Capacity planning – modelling unplanned admissions in the UK NHS

Presents a model designed to explore the stochastic nature of non‐elective admissions. Using historic data taken from the patient administration system of a large district general hospital situated in Plymouth, England, the model shows the importance of understanding the profile of risk behind non‐elective planning. This understanding may lead to more robust waiting times planning, promoting open dialogue between the trust and its commissioners on how such risk is managed. It also allows for the setting of clear goals for admission avoidance and early discharge schemes. At a strategic level, an understanding of the stochastic nature of non‐elective admissions raises questions about the potential cost of entirely ring‐fencing elective workload, disallowing the sharing of beds in times of peak demand. As a specific policy manifestation of this proposed ring‐fencing, the development of “diagnostic and treatment centres” may need to be more pragmatic than the “purist” view being expressed in the NHS Plan if overall efficiency is not to be significantly reduced.