Demand and capacity modelling across five major sites in Devon and Cornwall

Acute care in Devon and Cornwall has been facing difficulties; long wait times, workforce challenges and inefficiencies at the five acute hospitals all contribute to challenges in delivering high quality care. On top of that, the region is characterised by a growing, dispersed, and ageing population that, together with a backlog from the Covid-19 pandemic, are contributing to increased demand for acute services across the entire peninsula.

Given these challenges, a transformation of current services is warranted. To improve acute care, the Peninsula Acute Sustainability Programme (PASP) was set up as a collaborative initiative among NHS organisations in Devon, Cornwall, and the Isles of Scilly, to ensure long-term clinical, workforce and financial sustainability across the region’s five acute hospitals.

Their objectives are to:

• Improve patient and staff experience in acute care;
• Address workforce challenges, such as staff shortages;
• Optimise resource allocation and utilisation;
• Reduce health inequalities.

How we helped

Edge Health was commissioned to model a range of demand and capacity scenarios aimed at improving efficiencies and reconfiguring medical, surgical, paediatric, and maternity services across the peninsula’s five acute hospitals. Through a series of workshops with clinicians and chief medical officers from across the region, we identified and explored the patient cohorts that are mainly affected under each scenario.

Next, we developed models to assess the consequences of each scenario, focusing on impacts to patient activity volumes and detailed travel time analyses for patient groups that might need to be transferred to alternative sites. These insights were intended to inform evidence-based decision-making, helping to shape sustainable, high-quality acute services that meet the needs of local populations.

What we found

As part of the initial phase of PASP, the primary aim of the modelling was to describe the impact of different scenarios based on the available data, rather than to determine which, if any, should be implemented. Nevertheless, this descriptive modelling provided valuable insights into the feasibility and practical implications of certain scenarios, helping stakeholders better understand the operational realities behind potential changes.

Specifically, the modelling work highlighted areas where service reconfigurations might relieve pressures, optimize the use of specialist expertise, or improve patient outcomes. It also explored key challenges, such as the impact of longer travel times on patients and their families, the impact on volumes at other sites and the need for cross-site coordination, and the implications for workforce distribution. While this analysis was conducted for exploratory reasons, with no formal decisions made at this stage, the results created a robust evidence base that can help inform future phases of the programme, ensuring that any next steps are guided by a clear understanding of both opportunities and constraints.