Supporting Strategic Change in the UK NHS

The National Health Service (NHS) is the world’s largest public health body, providing 'free at point of use' healthcare to the UK's 60 Million citizens.


One of the regional bodies within NHS, Ayrshire and Arran NHS Board in Scotland, carried out a strategic review of emergency and unscheduled care, and the processes that deliver these.

The outcomes from this review would represent a major restructuring of services across NHS Ayrshire and Arran and are only being considered because of the robustness of the associated planning process, supported by simulation modeling carried out by SIMUL8 Corporation.

The Ayrshire and Arran trust employs around 10,000 clinical & support staff. It serves 7.3% of the Scottish population, is mainly rural, including a large island community and two towns 20 miles apart.

The Result

Following the review process The NHS Board unanimously agreed that the process had been robust, and therefore endorsed the proposal to seek wider patient, public and staff views on the outcomes through consultation.

Specifically, the consultation would consider the possibility of creating five Community Casualty Facilities; focusing all emergency receiving services at one hospital as opposed to the current two, whilst developing protected elective capacity at the other facility.

As part of this exercise a number of simulations were built by SIMUL8 Corporation, in particular to model the delivery of unscheduled care.

Inputs to the simulation model were demand of Elective and Acute patients by Patients Types, and included capacity in terms of beds available & Length of Stay.

The simulation model clearly demonstrated that based on the assumptions made, in terms of patient flows to Community Casualty Facilities and the operation of an Assessment Unit, that the Crosshouse Hospital site would have the capacity to deliver all of Ayrshire & Arran’s emergency care needs on one site.

David Rowland, Project Director – Review of Services Project explains:

"The outputs of this simulation modeling have proven to be invaluable in terms of adding to a comprehensive evidence base, presented to both the professional and public members involved in the planning process."

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