Tackling operational problems in health care using modelling and simulation – Dr Tom Monks

NHS clinical commissioning groups across the UK are all focused on improving patient care while facing the pressures of an aging population, increasing volumes of patients with multiple complex health problems and the stark political reality of the need to cut costs. 

The complexity of these decisions and how to improve care is often enormously underestimated in the popular media. Take for example, the waiting time performance of accident and emergency (A&E) departments in the UK. 

The headline is often a simple one: A&E departments are understaffed, underfunded and underperforming.  As catchy as these headlines are, the truth behind A&E ‘overcrowding’ and the challenges faced by frontline NHS staff is far more complex: A&E’s are connected to many other aspects of the health system and problems here may actually be symptoms of problems found elsewhere.

Creating a model of what creates demand on A & E
Creating a model of busy NHS systems like A & E can help clinicians and managers make decisions about risks

So how can we tackle these dynamic and hard to define problems such as A&E waiting times?  An underused approach is mathematical and computer modelling.  The great strength of this approach is that we mimic how an A&E currently works and then ask ‘what if we increased staffing at peak times’ or ‘what if delays in patient discharges from elderly care wards were reduced’ and compare the impact on patient waiting times.  Models such as these provide an objective way to analyse urgent operational problems before making any risky changes to the real A&E department.

In Wessex we are collaborating with our NHS partners on modelling projects supported through our methodological hub.  Projects range from modelling GP weekend working to the journey of frail and elderly patients through the local health system.  The tools and techniques to analyse these problems have been available for a long time.  It is now time to use them to support commissioning decisions and reduce the number of sensationalist headlines.

Dr Tom Monks
Dr Tom Monks
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