Remembering Steve Kingsbury

The development of CYPMH modelling tool was supported by a range of system experts with many years’ experience in delivery, planning, academia and commissioning.  One colleague in particular is worthy of note, Dr Steve Kingsbury.  

Steve was one of the founders of the Choice and Partnership Approach (CAPA) which revolutionised the understanding of CYPMHS of the benefits of demand and capacity planning.  Based on a model of full involvement of the children, young person and those who care for them in decisions about their care, CAPA enabled services to improve access, waiting times and service user satisfaction. 

CAPA was underpinned by a deep appreciation of the needs of children, young people and families and the desire by professionals to deliver effective services to the widest possible group whilst treating every child or young person as a unique individual and understanding of queuing theory. 

Despite being diagnosed and in treatment for  a Stage 4 brain tumour, Steve worked on the model, bringing all his expertise into its development , attending steering groups when he was well enough  and spending hours with the original modelling team until his death in 2015.
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Steve was the eldest of two sons of medical parents. His mother is still alive and brother is also a doctor. He entered Charing Cross medical school, qualifying in 1983. He always loved psychiatry and this is when I first met him- as junior psychiatrists at St Bernard’s Hospital in Southall. He flooded us all with his challenge, insight, creativity and a different way of seeing the world.
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After medical school he worked for a year in IT for the Medical Research Council and this experience was put to great use later in his career- both in his skill in writing IT code, website design and in research. He trained in psychiatry on the Charing Cross scheme and his experience working with young people and families rapidly turned into a passion to pursue this area as his career. He worked at St Bernard’s Hospital, West Middlesex, obtaining MRCPysch in 1988.

Steve trained in child and adolescent psychiatry in Oxford. He naturally understood people at a very deep level and this, combined with an exceptional ability to cut to the chase and sensitively but robustly challenge, led him to be a highly effective and valued clinician. He was able to précis any situation into a short, pertinent and highly accurate appraisal of the situation.

During his higher psychiatric training at Oxford he became very interested in suicidal behaviour in young people and published a seminal tool, still in use, called PATHOS. Steve’s ability to sound-bite the essence of communication is something everyone remembers.
In 1993 Steve was appointed consultant child and adolescent psychiatrist at Hoddesdon Child and Adolescent Mental Health Services (CAMHS) , where he was loved by colleagues, young people and families alike. He was Clinical Director of a partnership trust from 2001 leading to wide experience in integrating different multi-agency agendas in CAMH service delivery as well as writing strategic frameworks.

His passion was about working with young people and their families in a respectful and open way that furthers their concerns and choices using our expertise. His other interests were IT, attachment, ADHD and systemic practice. He was the Honorary Secretary for the Child and Adolescent Faculty Executive of the Royal College of Psychiatrists, the Chair of the general adult / child psychiatry interfaculty working group, and a Director of the national children’s mental health charity, Young Minds. From 2005- 2006 he worked as Advisor to HASCAS - The Health and Social Care Advisory Service.

From 2000 Steve worked intensively with his colleague Dr Ann York on what Steve often said was the greatest achievement of his professional career- the development of a continuous service improvement model, the Choice and Partnership Approach or CAPA. This evolved out of their training in demand and capacity theory and firsthand experience of service redesign.
Never planned or marketed, interest in CAPA spread around the world as it was (and still is) so accessible and effective for services. They wrote 4 books, developed and hosted a website (capa.co.uk) and developed monitoring and fidelity tools. Over 6000 staff all over the world have been trained to date, at their request. CAPA is now used all over the UK, New Zealand, Australia, Nova Scotia, Belgium, parts of the Netherlands and Ireland, in CAMHS and in adult mental health.

From 2006 to 2007 Steve was seconded to the Department of Health as Medical Advisor for CAMHS where, amongst other things, he developed quality standards for assessing services (You’re Welcome standards).

In the two years before his death he was a regular external assessor for the Parliamentary and Health Service Ombudsman. He sat on the NHSE CYP-IAPT Service transformation group and on the National Accreditation Council for CYP-IAPT. In this role he chaired a working group that developed values and standards guidance for CYP-IAPT called Delivering With, Delivering Well.

He was diagnosed with GBM in the early autumn of 2014. He had recently retired and was still working voluntarily for NHS England on the Children and Young People’s Improving Access for Psychological Therapies programme. He chaired a working group that developed quality standards for the associated service transformation, Delivering With, Delivering Well.

Having championed professionally for services to always be user friendly, collaborative, honest and strengthening, this is how he experienced the wonderful health services who cared for him.

He died peacefully with his loved ones around him on 29th April 2015 at 15.43.
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Academic;
Author of RCPSYCH Council Report CR106: “Acute in-patient psychiatric care for young people with severe mental illness.

Hawton K(1), Ware C, Mistry H, Hewitt J, Kingsbury S, Roberts D, Weitzel H: Paracetamol self-poisoning. Characteristics, prevention and harm reduction.
Br J Psychiatry. 1996 Jan;168(1):43-8.

Hawton K(1), Kingsbury S, Steinhardt K, James A, Fagg J: Repetition of deliberate self-harm by adolescents: the role of psychological factors. J Adolesc. 1999 Jun;22(3):369-78.

Kingsbury SJ: Clinical components of suicidal intent in adolescent overdose. J Am Acad Child Adolesc Psychiatry. 1993 May;32(3):518-20.

Kingsbury S: (PATHOS: a screening instrument for adolescent overdose: a research note. J Child Psychol Psychiatry. 1996 Jul;37(5):609-11.

York A & Kingsbury S: (2004) The 7 HELPFUL Habits of Effective CAMHS and the Choice and Partnership Approach- a Workbook for CAMHS. 1st Edition.

Kingsbury S & York A: (2005) The 7 HELPFUL Habits of Effective CAMHS and the Choice and Partnership Approach- a Workbook for CAMHS. 2nd Edition. Surrey: CAMHS Network

Kingsbury S & York A: (2 nd edition 2006, reprinted 2008) The 7 HELPFUL Habits of Effective CAMHS and the Choice and Partnership Approach- a Workbook for CAMHS. Surrey: CAMHS Network

York A and Kingsbury S: (2011) The Choice and Partnership Approach; a service transformation model. Surrey; CAPA Systems Limited.

York A & Kingsbury S: (2010) Book chapter: Demand and Capacity Management. Chapter 12 in Child and Adolescent Mental Health Services: An Operational Handbook (Second edition) chapter 12; Gaskell 2010 EDITED BY GREG RICHARDSON, IAN PARTRIDGE AND JONATHAN BARRETT