Introduction to basic concepts of

Capacity and Demand

26 June 2015Alison CrawfordNHS Improving

Summary

• Why do we use capacity and demand planning• Some relevent topics in mental health• Some definitions• Dispelling some myths using a model• An example of a mental health service which was

redesigned using capacity and demand planning• Questions

• Useful links

Why do capacity and demand planning?

https://www.youtube.com/watch?v=8NPzLBSBzPI

Reduce errors

Patie

nt ex

perie

nce

Reduce costs

Capacity and demand in Mental Health

What is demand, capacity, activity and backlog?

• Demand: All the requests / referrals coming in from all sources and how many resources they need (equipment time, staff time, room time) to be dealt with.

• Capacity: Resources available to do work. For example, the number of pieces of equipment available multiplied by the hours of staff time available to run it.

• Activity: All the work done. This does not necessarily reflect capacity or demand on a day to day basis. The activity or the work done on a Monday may be result of some of Monday's demand (i.e. emergency) and the previous week's demand. The capacity is the capacity available on the Monday but activity is often less than available capacity (ideally 80 per cent of available capacity)

• Backlog: Previous demand that has not yet been dealt with, showing itself as a backlog of work or a waiting list. It's logical: if you don't deal with today's demand today, there will be a backlog for tomorrow.

http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/demand_and_capacity_-_a_comprehensive_guide.html#sthash.1mRLTRUu.dpuf

Some myths about capacity and demand

1. Waiting lists are caused by too much demand and not enough staff

2. The average(mean) number of patients can help us predict the demand on services

3. Prioritising urgent patients helps people get seen faster

http://www.internetgroup.ca/clientnet_new/docs/CIM12_3_Silvester.pdf

• Case study to demonstrate the principles in the paper ‘Reducing waiting times in the NHS: is lack of capacity the problem?’ Martin Lee , Kate Silvester 2004

Principal Community Pathways - NORTHUMBERLAND TYNE AND WEAR NHS FOUNDATION TRUST

The problem• ‘why do I have to take a day off work each month for

someone to come to my house for less than an hour and drink my coffee?’.

• 30-40% of inpatients that need not have been admittedThe solution• New model of working• Untried• Developed with patients and carers• Review and retest assumptions

• Improve quality for service users through the implementation of new, evidence-based care pathways.

• Develop highly efficient, new ways of working that will increase the time staff spend providing patient care and will allow the new pathways to be implemented within existing community resource limits.

• Reduce reliance on inpatient beds and so enable the Trust to operate fewer wards and sites that will generate required financial savings.