locally captured referral data showed surge and supported the case for additional CAMHS Tier 4 capacity. Average length of stay based on forecast discharges (for 20/21)
  • Modelling for Eating Disorder services was based on Specialist Eating Disorder capacity only and admissions via GAU-ED pathway, as recommend by NICE could not be specified.


  • Using the various modelling scenarios, CReST indicated a regional bed deficit for the South East region.
  • As CReST modelling is based on retrospective data, this is likely to be conservative
  • The capacity modelling also indicated redressing the balance of beds in the region, with a specific need for increased ED over PICU bed capacity.
  • Modelling for other beds types such as Low and Medium Secure, Deaf CAMHS, Under 13s services was more problematic given the lower number of admissions per year.
  • The exercise enabled further opportunities for:
    • Forecasting and impact analysis for COVID surge recovery planning
    • Collaboration with NHS Benchmarking Network to share findings and explore modelling for workforce planning
Derby FT CReST Model Chart

“Outcomes were used to develop successful business cases for additional CAMHS Tier4 service capacity in the SE region”

“As a region, we were able to model the optimum number of beds required for past admissions activity for GAU/ED/ PICU and plan more effectively for growth trends to meet the needs of local and regional populations”