Case Study

Demand and Capacity Planning Stockport PCT in the UK wanted to understand the effect of a change in demand on waiting times. The initial analysis centered on the Orthopaedic Assessment Service (OAS). Using Scenario Generator, the PCT modelled the contracted flow of activity to determine if it was feasible for all patients to be seen within a 4 week period.

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“This has helped us to understand current demand and flow, and will enable us to have a more meaningful dialog with our providers about future contracting arrangements” Lisa Maginnis, Stockport PCT

Understanding Demand Capacity and Waiting Times 

Stockport PCT experienced a rise in GP Referrals to Secondary Care from April 2008 which coincided with the introduction of Patient Choice in the booking system. Previously, if a G.P. made a referral to Trauma and Orthopaedics, General Surgery, Dermatology, Urology or Gynecology the booking system would direct the referral to the local service, In April 2008, patients could choose which hospital they were referred to and referrals to local services fell. In the first 6 months of 2008/2009

local services accounted for just 23% of total referrals, compared with 33% for the same period the previous year. The PCT wanted to understand the effect of this change in demand on referral waiting times. The initial analysis centered on the Orthopaedic Assessment Service (OAS). Using Scenario Generator, the PCT modelled the expected flow of activity to determine if it was feasible for all patients to be seen within a 4 week period.

Provide the evidence for change

The results showed that, at the contracted levels of demand and capacity, 97% of patients could be seen within 28 days and 100%

of patients could be seen within 37 days.

Approach The PCT created a pathway to simulate contracted levels of activity at each stage of the patient journey, assuming waiting times of: • 24 hours from referral to triage • A minimum of 3 days from triage to the first appointment, with a maximum length of 14 days, but typically 7 days (to give patient reasonable notice to attend) • 18 days from the first appointment to follow up with a window factored in to allow for assumed diagnostics

Benefits Simulation and modelling provided the PCT with a means of understanding the flow of patients from referral through to discharge, and the expected time taken during the process. Future modelling scenarios include testing the impact on waiting times if there is further demand on services, if the service is redesigned, or if there are changes to the capacity available in the system. Simulation will also be used to examine other pathways.

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For more information on how Scenario Generator can help your trust make more informed strategic decisions about the future of its’ healthcare system please contact our support team.