Bedford Hospital Trust is a 450 bed district general hospital within NHS East of England.Over the last few years the trust has performed well against most operational targets but was operating in an environment of a recurrent financial deficit of £12m.

Specific problem areas included:

  • Fixed capacity reflected in rigid rostering patterns
  • Frequent bed gridlock situations
  • Declining length of stay indicators
  • Hampered improvement efforts
  • Disengaged clinicians and top down capacity management.

Operationally, this meant the trust needed to:

  • Deliver upper quartile performance while minimising organisational risk through uncompromised contractual delivery
  • Be more proactive and excel in forward planning, aligning resources to patient demand on an ongoing basis
  • Focus on staff engagement, ultimately moving control to clinical and operational staff, empowering them to coordinate and manage daily activity.

In 2007 the trust started to use CapPlan, a capacity planning tool for patient and resource management created by New Zealand company Emendo.

The trust saw the tool as an opportunity to improve their current abilities to manage hospital activity and resources.

The system is used in the following key areas:

  • Daily planning and operations management - advanced proactive actions to adjust capacity at all levels
  • Weekly planning - bed availability with an accurate picture of likely activity
  • Event planning, eg. Christmas - effective capacity planning in advance and adjusted where needed.

During the initial phase, the trust saved £110k and is now saving approx £600k a year for inpatient areas alone, achieved without reducing standards of care. Additionally, the access to timely operational reports by all staff has reduced the MIS resource requirements across the organisation.

Operational indicators have shown marked improvements in length of stay too. The number of patients with a length of stay greater than 10 days has reduced by 50 per cent.

The trust is now seeing strategic planning benefits from the system. It is a key tool in negotiating and commissioning activities, and supporting the workforce planning strategies such as annualised hours initiatives. “Staff planning is evidence based and aligned to workloads. There are fewer bed block events and fairer staffing allocations,” says Lisa Hunt, chief operating officer.

With limited IT resources available, Bedford Hospital has seen the benefits of an implementation process that involves standards based architecture and a simple one-way integration. Data integrity has also increased markedly without any additional data entry required.

With Bedford Hospital’s inpatient management processes significantly improved, they are now working with CapPlan on planning and managing theatre flow, and outpatient capacity management. This will provide a whole organisation approach to planning and coordinating staffing, and capacity to meet patient needs.

Bedford Hospital Trust holds on-site mini workshops to demonstrate the tool. For more information email