Combining large-scale engagement and complex data analysis, the Health Economics Unit created a robust foundation for informed and impactful future planning across multiple hospital trust specialties and directorates.
As George Eliot Trust embarked on its yearly planning process, the staff recognised an opportunity to use data to improve planning and management of the care they provide and financing. The trust’s leaders asked the Health Economics Unit’s expert team to work with multiple specialties to analyse and understand trust data, and generate insights which can be used in planning future services.
The HEU was given a tight two-month timescale, in order to generate insights in time for the next stage of the trust’s planning process. The team produced 28 models, across all the trust’s directorates.
Design through collaboration
The HEU took a flexible engagement approach, working closely with staff managing and delivering specialist services, before creating demand and capacity models for each area. These models mark a significant early milestone for the Trust in optimising their healthcare planning and resource allocation, now and in the future.
The models themselves were designed to offer a nuanced understanding of demand, assess existing healthcare delivery capacity, and support individual services to strategically plan for future capacity. Leveraging on the standardised NHS England advanced flow model framework, the project was developed on a solid and well-tested foundation. To produce outputs valuable to the services, the HEU extended the functionality of the existing templates with subspecialty breakdowns.
Demand and capacity modelling requires an iterative approach to gather consensus on the data and to interpret the outputs with the service experts. To achieve this, the HEU project team embarked on large-scale stakeholder engagement, to mitigate any existing data quality concerns and produce outputs that would be meaningful for their use. Key stakeholders, from finance, strategy, service and directorate management and information services played crucial roles in shaping, assuring and overseeing these models. Each model went through an extensive process of gathering activity, referral, waiting list and capacity data from either the data warehouse or experts in the trust. The outputs then went through a validation process with the service and general managers to review and confirm the insights aligned to what they were experiencing on the ground.
“We found the team to be very professional bringing expertise with the D&C models, helping GEH to get to grips with internal data quality issues, which have all been helpfully documented and will form part of our data quality improvement. Timely engagement on knowledge transfer to leave GEH in a good position to continue to do this essential work”
Yasmina Gainer, Head of Financial Planning and Costing at Geroge Eliot Hospital NHS Trust
Culture change and model insights
The detailed engagement and model ownership by services encouraged a change in culture across the short time frame across business planning, finance, and services. The understanding of available capacity and demand progressed significantly over the period, specifically the understanding of model inputs and interpretation. The project has brought together a multi-disciplinary team across service, finance and business planning providing education and insight into the services. Therefore, services are now better equipped to use available resources in order to meet the needs of the population.
Insights from specific models, such as T&O, Breast Surgery, ENT, Oral Surgery, Urology, Plastic Surgery, Gynaecology, and General Surgery, revealed valuable information on current capacity, demand scenarios, and recommended actions to align with service standards such as how much capacity is needed to reduce waiting lists to a sustainable size.
Improving models iteratively
The project suggested key recommendations for the future. Most importantly, the HEU’s work highlighted the need for a commitment to continuous model development and refinement, with some models needing further data and existing models requiring data quality enhancement, and capacity data automation.
With the in-depth handover the Health Economics Unit facilitated, George Eliot Trust is in a position to further develop the current models and have the skills to iterate models in the future.
The project outputs provided George Eliot Trust with an accurate representation of gaps in demand and capacity. On this foundation, the trust will manage the day-to-day running of services, and plan capacity to meet their populations demand and waiting lists going forward.
“We are hopeful, that this exercise will enable the organisation to continue the demand and capacity reviews more routinely and support service managers to understand their services at these granular levels delivering improved patient waiting list flow.”
Yasmina Gainer, Head of Financial Planning and Costing at Geroge Eliot Hospital NHS Trust
Get in Touch
For further inquiries, collaboration, or more information on this project, please contact the Health Economics Unit at HEU.support@nhs.net.
Reference
NHS England’s advanced flow capacity and demand tool