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
 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
 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
The Four Dimensions of Demand Forecasting
Defines need based on the
assumption that people
Defines need based on
know what they want now
the assumption that the
and in the future and that
presence of certain Population
Surveys of their articulation of need is
characteristics or needs
anticipated not influenced by any
conditions is a reliable assessment or
future need potential limitations of
indicator of demand for population
supply.
services. profiling

Service user Analysis of Redefines need through

Defines need based on the conditional examining the key factors
current take up of services to profiling
demand driving demand, and the
meet identifiable demand potentiality and amenability
multiplied by changes in the of that perceived demand, to
population change.
 The Four Dimensions of Demand Forecasting

Defines need based on the

assumption that the
presence of certain Population
characteristics or conditions needs
is a reliable indicator of assessment or
demand for services. population
profiling
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 ?
Shire in 1911
Shire 2001
Shire 2001 to national comparison
 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.
Shire data

Table 1. Estimated number of people aged 80 and over

with a dementia:

2001 2011 2028

5016 6080 8870

Table 2. Provision of care by older people

All people People aged 75-84 People aged 85+

providing 50 or providing 50 or providing 50 or more
more hours care more hours care hours care per week
per week per week

13,107 1,532 278

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.
The Four Dimensions of Demand Forecasting

Defines need based on the

assumption that people
know what they want now
and in the future and that
Surveys of their articulation of need is
anticipated not influenced by any
future need potential limitations of
supply.
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
 The Four Dimensions of Demand Forecasting

Defines need based on the Service user

current take up of services to profiling
meet identifiable demand
multiplied by changes in the
population
 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
The Four Dimensions of Demand Forecasting

Analysis of Redefines need through

conditional examining the key factors
demand driving demand, and the
potentiality and amenability
of that perceived demand, to
change.
 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.
 Next steps
• There is a need for a generic tool for extrapolating census data
that could be of benefit to LA’s 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?
Contact details

Nigel Walker, Network Lead

Tel:- 07795 266936

nigel.walker@csip.cat.org.uk

www.cat.csip.org.uk/commissioningebook
www.changeagentteam.org.uk
www.integratedcare.gov.uk