So here is the bottleneck theory bit…

A bottleneck is where there is a demand and capacity imbalance. It only appears when the demand exceeds the capacity. This may be an imbalance now or one in the recent past.

For example, a CAMHS team might have no waiting list and be seeing all the referred families. However, a maternity leave may add roughly 50 patients to a waiting list for a particular skill because of the large effect of staff loss on small teams and after the staff member and the team returns to demand/capacity balance the unseen 50 cases are still sitting on the waiting list. A bottleneck can occur at any step of a process and the symptom of a bottleneck is a QUEUE. Finally, there are two causes of bottleneck: 1) skills (people to do the task) and 2) kit (rooms or equipment needed).

OK here is a small bottleneck quiz…