As we know, the last year saw an unprecedented influx of Covid cases and a resultant dramatic reduction in elective care throughout the NHS. Worryingly there was also a dramatic reduction in referrals from GPs, and those patients who have carefully and considerately avoided the NHS during Covid are expected to return in the coming months. This will create massive backlogs nationally.
Planning our way out of this crisis cannot be with the same ‘business as usual’ processes and historic patient volume assumptions. Spreadsheets and firefighting to meet clinical breaches or waiting list targets must become a thing of the past.
Building new capacity plans and performance measures, to meet these burgeoning waiting lists, cannot be done the ‘old way’. The NHS needs access to today’s data on waiting lists by speciality, by location… if real demand is to be uncovered and any improvements tracked. Hospitals need detailed understanding of staff, consultant and clinic availability, diagnostic equipment usage, theatre schedules, projected length of stays, bed occupancy status – if they are to agree an activity level that will kick-start the catch up. An old 12-month plan will not meet today’s crisis. The need is for agile, rolling plans that tackle the worst risks first, find extra capacity and make the most of combined resources from across the system.
Only with accurate data can organisations accurately plan
While the NHS waits for potential DHSC funding, or the build of elective hubs for key specialties, there is much that each hospital and system can do to maximise its own resources and respond to the urgent needs of its own community.
Core to any responsive demand and capacity planning is an accurate, consolidated data foundation on which to base pivotal decisions. Patient Pathway Plus (PP+), from Insource, gives hospitals and regional systems a unified, accurate view of their waiting list backlog across all elective care, not just RTT, and across all specialities, showing the full scale of the problem. By incorporating clinical priorities, it allows Boards to plan and redeploy services against greatest need. Excel spreadsheets are last year’s tools. They struggle with the demands of modern NHS planning with its complex clinical pathways.
PP+ is a powerful data management platform that connects directly with the source systems and PAS to extract, process, validate and unify data automatically. Through automated data pipelines and a detailed yet consistent set of rules-based, data validation processes PP+ provides a ‘single version of the truth’ across the whole Trust or system and shows the precise status of electives waiting for treatment on any given day.
Planning to get ahead of the game – not firefighting
Working together Insource and Gooroo, form an integrated solution, that provides advanced forecasting and capacity planning across NHS hospitals and regional systems, with particular expertise in planning non-elective and elective beds tactically, at an agreed and acceptable level of risk, and incorporates a wide choice of scenarios for reducing elective waiting times. The combined solution enables hospitals to gain a clear picture of where pressures and bottlenecks lie and where capacity opportunities can be discovered, bringing real-life demand and capacity planning to hospitals to achieve optimum care throughput. This automated solution can deliver both long and short-term plans and connects the outputs to an organisation’s business intelligence system for weekly outcomes tracking.
Forecasting and capacity planning now needs to be elevated from a simple backroom, once per year, financially-led planning exercise to a responsive scheduling of activities that truly addresses the backlog and ongoing pressures. A process that helps and involves all levels of the organisation from operational management and patient scheduling, to clinical leaders and access standards managers, and includes information analysts and financial planners. Meeting the challenges of the post-Covid normal will require an all hands-on-deck approach – especially if any course corrections are needed mid-process as milestones are missed.
£1bn NHS fund allocation to tackle elective backlogs
How aggressively each Trust choses to address its backlog is a matter of choice and funding. Forecasting options for how you want your future to look could include:
- Continue at historic rate of care – same costs – waiting lists get worse
- Keep up with demand – increased cost – waiting list remains same
- Get back to e.g., 18-week targets by 2025 – substantial cost – waiting lists reduced
Through its Covid-19 recovery and planning processes, DHSC and NHSE/I are currently working with NHS organisations to agree how to spend a £1bn fund allocated for 2021-2022 to achieve maximum value. Without detailed modelling against accurate data, organisations can only make estimated choices against historical assumptions with little or no way to measure maximum value achievements.
PP+ Gooroo Planner can forecast both performance and demand and build in the constraints of resources, staff and efficiency gains… as well as input wait time standards and build this complex detail into a picture on which to make informed decisions. Decisions which outline the effects on manpower, equipment, clinics, theatres… and their budgetary impact that can define how to clear backlog and over what timescales.
Demand and capacity planning – must become a responsive process
If the NHS is to truly aim for elective recovery, organisations need to understand where to make the improvements, where the bottlenecks are, what implementations will give the greatest results, where is best to treat which patients, which specialities may need to share patients across regional facilities for faster treatment. And should new surges in demand arise, organisations need the ability to respond quickly with new measures.
Demand and capacity planning can no longer be a once-a-year budgetary process run on Excel Spreadsheets and without regard for clinical priorities or elective pathways. It needs to be based on real-time, automated data that is linked directly with prioritised waiting lists and measured activity outcomes. It needs a solution that allows for fast course corrections if activity plans are missed and new activity is planned. Forecasting and capacity planning post-Covid must be a responsive, inclusive operations-led process if we are to truly reduce the backlogs.