Paul Stroner gives an update on a programme by NHS England and NHS Improvement that aims to improve demand and capacity modelling in elective care
For many years I have been involved, in some way or another, in planning rounds. Every 12 months I brought in all the data, went through all the plans and often saw that the methodology for planning for the next year was “last year plus a bit more”.
The question for me was, how can we make planning data more robust and actually meaningful? How can we look past the numbers on a spreadsheet and make sure that we are planning for patients?
This is why in 2016, I jumped at the chance to be part of a new national piece of work on demand and capacity across elective care. The programme from NHS England and NHS Improvement has been designed to support NHS organisations to better understand demand and plan sufficient capacity so that patients do not wait longer than necessary for treatment.
Many of those taking part in the programme weren’t new to demand and capacity modelling – many had the models in place, but the numbers weren’t matching what was happening on their wards
We know that reducing waiting times means waiting lists build up, because demand for work often exceeds the capacity available for that treatment or procedure to be done. But when you accurately look at the whole journey, analyse the queue of patients and the capacity in the service, you can quantify the changes needed to manage the service effectively and bring changes to benefit patients.
Without great fanfare, it’s been amazing to see so many different parts of the NHS quietly taking part over the past 18 months. Nearly half of all NHS organisations in England have been on our introductory course. Many of those taking part weren’t new to demand and capacity modelling – many had the models in place, but the numbers weren’t matching what was happening on their wards or in their service.
“According to the model, the demand and capacity for colposcopy was good, but it didn’t feel good, so when we broke it down site-by-site we could see that one site had a huge chunk of capacity, 102 out of 175 slots, where the other three sites shared the remaining 73. That answered why on some sites, it didn’t feel like there was ever enough capacity… The data showed we did have capacity but not in the right place.”
– Jane Bryan, The Pennine Acute Hospitals Trust (see attached case study)
On top of this engagement, we’re also seeing great results on our demand and capacity trainer programme. This is our core offer, creating a pool of 300-400 graduates, embedding their knowledge in local health economies.
The training is hands on, where small, geographically located groups work with each other over six months. This offers a safe space to explore and challenge issues, and gives the graduates a community of support they can draw on long after the programme.
This isn’t just about numbers and our trainees aren’t just given the skills to develop demand and capacity models. They also learn personal skills to equip them with the confidence and tools to take back to their organisation to train and support colleagues from other disciplines.
“I’ve learnt new skills I didn’t know I had and I’ve learnt how to deal with things I don’t like. Four months ago, I wouldn’t have been able to stand in front of a camera and talk about myself, but this training has given me that confidence. I can now speak confidently in front of clinicians and directors.”
– Barbara Tringham, Lewisham and Greenwich Trust (see attached case study)
Good demand and capacity planning is about trust senior leader involvement, having commissioners and providers in a room together, and a commitment to action on the results. You can’t just put figures into the computer and hope it will give you all of the answers.
The Pennine Acute Hospitals Trust found that you have to look further than the numbers, talk to other members of the team to find out how it feels too.
Good demand and capacity planning is about trust senior leader involvement, having commissioners and providers in a room together, and a commitment to action on the results
“Everyone knows that having a robust capacity and demand model that meets the needs of the service allows you to forward plan and arrange the workforce to meet this. However, for many of us, it’s figuring out how to get there. Our consultants and matrons are quite rightly focusing on the day job. However, it was their insight and commitment to solving this common issue that made the difference.
“My advice to anyone is to start small, don’t try and fix the system in one fell swoop. Break down the problem one chunk at a time. Bring together your experts to focus on just one part of the puzzle, listen to what the data is telling you and find a trend, then importantly empower your consultants to help realise the change needed. Everyone is in this business to improve care for patients, by focusing everyone on this common goal we can piece together all the bits.”
– Jane Bryan, The Pennine Acute Hospitals Trust
It’s people like Jane and Barbara who are leading this quiet revolution, working within their trusts to make a difference to patients. So far, 2290 people from across the NHS in England have taken part in some part of our training, and not just analysts (194), 261 general/service managers, 51 commissioners and 24 clinicians as well as other job roles have also been involved.
As I’ve said, we’re at the half way stage, so there is still time for other organisations to develop their demand and capacity modelling. Like Barbara, you won’t just be given the skills to develop demand and capacity models but will also be equipped with the confidence and tools to take back to your organisation and train and support other colleagues from other disciplines.