As the season(ality) changes and recommissioning resurfaces, our team often find ourselves being asked to time travel. As analysts, we’re hardly equipped to transcend time and space, but we can make predictions about what the future may look like.
With new contracts requiring up to 10 years of projections about demand for recommissioned services, it can feel like looking into a crystal ball. A very foggy crystal ball. We can never be certain of what will happen in the future. For example, it would have been impossible to predict COVID 19, and the impact it had on the demand for at-home care, before it actually happened. Forecasting itself can be incredibly inaccurate, even in the short-term; has anyone checked Apple Weather recently? But we can make predictions about what will happen based on what has happened in the past, and what risk factors can increase impact, but we can never be certain. Having said this, the more data that we have about the past, the more confident we can be about our predictions.
It might be important to note that, when it comes to forecasting, this is not our team’s first rodeo. Typically, we like to predict using models that forecast based on historic trend and seasonality. In other words, the model looks at the trend of demand in the past, and whether demand peaks or troughs consistently at different points of the year. However, this method does have its limits. We only tend to use this method to forecast up to two years ahead, and we’d need years of historic data to do so.
So, when ECC’s Intermediate Care Board asked us to project demand for reablement services over the next seven years, I wondered why they didn’t just call up The Doctor. I’m just kidding, but I knew we couldn’t project forward to 2030 using just historic trends and seasonality.
In these instances, we can look to demographic growth within the population. Using what we already know about individuals who have been accepted into some form of intermediate care, we can identify key profiles within our cohort. We can then predict the prevalence of each key profile in Essex’s general population and calculate the growth rate of individuals matching the profiles in our communities up until 2030. Applying these calculations to our current demand for intermediate care can give us an indication of future demand.
Using this approach we identified three “reablement profiles”, each grouping adults with similar ages, needs and provision.
Profile 1 (Elderly with personal care needs): These adults are aged 75 and over and have a primary need of personal care and support. One in five are diagnosed with hypertension, their outcome after intermediate care is typically no further ECC-funded provision, and they are more likely to receive spot provision than adults belonging to other profiles. Nearly half of our recent intermediate care cohort fit into this profile.
Profile 2 (Elderly with mobility issues): Like profile one, these adults are aged 75 and over, but their primary need is mobility. As a result, they are most likely to receive ECC core reablement provision. One third are diagnosed with arthritis. Nearly a quarter of our intermediate care cohort fit into this profile.
Profile 3 (Younger reablement users): These adults are aged between 18 and 64, and are more likely than other profiles to transition into domiciliary care after their intermediate care provision has ended. One in five are diagnosed with diabetes, and they are more likely to have a depression diagnosis than other profiles.
In the current Essex population, we estimated that around 111,703 individuals fit at least one reablement profile. A large proportion of these individuals will never be referred to intermediate care in their lifetime, so after weighting growth rates and applying to the current demand, we estimated that the total demand for intermediate care in Essex will increase by +14% by 2030.
Essex already allocates significantly more of its budget to providing intermediate care services than other counties, which allows more eligible adults to receive quality reablement. A +14% increase in demand was therefore expected, and by rebalancing capacity and utilising resources more efficiently, the intermediate care system will be equipped to manage the projected increase in demand. Guided by our reablement profiles, each quadrant is now more able to understand the needs of their intermediate care cohort. The future is foggy, but Essex is now better prepared.
Controversially, I’d say analysts are pretty bad at time travel. But that’s not because our methods aren’t robust, it’s because we can’t transcend time and space. We will never truly know what will happen in the future, but we can become confident in the most likely outcome. In the meantime, does anyone have The Doctor’s number?
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