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What is
Clinical Capacity

Clinical capacity means the hospitals, facilities and personnel required to deliver clinical services to patients during BAU (business-as-usual) times (0700-1700 on workdays). Additional capacity is available during non-BAU times (1700-2100 on workdays and 0900-1700 on weekends or public holidays).

Available non-BAU time is equivalent to approximately 70% of BAU time across a 365 day year.


The NHS is currently suffering from a shortage of BAU clinical capacity -  doctors (>7%) and nurses (> 10%) and levels below OECD (e.g., 2.9 doctors/1,000 patients in England versus 3.7 in other OECD countries)

Existing Clinical Resources

In the U.K. across the four nations, there are some:
Hospitals
+ 930 NHS with ~100,000 core beds
+ 218 private (non-NHS) with ~12,000 core beds
Employees
+1.5 million employees across the NHS in the U.K., including in secondary care
Secondary Care
Associated 'clinical staff'
37,000 managers and administrators
54,000 consultants
75,000 doctors in training
320,000 + nurses, midwives and associated staff
Clinical capacity can be expanded by either increasing the resources (more hospitals and clinical staff) or engaging hospitals and clinical personnel to work more non-BAU time. Match+ Digital Platform facilitates increased use of existing hospitals and clinical personnel – during un-used BAU or non-BAU times.

What is 

Clinical Effectiveness?

Clinical Effectiveness provides an overall assessment of reported:
Patient clinical outcomes
After assessment, investigation, diagnosis and treatment
Quality of care
Including factors such as the experienced state of resources (either the necessary management and administrative personnel and physical property, plant, equipment and consumables of a hospital and/or its clinical personnel provided in care resources experienced)
Clinical productivity
The improving lower marginal cost or average overall cost per care pathway or episode of care along that pathway.
Evidenced health and economic impact
Measuring and reporting care pathway and individual health impacts (QALY - quality adjusted life in years) and population level economic impacts to demonstrate, amongst other things, positive value for public funding assessments

How Match+ Works

A digital platform that expands available clinical capacity by creating a 'spot market' in non-BAU time for hospitals and clinical personnel to offer their additional capacity. And, to drive improvements in clinical effectiveness by innovative application of AI / ML to patient care episodes and pathways. Over time, the AI / ML enhanced processes and data analysis will improve the efficiency and clinical effectiveness of the 'spot market' and help hospitals and clinicians achieve better outcomes, quality of care, productivity and evidencing of health and economic impacts.

Match+ can automatically‍

Optimise or moderate the design of Tenders created by the Commissioning Body
Optimise the bids of Secondary Care Facilities and/or Clinical Personnel to achieve preferred Tender outcomes such as lowest marginal cost, fastest execution, or other Clinical Effectiveness elements
Match Referred Patient Acuity (or specific elements of it) with Ranked Secondary Care Facilities and/or Ranked Clinical Personnel (or specific elements of the ranking) to achieve optimal or selected healthcare outcomes
Promote a reduction in inaccurate referrals or improvement in acuity assessments provided by referrers
Provide or recommended further education or improvement options to participating  Secondary Care Facilities and/or Clinical Personnel
Evidence, for the state or other funder that finances the Commissioning Body, the ‘value for money’ outcomes for such funding over time

Match+ Process Flow

01
System integration
This requires system integration to assure:
Access to required operation data such as bundled or un-bundled Care Codes, the identifier codes for Secondary Care Facilities, and Clinical Personnel data (from employment or contractor databases held by their Secondary Care Facilities)
IT/Digital  Infrastructure
System Security
Referred Patients’ data privacy and security
02
Enrolment of participants on the digital platform
Enrolls, authenticates as required, and provides the professional and personal details required to facilitate participation
Commissioning Body (administrator)
Hospital(s) (administrators)
Clinical person (clinical consultant, associate specialist, trainee doctor, nurse, nurse assistant)
03
Management of Referred Patients
Referred Patients awaiting secondary healthcare who may be classified and/or triaged and then stratified by:
Clinical Care Pathway, using single or multiple Care Codes
Acuity, using aggregated or specific standardised assessment levels of clinical urgency, complexity and risk
Geographic proximity or accessibility of the Referred Patients to participating Secondary Care Facilities
Targeted determinants or elements of Clinical Effectiveness (such as time to initial or final episode of a Clinical Care Pathway, improved patient clinical outcomes, improved quality of delivered care, or improved clinical productivity at lowest marginal cost)
Location within or referral from the geographic areas of a single or multiple number of participating Commissioning Bodies
04
Tender design
The Commissioning Body administrator, being funded by the state or other funding body, make a strategic decision on which Referred Patients and/or Clinical Care Pathways are to be the subject of a Tender, carving out a list of Referred Patients whose care is to be tendered by reference to the targeted:
Number of Referred Patients
Geographic location or accessibility of Referred Patients
Care Code(s)
Schedule within which the tendered care is to be provided (tender executed)
Secondary Care Facility or multiple Secondary Care Facilities at which the tendered care is to be provided
Minimum or threshold level of bid required whether in terms of the percentage of:
  • Tendered time slots for the clinical work to be done
  • Tendered limits (+ or -) by reference to the standardised unbundled cost attributed to the tendered Clinical Code
Cost per Referred Patients and/or Clinical Code
Referred Patient Acuity
Ranked Clinical Care Facilities and/or Ranked Clinical Personnel to be matched with the Referred Patient Acuity
05
Bidding – stage 1
The selected Secondary Care Facilities are requested to bid their:
Capacity availability, referenced to non-BAU or BAU hours (generally, clinical activity is organised around 4-hour (or other – e.g., surgical procedures are organized on longer time slots) programmed activity (PA) time slots within the BAU or non-BAU periods
Price for each time-slot that it bids, with the price being a percentage (%) (whether + or -) of the standardised cost attributed to the Clinical Code for their un-bundled services.
The Clinical Care Facilities may bid:
Alone, if tendered
Collaboratively with other Clinical Care Facilities, if the Tender permits
Tender questions or queries to the Commissioning Body’s administrator are dealt with on the Digital Platform and available to all bidders.
06
Matching – stage 1
The Digital Platform automatically matches the bid capacity and prices to obtain:
Earliest (fastest) completion of the clinical work
Lowest overall cost to complete the work
But such matching may be moderated on the Digital Platform by the administrator to take other Clinical Effectiveness factors into consideration (e.g., historical service quality or performance).

Once matching (whether moderated or not) is settled, the winning bidder(s) are awarded the clinical work subject to completion of Bidding - Stage 2.
07
Bidding – stage 2
The selected Clinical Personnel are requested to bid their:
Capacity availability, referenced to time slots within non-BAU or BAU hours as determined by the Commissioning Body based on the options automatically derived by the Digital Platform to achieve the Clinical Effectiveness objectives set by the administrator
Price for each time-slot that they bids, with the price being a percentage (%) (whether + or -) of the standardised cost attributed to the Clinical Code for their services.
The Clinical Personnel may bid:
Alone, if tendered
Collaboratively with other Clinical Personnel, if the Tender permits
Tender questions or queries to the Commissioning Body’s administrator are dealt with on the Digital Platform and available to all bidders.
08
Matching – stage 2
The Digital Platform automatically matches the bid capacity and prices to obtain:
Earliest (fastest) completion of the clinical work
Lowest overall cost to complete the work
But such matching may be moderated on the Digital Platform by the administrator to take other Clinical Effectiveness factors into consideration (e.g., historical levels of clinical outcomes or productivity).

Once matching (whether moderated or not) is settled, the winning bidder(s) are awarded the clinical work and the awarded Tender moves to execution phase.
09
Clinical Work Execution and Feedback
During and at the end of each episode of work, the provision of feedback into the Digital Platform by each of the Referred Patients, each Secondary Care Facility and each of the participating Clinical Personnel, is required. Subsequently other universally mandated data (e.g., on the clinical outcomes with respect to each Referred Patient) is also provided into the Digital Platform.

This data is automatically analysed, using ML/AI,  to inform the assessment of the Clinical Effectiveness and each of the determinants or elements of the clinical work undertaken by each Clinical Care Facility and Clinical Personnel (and their respective collaborators, if any, in each Tender).

The Clinical Effectiveness assessments are automatically applied to adjust the rating of each Clinical Care Facility and Clinical Personnel (and their respective collaborators, if any, in each Tender) so that in future:
Tender designs
Matching of Referred Patients and/or Clinical Codes with Rated Clinical Care Facility and/or Rated Clinical Personnel
The awarding of clinical work will optimise the level of delivered Clinical Effectiveness.

The Clinical Effectiveness assessments are also automatically applied to inform the provision or recommended further education or improvement options for:
Participating  Patient Referrers
Participating Secondary Care Facilities and/or Clinical Personnel (or their respective collaborators, if any)
10
Tender completion and payment
Subject to the provision of required feedback, the Digital Platform automatically executes the payment of relevant Clinical Care Facilities and Clinical Personnel, via either:
Normal payroll systems – for Clinical Personnel executing work in their normal homebased Clinical Care Facility
Normal creditor systems – for:
  • Clinical Personnel executing work otherwise than in their normal homebased Clinical Care Facility
  • Clinical Care Facilities
11
Applied AI /ML to drive improved tendering and clinical effectiveness
(Paper pending)
12
Estimating the clinical impact of delayed provision of care
(Paper pending)
13
Estimating the economic impact of delayed provision of healthcare
The versatility of design and applications ensure that the Match+ Digital Platform can be implemented in any state healthcare system that uses state or communal (e.g., insurance funded care) funding to manage or control patient inflow to secondary care.

Future Applications‍

Initially, the Match+ Digital Platform will be to help reduce the backlog of waiting patients on NHS PWL. However, the platform can also be deployed to more optimally manage BAU patient care pathways and episode of care along those pathways.

The platform can also be deployed in other international healthcare systems wherever there is significant public or insurance funding used to commission provision of care.
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