1 October 2021

Applying Quality Improvement methods to optimise flow, demand & capacity

By Auz Chitewe, Associate Director of Quality Improvement

Across the organisation, many services are looking at how to manage demand for services, capacity to deliver the service and flow of service provision across the system. Due to increased numbers of referrals and the effects of having to prioritise the acute phase of the pandemic, more than 20 services are using quality improvement to tackle issues of longer waiting lists and backlogs for assessment and treatment.

Read the stories of teams optimising flow, demand and capacity:

  1. Improving flow in Early Years Speech and Language Therapy
  2. A Collaborative Approach to Reducing Waiting Times in Hackney Integrated Learning Disability Service
  3. Using Quality Improvement to Manage a Huge Increase in Demand in Primary Care
  4. Improving Access to Newham Learning Disabilities Service
  5. Reducing Waiting Times for Occupational Therapy Interventions in the Bedford Community Mental Health Team

A series of four virtual learning sessions were organised on ‘optimising flow, demand and capacity’ between July and November 2021 to bring these teams together so they can learn from each other, receive some coaching and help accelerate their progress. Teams working on this theme have come from a broad range of services across the organisation including:

  • Community mental health services
  • Therapies services
  • In-patient & crisis services
  • Learning disabilities services
  • Community health services
  • Primary care services
  • Older people’s services
  • Children and young people’s services

Figure 1: Group photo from the September learning session


These teams are enthusiastically taking on the challenge of discovering how to improve the flow of service provision across care pathways and systems with support from operational structures, service users, QI structures and other stakeholders. This requires developing and testing changes that span beyond the immediate service but the broader system.

Reflecting on the ambition and effort of teams working to optimise flow, demand and capacity, Edwin Ndlovu, the Chief Operating Office, said:

“In order to maximise patient flow through our system, we must look at the entire patient journey. Using QI methods to analyse the demand and capacity within a number of services has enabled improvements to be made that ease the flow of service users through the system and helps to create a better patient and staff experience. This has helped us understand how we respond when there is a mismatch between demand and capacity and in many cases the resulting backlog. This is true across all our different services in inpatients, outpatients, community mental health and physical health services.

Thank you to all the teams and services who have been engaged with this work. I hope you are proud of your work to date, and you continue to seek improvements in your system. We are committed to using quality improvement methods to solve our most complex problems so we will continue to support services to do this and to spread all the good ideas and experiences. If your service users is experiencing unusually long wait times, I encourage you to try at least one of the things the teams mentioned in the stories above have done.”

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