Predicting Future Demand How to do you do more with less Shahida Naeem and Elena Karagyozova

Dundee Demographics Dundee has a population of Approx 148,000 Dundee population is expected to increase by approx. 6% by 2039 18% of the population is aged 65 or over Expecting 46% increase in the over 75 population by 2039 Dundee has the 2nd lowest life expectancy in Scotland 37% of Dundee population live in SIMD quintile 1 Dundee has low employment rates and high numbers of benefit claimants

Map of Local Community Planning Partnership Areas in Dundee

IRF work background Dundee was pilot site which commenced in 2009 and was based on data for 2019-10 and 2010-11. The aim was to identify unit costs per individual at GP level and use this to reduce variation, improve pathways and services and make spending more efficient. Allowed us to forecast expenditure and activity and identify unit costs for some services. Identification of High Resource Individuals District and community nursing data was a key gap. Fear and sensitivity about sharing identifiable data across Health and Social Work.

Challenges to Health and Social Care Partnership Increase in demand for services Ageing population Tightening financial environment Difficulties in recruiting staff.

Why it is important to predict future demand? Areas where predicting future demand is beneficial: Assist with discussions about budget levels and identifying cost pressures Assist with the development of longer - term financial plans Assist with the development of strategies for prevention and early intervention to tackle health inequalities Support the assessment of the sustainability and effectiveness of current service models

Locality Based Budgeting Locality based budgeting project was undertaken to develop a methodology to enable Dundee IJB to allocate appropriate resources to each of the eight geographical localities in Dundee The shift to locality budgets would enable the DIJB to plan better on how resources are spent in each locality Understanding how the financial resources are currently spend in the localities in order to develop plans to improve outcomes in the LCPP areas. Knowing which localities to target for prevention and early intervention Knowing which localities to target for different service groups e.g. Learning Disability, Physical Disability and Mental health resources

Locality Based Budgeting Other benefits: Establish the current consumption of budgeted resources to each locality Assist in the analysis of unit costing Assist in identifying gaps in information provision Assist in the development of locality strategies To demonstrate the importance of locality based budgeting

Workshop 1 Aligning the budgets to meet demand and needs of the population

Workshop Question 1 How your organisation approaches the alignment of budgets to meet demand? How are budget allocations made between different geographic and/or service delivery levels? What activity levels information you would use for allocation of budgets or what activity information you would want to be available? What challenges have you faced?

Challenges we have faced Difficulties with defining and obtaining activity levels information( i.e. what system are used to record the information and who to contact in retrieving activity information) The analysis and predictions are as good as the quality of input of data Difficulties obtaining activity level information for Health focussed services. Information not available at the desired disaggregated level. Activity information for certain services not available e.g. community based services.

Redesigning Services Developing locality based budgeting framework is the building block to remodelling services Development of home care tool in predicting future demand is a starting point for remodelling the service. Using data for hospital bed days, Care homes and Home care for the year 2016/17 Assuming no change to Hospital beds and Care Home beds Adding frailty due to old age and more people with complex health needs Data and model used for the review of Home care services and managing resource within the Home care service

Home Care Tool

Workshop 2 Remodelling of Services to meet demand

Workshop Question 2 If you have been involved in remodelling services, Which services have you remodelled How did you go about this What changes were made to the service. If you have not been involved in remodelling services, How would you go about this What changes would you expect to be made

Thank you for attending the workshop. Contact details shahida Thank you for attending the workshop! Contact details shahida.naeem@dundeecity.gcsx.gov.uk elena.karagyozova@dundeecity.gov.uk