Capacity modelling is the crucial next step to minimise the pandemic’s impact on elective care

With the UK’s elderly population increasing while bed numbers decline, it has become the norm for many NHS trusts to operate at near-full capacity, particularly during the winter period. At the peak of the Covid-19 crisis in England, resources needed to be redirected from elective care to treat patients with severe cases of the virus in order to prevent the system from being overwhelmed.

23 Jun 2020 | 3 min read

Andrew Branch, Head of Projects

There is no doubt NHS will be under increased pressure. The NHS Confederation has said that as a result of the backlog of cases, maintaining social distancing, and staffing, the number of people waiting for treatment could reach 10 million by the end of the year. NHS England has outlined the elective areas that trusts should prioritise, including acute cardiac surgery, open access crisis mental health services, and cancer care.

As trusts begin reintroducing cancelled services, and data from the previous few months becomes available, we can start to assess the impact of this disruption and quantify the effect of the pandemic on elective capacity. These analyses can help trusts predict demand over the coming weeks and months, which will enable them to plan their response and deliver timely elective care.

The Royal College of Surgeons has released guidance for hospitals looking to resume non-urgent elective surgeries. One of its key considerations is an assessment of surgical workload, including patient population need, estimated waiting lists, and available local resources.

We are already aware that there will be long-term effects on cancer care, with thousands of patients’ treatment delayed and thousands of cases undiagnosed due to suspended screening services. Figures from Cancer Research UK have revealed a 2.4 million shortfall in screenings, referrals, and treatment for cancer over the 10-week period from the start of lockdown compared with normal levels of activity.

April figures also show a 27 per cent drop in GP appointments in England compared with the same point in 2019. It is expected that following the lifting of restrictions there will be a spike in demand from patients who have been avoiding going to their GPs. There will undoubtedly have been a drop in primary care service use from high-risk individuals that have been shielding, and a proportion of these people are likely to need emergency care services as a result.

Additionally, when elective services are reintroduced, they may not be operating at the same capacity as before with safety measures in place to reduce the risk of infection. It could, therefore, take longer for trusts to work through the backlog.

At Dr Foster, we are working to help Trusts gain a view of waiting lists and identify patients at risk of breaching the 52-week threshold. Our team will also be modelling the effects of changing the number of outpatients, diagnostic, and theatre appointments across different services. This is important in developing an understanding of how increasing capacity in certain areas could help reduce future demand.

As Hospital Episode Statistics and Referral to Treatment data becomes available, we will also be plotting the performance of trusts in England and benchmarking these at Treatment Function Code level. The waiting list size and profile, and how this has changed from the previous year, can be measured, and trusts will be able to see how they have fared compared with their peers.

Using data to forecast and plan will help trusts minimise the long-term disruption caused by the pandemic on elective care and enable them to prepare to meet patient demand.

 

Dr Foster is analysing data during the COVID-19 pandemic aiming to explore how the increases in demand from COVID-19 patients and changes to supply of elective procedures will have a knock-on effect on volumes of patients in the wider population receiving both routine and urgent care. View our use case for quantifying activity reduction to find out what analysis we can do for your organisation. 

For more information on the work Dr Foster is doing on elective capacity modelling and to get in touch, email Andy.branch@health.telstra.com