Forecasting demand for services in secondary care

The recovery from Covid, combined with a growing and aging population, is placing ever greater pressure on the NHS. In order to plan for this pressure, understanding the drivers of demand in secondary and tertiary care is of paramount importance. Knowing why, and to what extent, demand will grow is essential for appropriate service planning. This knowledge can then be harnessed to generate system-specific predictions of future activity to move from a reactive to a proactive approach to healthcare provision.

Edge Health was commissioned by NHS England and Improvement to produce a 10-year national and system-level forecast of demand for secondary care in Ophthalmology, Cardiology and Musculoskeletal services at sub-specialty level. The outputs of this work would both aid systems in effective future planning, as well as be a springboard for deeper analysis of local provision.

An in-depth literature review of demand drivers associated with the specialties and their main subspecialties provided the basis for collaboration with clinical and analytical experts and operational leads. The hypotheses that emerged regarding the drivers of demand for acute Ophthalmology, Cardiology and MSK care were tested on real-life data obtained through Hospital Episode Statistics. A forecasting model was developed, using machine learning techniques, to take into account projected changes in the identified drivers of demand. This also accounted for historic trends observed in inpatient and outpatient services, which may be attributable to differences in model of care, patient choice and local capacity constraints.

The output was delivered as three publicly available dashboards (one per specialty), to serve as a tool for stakeholders at any stage of provision to understand future volumes, as well as identify where the change opportunities lie, and what planning might be needed to deliver effective care.

The dashboards can be accessed through the following links:

Ophthalmology

Cardiology

Musculoskeletal (Hip and Knee Arthroplasty)