Understanding demand in the NHS - a personalised approach

What if health and care services could truly meet the needs, demands and preferences of people and communities? What if, we were able to understand the particular needs of cohorts of people within our populations to design better, more responsive, and more cost-effective services?

What do you most like about your weekly online grocery shop, or your favourite department store? Likely, that it remembers your preferences, predicts when you might need something and allows you to customise your engagement with the service. How did they get there? They understood you. What about health and social care? We too, can enhance our understanding of patients and their needs and preferences in a way that allows us design services that are timely, effective and deliver value for tax-payer money.

Health and social care organisations and systems are increasingly recognising the need to transform the way they use data and analytics to improve performance and benefit those receiving, delivering, and planning services

The coronavirus pandemic pulled the need for change into sharp focus. Health and care services were required to quickly implement targeted and tailored interventions to a range of sub-populations with varied – and often competing – needs. This relied on using data, better analysis, and better decision-making to quickly test and implement change. So what did we learn? We used data and insights that we already had to unlock a range of possibilities. We also learned that organisations and staff within them didn’t need to be constrained by professional boundaries and could integrate more seamlessly than previously perceived pre-pandemic.

As we settle into life post-pandemic and new structures across health and social care, a major challenge for ICBs and their component parts is understanding demand for services. We are faced with what seems like ever growing demand, and a dwindling workforce. Personalising demand analysis means that we apply a more holistic outlook at what is at the heart of growing consumption of health and care services. We collaborated with a place-based health and care partnership to explore these issues and found what industry professionals have been expressing for years. Only part of the interactions with health and care services, whether for GP appointments, ED attendances, social care crisis calls - relate to condition profiles. Most relates to socioeconomic, genetic, and environmental circumstances… also known as wider determinants of health (or ‘real life!’) and we cannot neglect the demand for services that is driven internally through fragmented service design, arbitrary criteria, and endless loops of referrals and handovers.

In the example of an Intermediate Care system in the UK, we found that 11,000 people or 3.5% of the general population used intermediate care over 2 years. 556 of these people (the ‘vital few’) were responsible for 20% of all work activity in the system. And 84 people (0.8% of the adults who used intermediate care) represented an annual spend of £862,000 (nearly 5% of the annual budget). The cause of this disproportionate spend in this system was disjointed commissioning, lack of investment in preventative interventions and an over-focus on acute care. Ultimately – the needs of the patients and people in the system were not understood, and therefore not met. For people in this system, they needed services that would support them to age well, navigate changes in their circumstances, advocate for their preferences and help them receive support close to home – none of which appeared in any of the SLAs, commissioning intentions or dashboard measurements and ‘KPIs.’

So, what can we do now? We have the benefit in health and social care of long-term relationships with people and their families which means we can develop an intimate understanding of their lives and circumstances – shifting from episodic interactions to understanding to patterns over time. Understanding trends within cohorts of people allows us to work with the relevant people, communities and health and care professionals to design services that meet the true needs of adults.

At BearingPoint, our Healthcare Team has extensive industry experience and are able to guide organisations through a collaborative improvement process, to iteratively solve complex challenges in an inclusive and sustainable way. Using a data-driven approach to enhance insights, we identify opportunities for improvement, rapidly test solutions and meaningfully measure the impact of the change – all the while considering what makes the most difference to people receiving services and support.

Contact us today to start your journey.