Forecasting the effects of COVID-19 on patient experience and service delivery across a whole mental health system 

This research is led by Dr Jennifer Cooper and supported by the NIHR Bristol Biomedical Research Centre

The COVID-19 pandemic is triggering a surge in the numbers of people requiring support from NHS mental health services.  

This is partly being driven by existing demand, which had been suppressed because fewer people had sought help during the national lockdowns. COVID-19 itself is also driving new demand: including from healthcare workers, people affected by the social and financial consequences of lockdown, people who have been bereaved, and people experiencing anxiety about the disease. 

We need to know how the local mental health system will be able to cope with this increased level of demand. 


Our study aims to address the increased demand on mental health services in Bristol brought about by the pandemic. 

Study partners Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG CCG) and Avon & Wiltshire Mental Health Partnership (AWP) NHS Trust want to understand: 

  • how COVID-19-related demand is spreading through the local mental health system 
  • the pressures it is placing on particular types of services 
  • how increased waiting times are affecting the flow of patients through the system, and outcomes for these patients.  

What we are doing

We worked with clinicians and local healthcare providers to develop a schematic – a ‘big picture’ – representing the local mental health system: comprising primary care, secondary care, community care and specialist mental health services.  

We then used mathematical modelling to simulate demand and patient flow resulting from COVID-19 in real time. The model captures patient referrals and transfers, alongside the effect of escalating need should demand not be met efficiently, with associated outcomes for patients.   


The routinely collected data we are using – from GP practices, secondary care and community care services – covers the whole population of Bristol. This information is broken down by ethnicity, age, gender, socio-economic demographics and different types of mental health conditions. 

Impact on policy

Being able to forecast demand for mental health services more accurately will, ultimately, help services in Bristol to better meet people’s mental health needs as the pandemic unfolds, and beyond. 

In the long term, the model will enable the CCG to better design mental health services for people in Bristol. And, as the model is open source, it can also be used by other healthcare systems.