Health and Social Care Policy in the UK

Client: UK Government

Authors/Consultants: Wolstenholme E, Monk D, McKelvie D, Smith G

In 2000, the British government initiated a National Health Services (NHS) program aimed at improving the quality of health care services. This long range program included hiring new employees, providing more facilities in the form of intermediate care centers and beds, and access to diagnostics and treatment. This ambitious program sought to minimize delayed hospital discharges, provide reliable patient care and select appropriate sites for investment.

System dynamics modeling was used to increase policy makers knowledge about the issue at hand and the impact of proposed changes on behavior over time. Similar to many simulation studies, the categories of data required by the model did not completely match the categories of data stored by the client organizations. In system dynamics, simulations are checked against reference data to ensure that model behavior matches observed behavior as closely as possible. The model revealed an absence of data critical to the joint planning of the hospital discharge process.

The first model, a delayed discharge model, showed how reducing length of stay and delays could reduce delayed discharge cases and provide more bed capacity. Overall the model showed how to achieve as sustainable high quality and cheaper health services. Success in implementation of the delayed discharge model invited local health communities to develop similar models, tailored to local issues. The national discharge model was modified to study the impact of commissioning decisions (buying services) and capacity planning.

More information on this case can be found via Wolstenholme, E.F., Monk, D., McKelvie, D., Smith, G. (2007) “Influencing and interpreting health and social care policy in the UK”, Complex Decision Making: Theory and Practice .

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