TCST recently worked with colleagues from St George’s University Hospitals NHS Foundation Trust to develop a demand and capacity modelling approach for chemotherapy services.

The initial project scope was to better understand demand for the trust chemotherapy service over the previous three years to explore concerns around lack of capacity and a reliance on overtime. With clear indications that demand for the service was increasing, the modelling project helped to identify potential bottlenecks, support capacity and workforce planning and explore opportunities for improvement.

The initial plan was to use a demand and capacity model for chemotherapy originally developed by south east London – however, the data required to populate the model wasn’t available. Using chemotherapy activity data instead, it became clear that there was significant complexity within the service. There were over 64,000 separate lines of chemotherapy regimen data, one line for each drug given and 41,600 actual cycles of chemotherapy delivered. We matched regimen descriptors and chemotherapy cycles to the minutes required in the chemotherapy chair for each treatment.

When looking at chemotherapy cycles by day of the week and year, overall there was a 16 per cent increase between 2020 – 2021 and a six per cent increase between 2021- 2022, with increases in activity seen on each day of the week over the previous three years.

We analysed the time required to deliver chemotherapy over time to see how changes to this impacted on capacity. The modelling outputs also identified chemotherapy cycles by day of the week which was valuable as it highlighted opportunities for improving service efficiency.

A benchmarking exercise for chemotherapy regimens over the past three years showed that national trends align with the regional and cancer alliance trend as well as the trend seen at St Georges.

The modelling outputs enabled more efficient treatment schedules. Modelling also facilitated a review of treatment capabilities outside of the chemotherapy day unit to maximise on nursing skills and capacity.

For further information about demand and capacity modelling please contact Sarah Cooper