Demand Forecast Summary Tool - GOV.UK
DemandForecastSummaryToolDemandDemand forecastforecast summary tooltool
Contact us via email strategydevelopment@monitor.gov.ukPage 2What does the Demand Forecast Summary tool do?The tool These pages Provides a method of summarisingyour FT’s forecast activity levels overthe next five yearsUses your assumptions on howdemand for care at the trust will beaffected by:- demographic changes- non-demographic changes- commissioners’ plans- trust strategic changes Demand ForecastSummary tool indetail Offer guidance on factorsaffecting demand that canbe considered whenmaking forecasts Provide data sources youcan use to informassumptions Explain how the tool worksThe pages and model do not Provide monthly forecasts Include any dataProvides a method of summarising forecast annual activity changes for your top specialties (orother patient segmentation) and the whole FT for the next five yearsBuilds on last year’s activity as a percentage of demographic dataIncludes a ‘non-demographic change’ sheet to allow for different types of change, eg diagnosisrates or prevalence rates or changes in other trusts’ provisionIncludes a ‘commissioners’ plans’ sheet and allows for scenarios based on ‘percentage of targetchange achieved’ in commissioners’ plansIncludes a ‘trust strategic initiatives’ sheet to input assumptions about the impact of strategicchangesAllows user to save different scenarios PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 3Forecasting demand/activity for the FTIntroductionBy using the Excel-based Demand Forecast Summary tool your FT canpredict demand by service line, patient age and point of delivery. You candownload the tool here.Always read this document alongside the Strategy Development Toolkit,especially the Forecast chapter. If you use a different Excel tool (or othersoftware) to summarise your demand forecast you may still find this documentuseful, but your key document will be the Strategy Development Toolkit’sForecast chapter.This document offers guidance on how to forecast demand for clinical services.It includes factors you may want to consider, data sources you could use toinform your assumptions plus an explanation of the Excel tool’s functionality anddetails of the required inputs.The Excel tool uses current volumes and applies changes to them based onyour assumptions about factors influencing demand for care. These factors aregrouped in the tool as shown on the next page.The tool allows you to save different sets of inputs as a named scenario. Thismeans you can easily return to, and compare, different assumptions. PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 4The Demand Forecast Summary model comprises three main partsCurrent dataDemographic growthOther changes Inputs Historical data: last year’s activity byPOD, age, and specialtyDemographic growth: predictedgrowth for your FT’s catchmentpopulationThree input sheets for other changesSummary calculationsEngineOutput summary tabFull output tab Summary calculations: calculatesforecast activity changes from inputsheets Output summary tab: threesummaries of five-year activityforecasts are automatically produced:specialty and PODGranular outputs can be used tocreate summaries using acombination of POD, age and servicelineImpact of assumptions tab shows thechange due to each assumptionImpact ofassumptions Outputs PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 5Separate input sheet in the toolSummary of factors affecting an FT’s future activity12Demographic changesNondemographicchangesDisease prevalencea changes (on top ofdemographic change)Growth in populationChange in age profileRisk factors; epidemiologyAdherence to best practice care pathwaysTechnology changes and clinical innovationsDiagnosis and treatmentb rate changes (including viatechnology changes)Factorsthat affectfuturedemandand trustactivityvolumesConceptual considerationNational diagnosis/treatment policy changesIncreased patient awarenessComplementary provider (eg GP) changesSupply induced demand changesc Other changes3Service changes at neighbouring providersChanges in referrers’ choicesNational commissioning changesCommissioners’ plansLocal commissioning changes4Changes due to FT’s strategic initiativesThis input sheet is intended to be used after yourstrategy has been agreed, to understand impactof planned strategic changes on the forecastbase line Catch-up on waiting lists/existing backlog –one-off effectThis is a one-off effect that needs to be added onlyfor the year(s) where catch-up is expected PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 6Sources of assumptions for demand forecast modelling1DemographicchangesAge-specific2a diseaseprevalenceDiagnosis andtreatment ratechanges2b(including viatechnologychanges)2c Other changes3Commissioners’plansSources of forecasting assumptions Office for National Statistics (ONS) age/sex population forecasts To be aligned with commissioners – clinical commissioning groups (CCGs) and NHS England(NHSE) Public Health England; director of public healthFT’s proprietary data (eg analysis of patient administration systems (PAS)Health and social care information (historical hospital episode statistics (HES)Discussions with clinicians for observed changes in local and lifestyle factors Changes at neighbouring trusts (eg growing/reducing services, or Monitor Contingency PlanningTeam)Changes in referrers’ choices: analysis of GP and secondary referral patterns Discussions with the FT’s medical, nursing and other clinical specialistsGuidance/standards from medical Royal Colleges and other national bodiesAcademic literatureReviews of practice at leading-edge healthcare providers in England and abroadMost recent device/drug/treatment approvals from National Institute for Health and Care ExcellenceCentral government policy/Department of Health; NHS EnglandRegulators – Monitor, Care Quality Commission (CQC)Think tanks, eg Nuffield Trust, King’s FundComplementary provider changes: discussions with commissioners and providersSupply-induced demand: FT experience with local population/customer surveys; cliniciandiscussions; academic researchCommissioner plans (CCGs and NHSE specialised commissioners)Adherence to best practice care pathways/national guidance (as described under 2b above)Local authority plans (eg Better Care Fund)Commissioner-led regional reconfiguration (CCG or NHSE specialised commissioning) PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 7Choosing the level of detail to use in modelling activityYou can forecast activity at many levels – at the trust level, at point of delivery,specialty or health-related group (HRG) level. You can segregate demand andactivity in different ways – for example, by patient group rather than treatmentspecialty or treatment type (and technology used in the treatment).The Demand Forecast Summary tool assumes you may want to predictactivity by treatment specialty or HRG for high-volume work, and then include a‘remaining activity’ line. Forecasting all activity at specialty or HRG level will probably be too detailedfor strategic decisions. Forecasting all activity at point of delivery will probably be too broad andprevent you identifying different factors driving demand.You will need to choose which HRGs or specialties (or other aspects of youractivity data) you want to forecast as separate lines and which you include inthe ‘remaining activity’ line. Factors you could consider include: Expected rate of demand change in this HRG/speciality/patient group/etc: ifyou expect demand to change in an unusual way compared to averagechanges for the trust, you will want to forecast it separately Current share of trust activity or income: you may want to examine biggerspecialties separately Strategic questions about service change: you may want to examine servicessubject to focused strategic review separately PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 8Entering the user’s core model choices into the toolEnter your chosen specialties in the first page of the model, as shown.You will need to choose which year to start in by entering the lastcompleted financial year (ie the last year for which you have data).Summarises the different types ofcells and what changes, if any,users should make to each typeCore model choices are inputtedhere:1. Last completed financial year (ieyear of base data)2. List of specialties to be forecast3. Option to include assumption onthe percentage of commissioners’demand reduction initiatives thatwill be metThis tab provides information onhow to use the tool. Users shouldread all the information on thissheet PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 9Entering current activity levelsOnce you have chosen the level at which to model activity, you will need toenter the current activity volumes at this level by point of delivery (POD) and bypatient age. The age groups used are 0-18, 19-24, 25-34, 35-44, 45-54, 55-64,65-74, 75-84, and 85 .Data requirement 1:Latest financial year’svolume for each specialty,by point of delivery (POD)and ageIn the example below, the trust has chosen to use paediatrics and obstetrics asindividual specialties.All the orange cells needto be filled in with lastyear’s volumes for eachspecialty PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 10Entering demographic changeNext, input changes in the population to which you provide services.For data on forecast population changes, use ONS or other projections for thearea where most of your patients live.Data requirement 2:Demographic forecasts foryour geographic pool forthe next 5 yearsIf your catchment includes more than one geographic area, you should use acombined forecast based on where your patients come from. For example, if30% come from area 1 and 70% from area 2 – and you expect this split to holdtrue in the future – within the Excel cells you would use a weighted averagecalculation. For example: (Forecast population in 2014/15 in area one)*(30%) (Forecast population in 2014/15 in area two)*(70%) to give you the 2014/15figure.All the orange cells needto be filled in withpredictions for changes inpopulation, by age group,for the next 5 yearsThe grey cells with orangetext calculate thepercentage change basedon the absolute numbersentered above. Youshould not edit these cells. PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 11Entering non-demographic changeThe number of people you treat may alter due to changes in disease prevalencerates, diagnosis and treatment rates, referral patterns or services atneighbouring providers. The category of ‘other changes’ in effect describes achange in the share of patients that you treat, compared to other providers.Data requirement 3:Assumptions on any nondemographic annualchanges in activity forindividual specialtiesYou would also include the impact of trust-led initiatives already underway thatwill affect future demand.This tab requires you to enter the combined effect of all these factors.All the orange cells needto be filled in withpredictions for changes inactivity for the next fiveyearsSelectpercentageor absolutechangehereThe grey cells with orangetext calculate thepercentage change ornumber change by PODbased on the input in thedata entered above. Youshould not edit these cells. PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 12You can enter the change as a percentage or as a change in the absolutenumber of cases. Setting a percentage change may be easier when you are not aware ofspecific changes at sub-specialty level. Entering the change in the number of cases may be easier if you want totake into account changes at sub-specialty level; for example, you mayexpect an increase in cardiovascular stenting and are using ‘cardiology’ asyour specialty. You would add up the changes in the number of cases at eachrelevant sub-specialty then enter the change in the number of cases for thespecialty overall, setting the input to ‘Change in number of cases’.You can use many sources to inform your view of how non-demographic factorswill change demand for care. Ultimately, you will need to agree with clinicalleaders how you interpret data and others’ forecasts, and decide how youexpect demand to change at your trust. One good check once you agree this isto compare the forecast change to the rate of change you have seen over thelast few years. PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 13Entering commissioner plansChanges in local and national commissioners’ plans can affect your FT’s activitylevel.The model assumes that commissioners’ plans will attempt to decrease activity,but you can enter a negative number if your commissioner is planning toincrease activity for a service. For example, this could be the case for shiftingcare into community settings.Data requirement 4:Commissioner demandmanagement plans andassumptions onpercentage of eachinitiative achievedYou can enter changes overall, or for individual specialties by POD.For changes to individual services, you can specify the percentage of the targetchange forecast to be achieved. This will be useful if you want to test differentscenarios, as you can enter the assumption from commissioners’ plans onceand then change the percentage of the target achieved to compare possibleoutcomes.Overall change for all specialties by yearSpecialty specific activity change (reductionshown as positive number) by year, by PODEnter an assumption on what percentage ofcommissioners’ target demand change will beachieved PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 14Entering changes due to new trust strategic initiativesThe final input tab is where you set the impact of your trust’s new strategicinitiatives. You should leave this input sheet blank when you calculate thebaseline demand forecast as part of the Forecast stage. You should then returnto the model to understand the impact that all your agreed strategic changeshave on your activity (and hence income, costs and margin – through separatemodelling).Data requirement 5:Details of new strategicinitiativesAgain, these forecast changes can be entered as percentage changes or aschanges in the number of cases. You can also enter an overall change inactivity levels.Input overall change year on year PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 15Saving scenariosThe tool allows you to save a set of inputs and the associated outputs (ie ascenario). Once you have entered all the inputs for one scenario, you can clickthe button shown below. The model will ask if you are sure you want to save thescenario, then prompt you to enter a scenario name. That scenario will besaved in a new file in the same folder as the model.The new file will show three tabs – ‘Summary inputs’, ‘Summary outputs’, and‘Impact of assumptions’.Click here to save yourscenario when you areready PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 16Editing scenariosIn general, you will not want to edit scenarios. They are a completed piece ofwork enabling you to compare the impact of different assumptions.However, you may want to edit a scenario – for example, if you have entered anassumption incorrectly. In this case, you should click the button as shown below.This will restore the full model functionality to your scenario and you will be ableto edit it exactly as before.Click here if you want toedit your scenario PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 17How to use the modelFull outputThis table shows forecast activity by specialty, POD and patient age. You canplace outputs into a pivot table to create the output summaries that your FTrequires.SpecialtyTest Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1Test Spec 1PODAge Band 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19Outpatien0-18120 122.3139 122.5666 123.5497 123.3719 123.1363Outpatien19-24140 143.2738 144.1326 146.1505 146.7832 147.3273160 162.8308 162.9179 163.8462 163.2454 162.5819Outpatien25-34Outpatien35-44180 175.5465 168.1428 157.5809 145.7421 134.1461Outpatien45-54200 200.0315 196.696 192.5173 186.6251 180.7931Outpatien55-64220 226.3555 228.8945 233.9012 236.6521 239.2059Outpatien65-74240 248.2897 252.3917 259.9257 264.9218 269.6488Outpatien75-84260 264.4053 264.3556 265.5577 264.2896 262.9305Outpatien85 280 270.6146 256.6837 236.5187 214.5278 193.0147Elective 0-18150 169.8731 170.224 171.5893 171.3422 171.0149Elective 19-24170 193.2976 194.4562 197.1785 198.0319 198.7659Elective 25-34190 214.837 214.9518 216.1764 215.3836 214.508Elective 35-44210 227.5505 217.9534 204.2626 188.9165 173.8852Elective 45-54230 255.5848 251.3229 245.9836 238.4548 231.0028Elective 55-64250 285.7901 288.9956 295.3168 298.7898 302.0139Elective 65-74270 310.3487 315.4759 324.8928 331.1375 337.0456Elective 75-84290 327.6676 327.6059 329.0955 327.5238 325.8392Elective 85 310 332.8845 315.748 290.9428 263.8914 237.4279 PreviousForecastactivity foreach year bypatient age,POD, andspecialtyNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 18Summary outputThese tables contain the forecast aggregated by specialties and PODForecastactivity foreach year byspecialtyForecastactivity foreach year byPOD PreviousNext Demand forecast summary tool
Contact us via email strategydevelopment@monitor.gov.ukPage 19Impact of assumptionsThese tables show the impact of the four categories of drivers of change onthe five-year demand forecastSelect the specialty orPOD you want to see inthe graph PreviousDemand forecast summary toolGraph shows the effectof the four categories ofdrivers of change on theselected specialty orPOD
ea ea a Forecasting demand/activity for the FT Introduction By using the Excel -based Demand Forecast Summary tool your FT can predict demand by File Size: 1MBPage Count: 19Explore further7 Best Sales Forecasting Methods to Predict your Revenue .blog.klenty.comImportance of accurate forecasting for resource management .dsdweb.co.ukAdvanced forecasting techniques - NHS Englandwww.england.nhs.ukHow To Forecast In Excel: Analyzing And Predicting The Futurespreadsheeto.comPlanning, assuring and delivering service change for patientswww.england.nhs.ukRecommended to you b
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