Providing embedded COVID-19 planning support to London STPs

 

Starting in late March 2020 as COVID-19 admissions figures began to rise across London, CF deployed dedicated modelling and engagement leads to each London STP. We partnered closely with acute, community, social and primary care leads in each sector to develop, test, and refine dynamic, end-to-end demand and capacity planning tools that balanced local nuances with regional and national guidance. We also crafted governance measures to ensure leaders across each patch remained in close communication and could make holistic, data-informed planning decisions.

 

Key facts

  • Collaborative nature of model development and testing led to ground-breaking tools that aggregated, analysed and offer scenario planning for both acute and out-of-hospital purposes
  • Engagement structure fostered and strengthened relationships between acute, community, social and primary care leaders
  • Outputs aided STPs in their planning efforts during COVID-19 peak planning and continue to influence planning decisions for restoration and recovery

 

Issue: significant uncertainty regarding impact of Covid-19 pandemic on resources and planning

The rapid outbreak of COVID-19 across local, national, and global levels introduced considerable concern regarding how health and care organisations would plan for and support an uptake in care needs. The unique nature and speed of infection rates rendered most existing planning processes irrelevant, incomplete or disjointed. CF offered to re-design and configure a set of unified tools to allow for real-time understanding of trends to improve planning decision-making.

 

Outcome: robust demand and capacity tools with linkage across acute and out-of-hospital settings

CF partnered closely with local and regional leadership to produce a series of tools aligned to core planning needs in terms of staffing and beds. Our embedded team members fostered close relationships with STP-level leadership and modelling teams and ensured that tool development reflected key needs of each sector.

 

Methodology:

Our team combined our experience in clinical operations, analytics and programme management to craft an approach in four stages:

 

  • Conducted assessment of baseline capacity and demand: We pulled SITREP data, conducted discharge audits and collected current capacity information down to the site level for a clear understanding of existing capacity. We also leveraged 5 years of historical activity to understand the business as usual environment.

 

  • Partnered with regional and national leads to determine demand curve assumptions and trends: We incorporated governmental guidance and leveraged international demand curve data to produce custom demand curves to support a dynamic menu of options for local planning teams. We worked closely with local leads to understand COVID-19 spread in their areas and how that impacted scenario planning for future demand.

 

  • Customised impacts of COVID-19 to baseline capacity figures: We worked closely with each local leadership team to determine impact of COVID-19 on clinical pathways, lengths of stay, discharge apportionment and staff-related elements such as sickness.
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Figure: Non-bedded dashboard for community capacity and demand forecasting
  • Coalesced key stakeholders to ensure alignment in planning assumptions, outputs and decisions: Upon refinement of the model, we engaged leaders and modellers across the various care settings to ensure proper understanding of the functionality and to demonstrate the value of the tool on local and system-wide levels. We completed an extensive handover process with user guides and video tutorials to ensure new leaders and stakeholders would be able to ramp up quickly to leverage these tools.

 

Results: strengthened position in planning efforts with enhanced tools and engagement structures

Our efforts have equipped STPs and London-wide leadership teams with tools and structures that will support ongoing planning capabilities, especially as assumptions around forecasted activity continue to vary considerably as the country copes with the ever-changing prevalence of COVID-19. Systems have spoken very positively about their experience in the development and usage of the tools, and we are see an increasing usage of the tools each day as teams begin to embed these tools into planning decisions.