Table 1.

Outline of themes and sub-themes identified across three key stakeholder group interviews

Theme	Stakeholder group
	CAMHS Staff	CAMHS commissioners	CAMHS patient groups
1: Conflicts in quality definition	- Fluid and nebulous - Reflects variety of stakeholder opinions - Based on policy, theory, & research evidence - Dynamic in integration and execution of different perspectives - Personal qualities and values of staff - Paramount in assessment and treatment	- Seen as patient experience, outcomes, and safe-guarding - Management of patient queries/complaints - Paramount in meeting patient expectations	- Reputable and recommended service - Knowledgeable, trustworthy, and communicable staff - Attention to the individual needs of patients - Prioritised staff qualities over facilities - Paramount in access to services and timely treatment
2: Conflicts in IOM framework interpretation	- All were seen as relevant - Timeliness and patient-centeredness: pros & cons due to individual circumstances - Suggested three more domains: sustainability, staff wellbeing, and multiagency working	- All were seen as relevant - Emphasised patient safety issues and timeliness of offered services - Suggested multiagency working as holistic approach to meeting mental health needs of patients	- All were seen as relevant. - Parents prioritised timeliness and efficiency - Young patients felt that all six were represented in the treatment they received
3: Barriers to implementation of quality care in CAMHS	- Identified issues with existing measures of quality - Suggested improved ways to measure quality - Identified a wide range of barriers at service level to defining, measuring, and delivering quality services	- Addressed existent issues in reports on guidance and medication - Either identified broad national measures of quality were not aware of them - Could not identify outcomes of known measures - Were in consensus that quality needs to be measured - Identified the need to be better informed through concise reports and improved communication with all levels - Suggested change in how services respond to GPs/commission	- Suggested alleviating first-appointment anxieties - Identified the need for child-friendly communication letters - Wished for increased access (referral, timing) - Asked for a choice of clinicians Patients were not asked about existing measures of quality as it was not applicable to their experience of CAMHS