Providing an evidence-based review of a new care model for Derbyshire Healthcare NHS Foundation Trust
The Trust had developed a new model of care, primarily based on devolution of a range of services to local neighbourhood teams across the county. They wished to have an independent evidence-based perspective on the robustness of that model: whether the proposed organisation of services would be deliverable in practice, taking account of capacity, demand, demographic change, and expected resource reductions.
We began with a series of introductory events for a wide range of staff from across the Trust. We then designed a discrete event simulation model and populated it with local activity data, cleansing the data to ensure local confidence in its reliability. Over an iterative series of multidisciplinary workshops, held across the county, we explored firstly the baseline situation, and then a range of scenarios for service change. This work identified both pressures and opportunities to change aspects of the model and individual services to relieve those pressures. We looked at possible service changes in combination, and considered how resources could be better used to bring capacity and demand as close as possible to balance. We considered scenarios with reductions in the Trust’s financial resources. We finally fed back our findings in a further series of multidisciplinary discussions, leading into the Trust’s internal implementation planning.
Our work concluded with recommendations addressing the robustness of the Trust’s plans for both inpatient and community services. We identified a series of prospective action areas addressing:
• The use of the inpatient bed pool
• Flexibility within the organisation of neighbourhood teams
• Providing crisis support for older people with both functional and organic illnesses
• Specialist services for people with a personality disorder
• Productivity within community teams
In each case, recommendations were detailed and exactly quantified.
As a provider delivering a complex transformation programme across a range of interconnected services the need for external assurance by way of future impact was essential. The process of engaging staff in the modelling process increased ownership and transformational planning transparency.
The final report from Sim:pathy enabled the Organisation to:
• Provide external assurance to support the Board Assurance Framework
• Provide evidence of continued delivery levels to commissioners
• Act as a reference point in internal and external consultation documents
• Support a workforce capacity planning approach
• Act as an anchor for a number of delivery projects within the transformational change programme