The development of a scale to aid caseload weighting in a community mental health team for older people

Background: Community mental health teams (CMHTs) receive high numbers of referrals and staff who work in these teams are under constant pressure to take on more patients. Local CMHT staff expressed the need for a more accurate way to represent their workload than purely reporting numbers of clients on their caseload. Aims: The project aimed to develop a brief case weighting scale (CWS) specifically to rate cases in CMHTs for older people in Leicestershire. Methods: An eight-item scale was designed to include the main aspects of a client case that contribute to increased work input by CMHT members. A multiple regression model was used to assign different weightings to each of the items in order to predict time spent on the case over a four week period. Results: The items on the scale together ‘‘accounted for’’ 58% of the variation in time spent on client cases. The re-test and inter-rater reliability of the scale were shown to be good. Agreement with the HoNOS 65þ was investigated. Conclusions: The CWS can be used to rate both current client cases and new referrals following first assessment, and aims to provide CMHT staff with a useful and useable indicator of their clinical workload.