The capacity of the local NHS to meet the demand for health services

Many questions were raised and views expressed on the capacity of local health services to meet the growing demand, particularly for emergency care. Specific issues raised by the public include:

• Will the planned increase in beds be sufficient to meet future demand?



• Will there be sufficient numbers of operating theatres, clinics and other services, particularly in view of the long time people have to wait now?



• Are the forecasts for population growth high enough?



• Have the plans allowed for housing developments such as the Hamptons or March and Chatteris?



• Will any services be cut?



• Don't we need two hospitals to cope with the increase in demand for healthcare?



• What happens to the current service over the period of the expansion plan?

To forecast the future demand for services we have analysed a wide range of information drawn from local authorities, the health service and nationally published statistics. The main factors that will influence future demands are:

• Population growth and changes to the health and age profile of the local population. This work has been based on local authority forecasts and data from the National Statistics Office. It includes all the planned housing developments in the area, including the Hampton township. We have also analysed how the age profile of the local population will change. Elderly people make significantly greater demands on health services and must be factored into our forecasts.



• Historical patient activity and local trends for changes in the demand for services. This is particularly important, as the rate of increase in emergency admissions is far higher than the local population growth. By analysing our patient activity we are also able to determine which patients would benefit from the provision of services based in the local health care centres.



• Current patient waiting lists and the NHS Plan targets for reducing waiting times. By 2005 the maximum wait for an outpatient appointment should be three months and six months for an inpatient appointment. To achieve these targets we must increase capacity in the short-term and ensure longer-term plans allow us to maintain this position.



• Changes in technology and medical practice. Advances in equipment, drugs, and medical knowledge mean we are able treat more patients as day cases and reduce the time inpatients need to stay in hospital. The number of operations undertaken as day cases is expected to increase by about 60% by 2010. This change from inpatient to day case surgery requires new types of facilities and improved community support.



• The introduction of new drugs and treatments. The range of conditions that can be treated is increasing all the time. We are also able to successfully treat patients with more severe illnesses and injuries. This means some patients will be staying in hospital for longer and must be allowed for when forecasting the number of beds we will need.



• Planned service developments. Some of the service developments that are planned to take place will mean patients do not have to travel to other hospitals to be treated. This includes services for patients with cancer and cardiac problems.

In 1998 the Secretary for state for Health established a National Beds Inquiry (NBI) to review assumptions about the growth in the volume of general and acute hospital services and their implications for hospital bed numbers. The study looked 10 to 20 years ahead and concluded there was a need to plan bed capacity on a regional basis and generally increase the number of hospital beds.

Subsequently a national formula and model was published for planning future bed requirements. All development plans must demonstrate they are compliant with the NBI model and the government has set targets to increase hospital beds over the five years from 2000 to 2005.

The Health Investment Plan includes the provision of 100 more beds than currently available in the Peterborough and Edith Cavell hospitals. The plan also includes the provision of more operating theatres and outpatient clinics. Some of the additional beds and clinics will be provided in the new local Health Care Centres, providing easier and more local access to services for many patients.

It is very difficult to precisely forecast our future requirements; therefore, the new developments will be designed to be easily adapted as services change and will clearly identify how they can be expanded to provide any additional capacity we may need in the future.

Some parts of the Health Investment Plan will be implemented quicker than others, particularly the local Health Care Centres. These facilities and other developments planned for the next three years will help provide the additional capacity we need before the completion of the new hospital development.

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