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Mental health services and Covid-19

Understanding the impact on capacity and demand

Mental health services need now to be planning their capacity requirements for the coming year – inpatient beds, community teams, referrals and caseloads. All of this has been made both more important, and more difficult, by the ongoing Covid-19 pandemic. We know that services are seeing:

  • increases in demand arising directly from the outbreak, for example presentations related to depression, anxiety, or (in the longer-term) PTSD.
  • increases in demand indirectly caused by the outbreak, for example acute presentations of psychosis related to missed medication.
  • reductions in demand related to the outbreak, for example continuing reductions in presentations to A&E, or to health services more generally.
  • changes in supply responses, for example greater use of telemedicine, but also higher levels of staff sickness/absence.
  • opportunities arising from intended national prioritisation of mental health services as part of recovery from Covid-19.

How do you build all of this into a new capacity and demand plan for your mental health services?

Niche can work with you to model all the various potential scenarios – and to plan robustly for what you should do next. We’ll help you to take account of:

  • all of your different patient groups – by age, sex, diagnosis, service offer
  • all of the flow metrics: patterns of referral, patterns of care and treatment, lengths of episodes, caseloads and staff utilisation
  • your options for modes of working: telephone, video-call, direct face-to-face
  • your local experience of the pandemic – where you’re seeing more or less demand than expected. Local experiences are very different, and simply using national data is much less useful
  • How services can be configured to offer the best fit between demand and capacity – and feasible buffers for periods of peak demand
  • Short-term changes to make now – and longer-term changes which you should begin to plan for

Niche have worked on many mental health modelling projects across the country. We can therefore bring both technical expertise (using discrete event simulation) and a wealth of informal knowledge of how other services have been addressing these questions.

Our simulation modelling will ensure that the full range of variation in your real patient flows is captured, and that options for the future service model allow you to understand the risks and benefits of each approach.

Historic analysis

Our work would begin with a series of analyses of historical caseloads and occupied bed numbers. To test for the effect of Covid-19, we will set control limits based on activity to the end of February 2020. If any cohort (by age, diagnosis etc) persistently breaches the control limits after February 2020, we can estimate the likely “Covid effect” and project forward its implications.

Planning the future

In looking to the future, and planning for service changes, we will work with you, and with nationally available evidence both to identify a full list of effects, and to estimate:

  • The maximum effect each factor could be expected to have.
  • The minimum effect each factor could be expected to have.
  • Our best collective estimate as to the likeliest effect.

We will develop the models in such a way as to permit rapid re-estimation of their effects as new data emerges, as it undoubtedly will over coming months. 

Timescales

Given rapid access to pseudonymised service data, we can turn round historic analyses very quickly: a “first cut” within two weeks of data reaching us, and a full understanding within 4-6 weeks. Planning future scenarios and then be completed in another four weeks.

Fees

We offer very competitive rates for our work. Depending on the detail of your project, full historic analysis can be undertaken for as little as £10,000; and a full modelling project seldom costs more than £30,000.

           

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