The NHS could be run more effectively if senior decision makers used simulation software to test the outcome of different approaches before rolling them out, according to a report out today from the Cumberland Initiative.
Simulation software can be used to test-drive certain situations in a relatively inexpensive and safe environment where mistakes can be made without hurting patients or staff.
The Emergency Simulation report – published by a collaboration of academics, clinicians and industry partners (including IBM and BT) that are working together in a bid to transform the quality and cost of NHS care delivery through simulation – calls on NHS England to model every significant infrastructural change in advance.
The report illustrates how various institutions within the NHS can effectively deploy simulation software, while highlighting a number of institutions that are already using modelling successfully within the organisation.
One such example is the Royal Free Hampstead NHS Trust, which is in the process of planning a new Emergency Department after it was told it would have to manage additional patients due to a local reconfiguration that meant more ambulances would be routed to its facility.
The Trust said it used simulation software to model existing and increased activities through the new department to test whether it would still be fit for purpose. Modelling was also used to understand the expected change to the flow of patients through the emergency department and the likely impact on the number of beds in occupation. On this occasion, the simulation models assured the Trust that it would be able to meed the anticipated demand with its existing facilities.
“Mathematical models could also be used to help hospitals manage elective arrivals and discharges,” Vile added. “I hope to show that if consultants began working at 8am daily, instead of 9am, this could lead to earlier patient discharges and reduce overcrowding in A&E.”
Modellers have also been working on ambulance services in Wales, which until recently had the worst response times in the UK. “We showed that if ambulances could achieve the 20 minute turnaround, it’s as effective as making more ambulances available,” said Vile.
Terry Young, co-founder of the Cumberland Initiative, was unable to specify exactly how much money the NHS could save through wider user of simulation modelling. However, he did claim that when such technology has been deployed within the NHS, it has been able to help organisations save millions of pounds.
Meanwhile, software simulation firm Simudyne argues that it’s now “criminal” to make healthcare decisions without simulating the possible outcomes of that decision first.
“Often what seems like a good idea on the surface is in fact not a good idea,” Simudyne CEO Justin Lyon told Techworld. “Simulations allow you to test something and it doesn’t matter if it’s not a good idea. There are no real lives at stake. The idea behind computer simulation is that we can explore the ramifications of a lot of different policies quickly and cost effectively with literally no risk to any patients.”
NHS England claimed that simulation software is already used across the organisation to run models for a wide range of scenarios.
An NHS England spokesperson told Techworld: "There are many uses of simulation by analysts in NHS England in order to understand and improve the delivery and efficiency of health and care services in England.
"Simulation models can be extremely useful in helping organisations make operational and strategic decisions, and they are widely used across the NHS, alongside a range of other analytical tools. Simulation models have been used to help inform decisions on waiting times and the design of A&E systems.
"In particular simulation modelling was used for policy development in assessing the deliverability of the A&E target and also as a consultancy tool with specific hospital trusts to aid the assessment of options for improving patient flow."