Effective service planning relies on robust estimates of future healthcare need. Standard NHS planning processes use population projections, such as those produced by the Office of National Statistics, along with the strong, non-linear relationship between age and healthcare use to estimate the impact of population change on healthcare demand. This approach, however, makes a critical assumption, that reduces its reliability, and obscures the potential to moderate future demand. It assumes that levels of health at a given age, are fixed and do not change over time. Data suggest otherwise. The age-specific incidence and prevalence of many conditions is known to vary in time, and trends in life expectancy and disability free life expectancy do not move in tandem. In some periods, we see an expansion of morbidity, with individuals living an increasing proportion of their life in poor health. At other times we see a compression of morbidity. This project seeks to incorporate this knowledge into planning processes, improving the quality of our demand forecasts, and opening up the debate about the value of primary and secondary prevention programmes to offset future demand.
We anticipate two key deliverables:
- an online tool that ICB analysts can use to estimate future demand for a specific healthcare service. The tool will be pre-populated with ICB-specific age/sex utilisation rates for many core healthcare services, but the tool will also allow users to import these rates for other local services. Users will be asked to select one or more of the ONS population projections (principal or variant) and indicate an age-specific health status trajectory. The model will produce estimates of future demand.
- A report setting out the competing theories of ageing, the markers of health-status than are available and the methods that might be used to incorporate this information into healthcare planning assumptions. The report will contain specific advice and guidance for analysts using the tool described above.