It is expected that following a lifting of restrictions there will also be a “bulge” in demand from patients who have been avoiding going to their GPs. This will be evident in the data in time for Dr Foster to help Trusts prevent failure.

The earlier the Trust is aware that a breach is becoming more likely, the more effectively it can mitigate against it or, as a minimum, communicate to the commissioners that it is a possibility.

Dr Foster can offer the following support to Trusts:

  1. Visualise the elective waiting list from locally held referral to treatment (RTT) data in a way that communicates the problem clearly and promptly
  2. Put in place triggers that will alert the Trust to developing problems in a way that enables mitigation
  3. Simulate different models of care and enable the right action to be taken to efficiently return the Trust to delivering timely elective care.

What risk factors can we analyse?

Dr Foster has been approached to develop a flexible model of the ‘elective system’ that would demonstrate the effect on waiting times of changing how, in what quantity and by whom facilities like theatres, outpatients and diagnostics are utilised.

  • Calculate the percentage change in activity between historical numbers of patients waiting at particular points in the RTT (based on the position in the previous year) and the actual volumes of patients at the same points.
  • Estimate the unmet need based on previous year’s data.
  • As the HES and public RTT data covering the COVID peak(s) become available, Dr Foster will plot how other trusts in England are performing and benchmark the Trust against them.


Additional analysis

  • Calculate the activity and capacity requirements to meet a defined waiting time for range of scenarios
  • Provide outputs around each of these scenarios for both recurrent and non-recurrent levels of activity required to deliver chosen waiting times
  • Modelling the required bed numbers to deliver the chosen admitted patient waiting times
  • Create a model that will enable the inputs to be manipulated to reflect changes to the delivery of outpatient appointments, diagnostics and theatre sessions.


The NHS is moving in to an unknown environment, Dr Foster does not propose to implement one solution and assume that the parameters will be unchanging. Instead, Dr Foster will follow an agile approach focused on the delivery of value.

The analyses proposed above can be delivered as a Tableau dashboard available to be read using Tableau Reader or as a static PDF report. The models and data accompanying Tableau can also be provided separately in Excel as required.