Modelling NHS Data for Accident and Emergency Departments to Reduce Attendances and Costs in Twelve London Trusts. Forecasting – Long denigrated as a waste of time at best and a sin at worst – became an absolute necessity in the course of the seventeenth century for adventuresome entrepreneurs who were willing to take the risk of shaping the future according to their own design. (Bernstein, P. 1996) K0750834 May 2010
Business Forecasting and Modelling
This report will look at the various attendances at Accident and Emergency Departments of a number of NHS Acute Trusts in the London region. As it is understood that the NHS in London has had a great deal of difficulty with accurate reporting of patient figures for the past several years, only those Trusts with accurate and (mostly) complete data will be considered for this report. Furthermore, data from before 2005 is deemed to be so incomplete and of such varying accuracy that it is not included in this report 1. The paper has been commissioned as the wider London NHS needs to understand the trends in patient flows to A&E Departments in order to model new care pathways to lead to a reduction in the cost of overall NHS care in London. Attendances at A&E are up to ten times more expensive that Primary Care appointments (GP, Dentist, Pharmacy, Specialist Clinic, etc) and the abuse of the A&E system is leading to a diminishing available budget for care of the London population. Recently, schemes such as NHS Direct and various Walk In Centres and Polyclinics 2 have all allowed Primary Care Trusts (PCTs) to make savings in their commissioning budgets, and these funds have been used to finance further patient care. This paper models the expected attendance of patients at twelve of the London Trusts and seeks to outline to PCTs the various areas in which attendances are expected to rise up to the end of 2012 (calendar year). 2012 is a very important year for London. The Olympic Games will be held in a number of London venues over the summer of that year, and over 10 million tickets are expected to be sold 3. This will equate to a dramatic rise in the number of people who are staying in the capital many of whom will have no other care option but to use Acute based services such as A&E. People from the UK may be staying hundreds of miles away from their primary care providers, and are unlikely to know which alternative services are available. Foreign visitors will not understand the complex model of primary, secondary (acute) and tertiary care available in the UK and are also likely to use the A&E departments at time of need. Add to this the number of athletes competing and their various delegations, and the strain on the service could become an issue. By modelling the expectations for the next few years, this report will outline various areas in London where there is likely to be an increase in A&E attendance (without allowing for the Olympic Games). This information should be used by PCTs and Acute Trusts to remodel patient pathways to ensure that as many people as possible refer to primary care solutions before seeking A&E assistance. The report concludes that in the case of modelling patient attendances at A&E Departments in the chosen Trusts, both qualitative and quantitative methods should be used in combination to ensure the most accurate models are created.
Commissioning Support for London Confidential Internal Paper (2009) See Lord Darzi Report on Healthcare for London – Darzi, A. (2007) 3 London Committee for the Olympic Games 2010
Business Forecasting and Modelling
The report also suggests that NHS London should use the models to identify areas where A&E attendance is expected to rise, and these should be targeted as the main areas to address when looking to move services away from A&E and into more Primary Care Settings.