A4.1. Demand analysis

Demand analysis

What should I expect the outcomes to be of using the tool?

Quick and easy to undertake, this analysis tool can help to identify some “quick win” service improvement opportunities as well as potential improvements that may require further analysis/exploration. It can also help us to understand what we’re busy doing, and help us challenge whether we’re busy doing the right things.

Tool/ method

Our “Demands” are all of the requests, referrals, orders and enquiries coming into our team or service which generate a piece of work or require some effort to resolve. They typically include face-to-face interactions, telephone calls, emails, faxes, post, documents etc. Some may be recorded in our systems and passed-on, while others may just be dealt with and resolved at the point of contact. The aim of Demand Analysis is to understand all of our incoming work, and to categorise it into two types, the demands we want and that we are here to fulfil (Value Demands), and demands which could be prevented if we were to do something differently (Preventable Demands).

Why we may choose to use this tool/ method?

The simplicity of this tool makes it ideal for teams or services at the beginning of their improvement journey, and it can be a means of quickly releasing some capacity which can then be used to undertake more complex/involved improvement activities. It is also useful to revisit as a periodic health check to understand how improvement activities are impacting or influencing incoming demand.

How you might use this tool/ method?

Preparation:

  • You’ll need to find out where all of your team/service’s demands come in, i.e. at reception, in the post room, by telephone and email to administrators, directly to practitioners etc.
  • You’ll also need to dedicate some initial time to spend at each of these locations, watching and listening to incoming demands

Engagement:

  • All colleagues who receive initial demands will need to be aware of what you’re doing, and why (you’re going to need their help to collect some data).

Method:

  1. Spend some time at each place where demands come into your team/service.
  2. As each new demand arrives, make a note in the customer/client/referrers own words of what they’re asking for… see the example below.
    (Note: often as demands arrive we rephrase or reframe them to fit with our recording mechanisms and systems. For this exercise we need to capture what the demand is before it’s categorised).
  3. If a particular demand comes in more than once from different sources, keep a 5-bar-gate tally of the numbers.
    Example…
  4. Discuss the types of demands with the staff who are receiving them, once they advise that you’ve seen most or all of the common demands they receive, you’ve completed this phase of the exercise.
  5. Compile the notes you’ve taken whilst in each place or area. You should now have a list of all of the most common demands your team/service receives. Turn these into a record sheet – a 2-colum table or spreadsheet with each demand down the left-hand column and the right-hand column is blank.
  6. Choose a two-week period during which you anticipate pretty average demand volumes, and distribute your record sheets to all of the staff who receive demands. Ask them to keep a 5-bar-gate tally of the volumes of each demand they receive over the two weeks. Any new demands which arrive that aren’t already on the sheet can be added to the bottom by individuals as they receive them.
  7. At the end of the allotted period, collect all of your Demand Record Sheets.

Analysing your data

  • You should now have a pretty comprehensive list of all of the demands your team/service receives, and a picture of how often each type is received. The next task is to categorise these into two types, Value demands and Preventable demands.

(You may find this easier if you can get a few people together to do it…)

  • Start allocating each demand type into one of the two categories, here are some common examples of each…

Examples of value demands: “My mum isn’t coping and needs your help” “I’d like to make a referral for my patient” “I no longer need help and would like to close my case.”

Examples of preventable demands: “Can you tell me what’s happening with my case?”
(Progress-chasing demands might be prevented by proactively providing updates on progress, or better management of expectations and understanding of timescales from the outset)
“I don’t understand the letter you’ve sent me”
(Perhaps we could review the layout or wording of our letters to make them easier to understand, which would prevent these demands?)
“Where can I find information about …?”
(Is the information already available? Is it accessible & easy to find? Is it easy to understand? Perhaps we could improve one of these elements to help people find this information themselves, thereby preventing these demands?) You should now have a list of demands which, with some work, could be prevented and therefore could free-up some capacity within the team/service. You should also have an idea of roughly how many of each of these we receive (take the number received during your 2-week analysis and multiply by 26 for an indicative annual volume) and understanding on average how much staff time is involved in processing each one will help get an idea of how much time could be saved through prevention. If you have a long list of preventable demands, to help prioritising them think about which could be quick/easy wins? Which are the highest volumes? Which involve the most staff time/capacity?

What next?

Next steps are about taking action to prevent the incoming demands you’ve decided to target. You may need to collaborate with other teams/services/organisations to tackle these together. Involving colleagues who receive and process the demands is often a good way of maintaining their engagement, would some be willing to coordinate or project-manage elements of the action plan? Your initial demand analysis provides good baseline data, against which you can measure progress by undertaking further periodic Demand Analysis exercises. Have the preventable demands you prioritised stopped? Have they changed? Have they been replaced by others? Which preventable demands should we tackle next?

Examples/ case studies/ links to best practice/ evidence

When Cumbria Adult Social Care undertook this exercise, one of the most prevalent preventable demands was from customers calling because they couldn’t understand the bill they’d been sent for their care. Some further exploration found that the bills were auto-generated from the computer system monthly and posted to customers. Many customers rang each month. Preventative measures simply involved making the bill template more user-friendly (with help and input from customers), and Social Care staff explaining the format and information contained in the bill to customers at the time they were undertaking their initial care assessment, so customers know what to expect when their first bill arrives. Demands prevented – approximately 2,000 per year, 5 minutes each, saving approximately 160 staff hours per year.

Contact for further information

Rachael Davies, Cumbria Partnership NHS Foundation Trust

rachael.davies@cumbria.nhs.uk 

Demand analysis – A step by step visual

CPS TOOLKIT

Toolkit overview
The purpose of this toolkit
What is the Cumbria Production System?
How can we transform our services?
Cumbria Production System - improvement principles
What improvement outcomes and results can we expect?
When should you use the tools?
Key tool templates and visualisations
Summary of tools
Module 1: Our approach to improvement
1.1 Plan, Do, Study, Act (PDSA)
1.2 After Action Review (AAR)
1.3 Data gathering and evidence and '5 whys'
1.4 Measuring for improvement
1.5 A3
Module 2: Seeing the issues and adding value for the people who use our services
2.1 Maximising value
2.2 Customer Journey Mapping (CJM)
2.3 Process mapping
2.4 Value Stream Mapping (VSM)
Module 3: Waste removal and standardisation
3.1 Waste, waste wheel, waste walk
3.2 Spaghetti diagrams
3.3 5S workplace organisation
Module 4: Flow, demand and standard operations
4.1 Demand analysis
Module 5: Taking people with us
5.1 Stakeholder analysis
Appendices
A. The tools in detail
Module 1: Our approach to improvement
A1.1 Plan, Do, Study, Act (PDSA)
A1.2 After Action Review (AAR)
A1.3 Data gathering and evidence and '5 whys'
A1.4 Measuring for improvement
A1.5 A3
Module 2: Seeing the issues and adding value for the people who use our services
A2.1 Maximising value
A2.2 Patient/ Customer Journey Mapping
A2.3 Process mapping
A2.4 Value Stream Mapping (VSM)
Module 3: Waste removal and standardisation
A3.1 Waste, waste wheel, waste walk
A3.2 Spaghetti diagrams
A3.3 5S workplace organisation
Module 4: Flow, demand and standard operations
A4.1 Demand analysis
Module 5: Taking people with us
A5.1 Stakeholder analysis
C. References and acknowledgements