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Demand & Capacity Modelling: Regional Elective Hub

Four Eyes Insight was asked to provide a 10-week programme and demand and capacity model to support the development of operational plans for a new regional surgical elective hub for an NHS Acute Provider Collaborative.

As part of the 10-week programme, Four Eyes Insight (FEI) produced an integrated activity, workforce, and finance model supported by a compelling narrative describing the benefits of launching a high-volume regional elective hub for an NHS Acute Provider Collaborative (APC), as outlined below.


  • A scenario-based modelling tool to support the planning and delivery of activities was created.
  • Activity predictions were built up from procedure-level data based on average touchtimes.
  • Clinical agreement to the ability to perform certain procedures through high-performance lists, also known as super-lists was established.
  • The ability to manipulate core inputs (utilisation/session duration/session volume/volume of high-performance lists) in an interactive tool allowed flexibility to increase and decrease expectations weekly across the year.


  • A financial strategy options paper provided three main options for decision, largely premised around the profit/risk share model across Trusts.
  • Incentivisation options were presented at organisational and workforce levels.
  • Financial implications of the hub were considered as part of the integrated modelling with the ability to demonstrate impact due to implementing various scenarios.


  • There was discussion and impact modelling of the effects of various alternative roles.
  • A review of staffing implications for high-performance lists was conducted.
  • Workforce modelling was integrated within the demand and capacity analysis and staffing requirements were varied alongside operational plan alterations (e.g., session duration and volumes)
  • Supporting documents for the recruitment strategy were developed.
  • Consistent and high-quality job descriptions addressing the skill sets and deliverables specific to Elective Hubs were designed.

Engagement and Results

  • Subject Matter Expert-led clinical engagement sessions were held to support the ambition for change and improvement.
  • Operational delivery model scenarios were agreed.
  • A compelling narrative was written to communicate the model across providers.
  • Workforce recruitment commenced aligned to the agreed new ways of working.
  • Anticipated benefit: the ability to treat an additional 4316 ENT and urology patients annually and 52-week backlog clearance within 3-6 months.
  • Almost 2500 hours of capacity was identified for release at non-host sites.