The Royal Cornwall Hospitals Trust (RCHT) have been tasked by NHS England to develop a high-level understanding of demand and capacity outside of hospital. PenCHORD will develop a simulation model that helps to better inform whole systems capacity decisions moving forward. Specifically, the model of the system will cover arrival at the Emergency Department (ED) to discharge and transfer or step down care. This will allow for a better understanding of how increased capacity in elements of the health and social care system could help to improve flow.
To develop a high-level simulation model of the system from arrival at ED to discharge / transfer / step down destination in Cornwall.This will allow decision makers to better understand where the strains are on the current system, and how patterns of patient flow are changing over time.Such information can then be used to identify where capacity and resources may be best placed within the health and social care system in Cornwall to reduce delays.
A high-level System Dynamics model has been developed that captures the Emergency Department at Treliske, the wards at Treliske, the delays from when patients are medically fit for discharge to the time of their discharge, and discharge destinations including home, home with a package of care in place, community hospital and care home. Data to parameterise the model is being collated by representatives from across the system, and the design of the model is being refined based on feedback from the project stakeholders.
It is hoped that the insights generated from this model will, in the short term, help with planning for winter pressures in Cornwall and, in the longer term, help with planning for resources and capacity across the whole health and social care system in Cornwall.It is intended that the results from this modelling work will feed into the Cornwall Sustainability and Transformation Programme (STP) – “Shaping our Future”.