Case Study

Discharge to Assess - Demand & Capacity Modelling

Service Area
Clarity Insights
Buckinghamshire CCG
Delivered data modelling for D2A covering in-hospital demand analysis and out-of-hospital capacity, drawing on demographic insights to produce reconciled reporting, supporting a change in investment to manage capacity, extensive analysis of demand and change in demand over time, and modelling forecasting scenarios. Re-modelled data collection points to ensure teams operate more efficiently.


During its response to the Covid-19 pandemic, the Buckinghamshire system commissioned a D2A pathway to help relieve pressure on acute hospital beds. Funding has been previously available from several sources to support accelerated implementation, including initial D2A support and Covid-19components. However, it was anticipated that these funding sources would cease, and the system would need to continue to support D2A from existing funding envelopes.

With that in mind, in 2021 the system sought support from Clarity to establish and manage a D2A demand and capacity model for the system, to inform the efficient management of service pathways and ongoing service planning.

Initial problems the system and Clarity team faced included:

  • Quality issues in key datasets. Data had been captured to meet immediate service priorities rather than recording trends. Datasets did not follow the pathway or outcomes desired to enact change and were limited in helping to understand true demand or address capacity concerns.
  • Data flow along pathways was severely limited. Patient details were re-recorded in each service, often without a clear record of the first patient touchpoint – limiting the ability to link flows between elements of the discharge service.


Clarity systematically linked relevant datasets and reconfigured collection points to follow the pathway, working with Clinical/Operational leads to ensure ownership and to embed an appreciation of the importance of data architecture to fully support the service.

Informed by an understanding of how primary and secondary care pathways and services operate and interlink, the Clarity team led by Alex Thomas quickly identified the key areas of each pathway, links and gaps between data sources and the key metrics that would form the basis of reporting to give a clear and accurate view of discharge demand and capacity.

Proactive and continuous engagement enabled the system to move quicker in identifying the key answers to each component and to deliver change through intelligent data design, meaning that the output could be viewed and understood through many lenses.


  • Acute dashboard for pathways 0-1 – providing an overview of the impact of D2A on LoS; occupied bed days; where patients present from; presenting conditions.
  • Pathway 1 – redesigned Home First data collection processes to follow the pathway and meet the needs of the Executive Board, ensuring high-quality, accurate data to give a complete picture of weekly demand and capacity. Still collected daily and relied upon by the board for decision making.
  • Pathways 2 and 3 – collated a reporting mechanism to understand a 5-year forecast of beds capacity and utilisation, how and why volumes have changed and may change over time



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