Modelling healthcare scenarios: what we know and where to go next, 2015 Cumberland Initiative publication, 34 pages. This is an easy-read version of the Festival of Evidence outcomes.
Location Cumberland Institute, 163 Bestobell Road, Slough SL1 4SZ
Date/Time Monday 6th July 2015, from 15.00 – 19.00
Care services need new ways to address their many challenges holistically and at scale. Simulation modelling, serious gaming and other Operational Research methods are viable and attractive for allocating resources, designing services, managing at all levels, and scheduling.
The Cumberland Institute is a new specialist facility established specifically to address these challenges and is the home of The Cumberland Initiative.
Programme
15.00 Registration The Cumberland Institute Showcase
17.00 Official Opening 17.30 Reception
19.00 Close
R.S.V.P and for any enquiries regarding the launch, please contact: Romana Hoossein
Executive Assistant to Professor Terry Young at: [email protected] or + 44 (0) 1895 267060
Please find attached invitation
Opening Invitation Cumberland Initiative
Mr Dorrell said, “There is no doubt in my mind about the important role real time modelling should play in NHS decision making and I very much welcome the progress that the Cumberland Team has been making in demonstrating this concept.” During the meeting on 16 July, Claire Cordeaux of Simul8 presented a model built with the NHS’s Interim Management and Support team around urgent and unscheduled care. Professor Paul Harper from Cardiff University added that such simulation was being used in Wales to address the coordination of ambulance services and to free up the equivalent of three extra vehicles.
Dr Julie Hankin from Avon and Wiltshire, explained that, as a doctor leading organisational change, she faced her task without tools for designing services or for identifying unintended consequences. Meanwhile, Loy Lobo from BT Health picked up Mr Dorrell’s challenge to re-imagine health and care services, acknowledging the need for four per cent efficiency gains year-on-year. This would not be possible without creating a safe environment in which the future could be envisioned, simulated, with its implications for leadership and change fully understood.
Rob Berry from the Kent, Surrey and Sussex Academic Health Science Network, drew on his experience in the military. He made the case for trialling methods through manoeuvres and modelling and that this participatory approach had tremendous impact on the quality of decisions made in the heat of a difficult moment.
Professor Terry Young presented ‘Emergency Simulation’, the Cumberland Initiative Report on urgent and unscheduled care – hot off the press – and invited Mr Dorrell to the opening of the new Cumberland Initiative building in Slough, on September 23rd.
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Their presentations are below:
• Russell Emeny, Director, Urgent and Emergency Care Intensive Support Team, NHS IMAS
• Mr Andrew Fordyce, Consultant Oral & Maxillofacial Surgeon and Clinical Systems Engineer, Torbay Hospital
• Dr Mike Williams, University of Exeter Business School
• Dr Michael Allen, (Peninsula Collaboration for Health Operational Research and Development, University of Exeter Medical School)
• Professor Paul Harper, Cardiff University
• Dr Danny Antebi, Aneurin Bevan Health Board, Wales
• Peter Lacey, CEO, Whole Systems Partnership
• Professor Sally Brailsford, University of Southampton
• Professor Duncan Shaw, University of Warwick
• Claire Cordeaux, Simul8 Corporation
More information: [email protected]
Modelling offers huge opportunities for the planning of mental health services. The good news is that the process of adopting such methods should become easier because trusts are collecting more and more of the information that effective modelling requires.
There are two ways that modelling can be particularly useful. First, mental health is not just about what happens in a consulting room. It is affected by education, the criminal justice system, by employment and a host of other factors. If one can start to build some of these variables into the modelling of mental health care, then one is beginning to performance manage outcomes and not simply modelling the processes of service delivery.
Perhaps less ambitious, but more practical in the short term at least, modelling can allow you to look across different health and social services and see the impact of different commitments at various points in the patient pathway. It can really help us to optimise the positioning of resources and see, in advance, the knock-on effects of altering allocations in a particular area. Knowledge of these consequences should help us to be more sensitive in redistributing resources than we could be in the past.
This is not a pipe dream. Lots of businesses use modelling of this type very effectively. There is no reason particular to healthcare why we cannot also do it for mental health services. Indeed, as I say, it should become easier. Now that we are moving to the tariff payment system and payment by results, information systems around activity and disaggregated costs are being collected more comprehensively. These figures can highlight issues, for example, related to patients who may be well but who are unable to move on because of accommodation shortages. They also show us where the pinch points are in our systems so we can allocate staff to the most stretched areas.
Modelling is also vital for any service to gain the firm attention of senior managers. They need choices to be laid out in a digestible, accessible form, including all the opportunity costs. It’s the route to sound management and can only help mental health services to achieve the priority to which they are entitled in the hierarchy of service delivery.
Dr Julie Hankin is Consultant Psychiatrist and Clinical Director (Service Improvement) for Avon and Wiltshire Mental Health Partnership NHS Trust.
]]>Having said that, there is one part of the local primary care system that I have frequented: our Walk-in Centre. As its name suggests, you don’t need an appointment and it is open all day, in the evenings and at weekends. So, on the odd occasion (for example, if I know that I probably need a course of antibiotics) I just pop in and get the problem sorted, at a time I can fit round work commitments and without bothering my overworked GP.
What a great system – convenient for patients and cheap because it’s run by nurses. I wish the Walk-in Centre had been operating when my children were small, or my elderly parents were still alive, for the sorts of situations when I knew they were not really poorly enough to justify an urgent GP appointment and I just needed some timely, face-to-face, expert advice.
So why on earth are they planning to change the Walk-in Centre, so that it’s now only going to be open at weekends? How can the Centre not be cost-effective? Have they really looked at all the options? How can it be more economical to use GPs than nurses? Has anybody modelled this system? In particular, has anyone done any what-if simulations looking at predicted use of the Walk-in Centre in the light of future population change?
Sally Brailsford is Professor of Management Science, School of Management, University of Southampton
]]>And yet, a century beforehand, Nightingale applied statistics to health, creating an early version of the pie-chart to communicate what the numbers were saying. Meanwhile In 1950, Doll and Hill linked smoking to lung cancer and, in doing so, opened up a stream of methodology in controlled trials, meta-analysis and a concept of evidence that transformed medicine.
However, the application of numbers to predictive risk, operations management and service delivery has not taken off. The Cumberland Initiative is a response, initially from the academic community, to the call to invest in the service and systems side of healthcare: the business of delivering repeatedly, reproducibly, against agreed plans to commonly expected outcomes.
The Cumberland Initiative advocates a sustained level of massively cross-disciplinary research and transformational activity to define the evidence, develop the methods, deliver the tools and dig in with service providers, including the NHS. In meeting these challenges, it seeks a solution ultimately embedded and overseen though a new National Institute for (Health) System and Service Excellence (NISSE). NISSE could balance the scales and make a huge impact in operations, services and commissioning.
The non-drugs, non-technology piece of healthcare is about 85 percent of the healthcare pie. Some 85 percent of more than three trillion dollars spent around the world on healthcare provides considerable scope for new businesses in improvement, risk-management, modelling, operations research, and data mining. Good for healthcare. Good for UK plc. NISSE could make sure that we got the system solutions right.
Professor Terry Young is Chair of Healthcare Systems, School of Information Systems, Computing and Mathematics, Brunel University
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