Demand forecasting

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Demand forecasting
Nigel Walker - Better Commissioning Network
With acknowledgement and thanks to the Institute
of Public Care for some slides
Health Service Journal Conference London 6th July
2006
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Why Demand Forecasting ?
Need for twenty year commissioning
strategies More clarity about what is required
from a user perspective Demography brings its own
challenges Expectations raised Recognise
opportunities Greater integration required but
of what? Need for sound dis-investment and
re-investment plans
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What is demand forecasting ?

• Assessing the type and quantity of services
  required far enough in advance to ensure good
  investment decisions
• Properly considered timescales
• Bringing the right service levels and quality to
  the right people in the manner they wish them at
  the right time
• Most efficient delivery
• Most cost-effective price
• It will also assist in equitable rationing if
  this is required

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The Four Dimensions of Demand Forecasting
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The Four Dimensions of Demand Forecasting
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Population

• Variable use of population data by authorities,
  but analysis tends to be in generalisations
• Can provide information about general trends,
  particular issues or with service data something
  about strike rate
• Can enable reasonable look ahead for planning
  purposes
• Data tends to become less useful as the next
  census draws nearer
• Is there a role for Office of National Statistics
  ?

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Shire in 1911
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Shire 2001
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Shire 2001 to national comparison
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Shire data

• Shire predominantly a rural county
• 40 of the population lives in very rural areas
  or in settlements of less than 2,000 people.
• Of the remaining 60 half live in the larger
  villages and smaller towns with populations
  between 2,000 and 10,000 and the other half in
  the nine larger settlements of over 10,000 people
  ( this compares to over 80 in England and Wales
  living in settlements of this size).
• The distribution of older people in the County
  reflects this. 25 of people aged 75 and over
  living in areas with a population density of
  fewer than one person per hectare and 14 living
  in settlements of fewer than 1,500 people.

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Shire data
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Potential impact on Shire in twenty years

• Extrapolating the population trends could mean
• 6,660 additional assessments of older people per
  annum.
• Another 18,000 hours of domiciliary care per
  annum.
• An additional 2,220 places in residential and
  nursing home care.
• 2,715 people aged over 75 providing more than 50
  hours care per week to another person.

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The Four Dimensions of Demand Forecasting
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Surveying anticipated futures

• How do changing needs and perceptions translate
  to new services the unexperienced cannot always
  be expressed, only dreamed of
• National data rarely built on locally
• What we want is not what we plan for others
• Known unknowns - increased wealth and health,
  pensions black hole, new or different medical
  interventions
• A lack of ways to meaningfully engage with
  communities

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The Four Dimensions of Demand Forecasting
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Service User Profiling

• Need to map existing provision to see if it
  matches current usage
• Information about provision is not the same as
  knowing demand
• Ways of recording data and sharing across
  boundaries is not well developed
• Analysis skills often poor in both Health and
  Social Care systems
• What is the way in which we can best understand
  public reactions to new professional thinking (eg
  outcomes, telecare)
• Can we describe how people use services and then
  as questions at critical key moments?
• Role of Public Health and PH Observatories

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The Four Dimensions of Demand Forecasting
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Conditional or perverse demand

• Are services outcome or output driven?
• Example meals service, provision of equipment.
• Are there needs being presented where targeted
  interventions could improve outcomes but where
  this is not occurring?
• Example Alternatives to res. care, dehydration.
• Is the intensity of the service provided
  sufficient to achieve the outcomes desired?
• Example stroke rehabilitation, continence
  services.
• Are service delivered at the right time to have
  the maximum impact?
• Example Support to carers of people with
  dementia.

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Next steps

• There is a need for a generic tool for
  extrapolating census data that could be of
  benefit to LAs and PCTs in helping to establish
  a baseline for demand.
• Clear establishment of local data sets that focus
  on information at the interface of health, social
  care and housing and that enable agencies to much
  more effectively target key populations.
• For those target populations establish a much
  clearer idea of cause / effect and cost /
  benefit.
• Use national surveys to much more effectively
  develop local consultation exercises which build
  on rather than replicate that survey data.
• Assist in building skills and expertise in demand
  forecasting to help commissioners. Is this a
  regional rather than local role?

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Contact details
Nigel Walker, Network Lead Tel- 07795
266936 nigel.walker_at_csip.cat.org.uk www.cat.csi
p.org.uk/commissioningebook www.changeagentteam.o
rg.uk www.integratedcare.gov.uk