24 December 2020

Improving the New Starter Process with Tower Hamlets Child and Adolescent Mental Health Services

Words and images by Nicola Ballingall, Improvement Advisor

This story explains how Tower Hamlets Child and Adolescent Mental Health Services (CAMHS) were able to improve their new starter process using QI methods.

2 minutes read time


As part of their work in the Enjoying Work programme, Tower Hamlets Child and Adolescent Mental Health Services (CAMHS) are improving the experiences of their new starters.


Enjoying Work with Tower Hamlets Title


Image of new starter, with title 'Understanding the Problem'

The inconsistent new starter process in Tower Hamlets Child and Adolescent Mental Health Services was an emotional rollercoaster for new staff: 

“I didn’t know I might be asked to line manage and I didn’t think it was appropriate as I hadn’t oriented myself to the service”

“I’ve needed to be quite proactive in inducting myself.”

“I was handed 29 cases in my first week.”

“I was not expected on my first day.”


This also meant that service users had a longer wait than necessary for their care. 

Jigsaw puzzle pieces representing the plan, do, study, act cycle, all coming together

Project lead Chris Kowalski and QI Coach Chris Spanton led the team forwards in testing their change ideas. They struggled to protect the time to study the impact of their changes, and when covid hit they had to iterate their ideas to suit the virtual working world. Just when the pandemic was exhausting the team, in came a newly trained QI Coach, David Walter – just the energy boost the team needed! They’re now using the protected time in the Enjoying Work learning sessions to get together as a team and focus on achieving their goals. 

Aim: to reduce variability of new starters' rating of the Tower Hamlets CAMHS's joining process and to increase the average score from 7.3 to 8 out of 10


an arrow pointing up, suggesting something improving


Stories from new starters at CAMHS reveal the real impact of the work:

“Buddy system of peer support.”

“Induction pack has been useful.”

“They put on a lunch to introduce me to the service…wow!”

“I was also encouraged to think about areas of interest, and was given half a day a week for this.”  

“Personal warmth of colleagues, plenty of empathy as to what it is like returning after mat leave/career break.”

“I was also given a guided tour by my manager which included a visit to the Royal London Museum, the Bell Foundary and a trip to Tayyabs for lunch.”


If you would like to try the New Starter Checklist with your team, contact the QI Department at elft.qi@nhs.net for more information!


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  • YesNo
  • 12345
    1 = poor | 5 = great
  • 12345
    1 = not useful at all | 5 = very useful


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