Achieving the 18 week maximum wait Tom Bowen The Balance of Care Group Routledge Health Management Conference 14 September 2006

Content Models of elective patient flow through outpatients, diagnostics and inpatient services Identifying all the knock-ons such as referral rates and decisions to admit Patient choice and the independent sector Generating commissioning plans and implications for hospital activity and capacity

Business Planning Model Bowen & Forte (1997)

What is the 18 week policy? 18 week maximum wait from referral to procedure 6-6-6: could be six week maximum wait for each of outpatients, diagnostics and inpatient services Redesign the whole patient pathway Abolish waiting lists

Modelling Waiting Times - 1

Modelling Waiting Times - 2

Modelling Waiting Times - 3

Modelling Waiting Times - 4

Objectives of the exercise Activity projections and assessment of capability to meet: –18 week maximum wait from referral to procedure –admission avoidance targets –patient choice Identify independent sector role Cover PCT and Trust interests: all levels

Key Findings Resource implications of achieving 18-week maximum wait may not be massive, but they need to be kept in balance Demand for MRI and CT is unclear, and may not be related to this pathway Key role for commissioners to set activity plans and negotiate delivery (even though its all in Payment by Results territory)

References Bowen T and Forte P, 1997, Activity and capacity planning in an acute hospital. In: Cropper S and Forte P, (eds), Enhancing Health Services Management pp (Milton Keynes, Open University Press)