Modeling GP Out of Hours Demand While Gaining Stakeholder Trust

SIMUL8 was used at NHS Grampian to model demand for GP out of hours service; exploring service utilization, travel times, resource availability and cost implications, while at the same time satisfying stakeholder views.

In the UK, The National Health Service (NHS) provides healthcare to approximately 60 million UK citizens. The NHS is divided in to several geographic regions, with one of these regional providers being NHS Grampian, who serve over half a million people.

Overseen from one central location within Grampian, their major objective is to ‘provide services that have patients at the heart of the service, receiving safe, high-quality treatment on the basis of clinical need, when they need it, and within comfortable surroundings’.

With the Grampian region being Scotland's second largest region in land size, and with over half of its population located in rural areas restricting accessibility, NHS Grampian has a challenging task of maintaining a quality service.

The Challenge

When the British Medical Association negotiated contractual services agreements, General Practitioner’s were able to opt out of 24 hour care for patients. NHS Grampian was aware that its geographical situation of extended journey times to rural areas for many patients presented major challenges in developing a new service which would maintain current quality.

They needed to explore demand for service,utilization, travel times, resource availability and cost implications, while at the same time satisfy many of NHS Grampian’s stakeholder views.

The Solution

NHS Grampian’s Health Intelligence Unit has worked with SIMUL8 for several years and recognized that SIMUL8’s powerful software package not only aids the development of new services but also has transferable skills internal and external to the organization, for example, improved stakeholder comprehension.

By creating a process flow of patient demands, SIMUL8 enabled the group to use the model as a major decision-making tool encompassing many complex variables. It returned results that highlighted aspects such as:

* Current bottlenecks
* Under utilization
* Resource movement

By applying validation techniques from historical data, there could be confidence in the predicted future results of the model.

The Result

The review was the largest public consultation undertaken by NHS Grampian and had high media profile, meaning acceptance of the chosen decision was key. The varied views and comprehension of the stakeholders made this task more complex. However, SIMUL8 successfully engaged all major stakeholders; GP’s, local politicians, community representatives and members of the Public.

SIMUL8 delivered a dynamic and graphical tool that created assurance that the favored decision of a mid priced service replacement costing £6 million would be most beneficial. This was achieved by results displaying maintained levels of safety, efficiency and effectiveness.

SIMUL8 was able to go beyond the initial remit by demonstrating areas where service levels would improve for patients, achieving reductions to response times in rural areas and eliminating bottlenecks, again helping neutralize concerns from stakeholders.

SIMUL8 is continuously involved in evolving NHS Grampian services further.