Avoiding Design Errors in the NHS24 Contact Center

SIMUL8 provided the NHS24 management team with a solution that gave them the ability to identify and manage potential periods that could result in future under performance. The simulation solution created provides information in advance as a risk with a potential solution.

SIMUL8 also provided an accurate means for NHS24 to test the benefit of proposals in advance of implementation, avoiding potential costly errors in design.



As the equivalent to England’s NHS Direct, NHS24 was established to provide the 5 Million people of Scotland with 24-hour telephone health advice.

Employing more than 1,000 clinical and support staff, three contact centers were established at a cost of approximately £115 Million.

From January 2005 NHS24 took on additional responsibility and demand, with GP calls outside normal hours automatically forwarded to the NHS helpline.

At peak times the service was handling volumes in excess of 14,000 calls per day. This demand was significantly above the initial design, resulting in low levels of patient service, and high profile Press coverage and Government scrutiny.

SIMUL8 Support

Given SIMUL8 Corporation’s expertise in both Health and Contact Center modeling, NHS24 contracted SIMUL8 to play a key role in evaluating the root cause of the existing performance issues.

In particular, SIMUL8 assisted the service in identifying and testing the benefit of potential business improvement proposals, prior to their implementation in practice.

Establishing the existing barriers to satisfactory performance

When an urgent call is received by NHS24 it is answered by an initial call handler, who either passes the call to the 999 emergency ambulance service, or to an internal nurse adviser where one is available.

If no nurse adviser is immediately available, arrangements are made for one to call back within a certain period, based on an initial assessment of the importance of the call.

The process of ‘Call Back’ had at peak times resulted in some patients waiting more than an hour to be called back.

Using advanced Contact Center simulation, SIMUL8 allowed NHS24 to quantify the most appropriate resource and skills mix to this complex hand-off process, identifying the level of demand that could be handled by all stages in the process to reduce the reliance on this ‘Call Back’ process.

"SIMUL8’s support has been invaluable in regaining internal and public confidence in NHS24, and in allowing us to ensure that the proposed performance initiatives will deliver the benefits required"

Graham Dixon, Director of IT, NHS 24

Testing the benefits of improvement proposals

Further strategic options were also being considered to improve the existing performance, such as establishing additional ‘hub’ contact centers to ease the burden on the existing facilities at key times.

SIMUL8 Corporation had significant influence on the business case for these ‘hubs’, demonstrating the future benefit of establishing the facilities, the resources required to provide the appropriate service level improvements, and what the most appropriate skills mix and shift patterns for these additional resources should be.

SIMUL8 provided an accurate means for NHS24 to test the benefit of their proposals in advance of implementation, avoiding potential costly errors in design, and providing quantifiable benefit for the proposed investment.

SIMUL8 as an operational support tool

The solutions provide the NHS24 management team with not only the ability, but also the confidence, to identify and manage potential periods of future under performance.

The advantage to NHS24 of using the SIMUL8 solution is that it provides information in advance, as a risk with a potential solution, rather than a result with an actual consequence.

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