Planning mental health services using simulation and modelling

by Dr Julie Hankin

Modelling offers huge opportunities for the planning of mental health services. The good news is that the process of adopting such methods should become easier because trusts are collecting more and more of the information that effective modelling requires.

There are two ways that modelling can be particularly useful. First, mental health is not just about what happens in a consulting room. It is affected by education, the criminal justice system, by employment and a host of other factors. If one can start to build some of these variables into the modelling of mental health care, then one is beginning to performance manage outcomes and not simply modelling the processes of service delivery.

Perhaps less ambitious, but more practical in the short term at least, modelling can allow you to look across different health and social services and see the impact of different commitments at various points in the patient pathway. It can really help us to optimise the positioning of resources and see, in advance, the knock-on effects of altering allocations in a particular area. Knowledge of these consequences should help us to be more sensitive in redistributing resources than we could be in the past.

This is not a pipe dream. Lots of businesses use modelling of this type very effectively. There is no reason particular to healthcare why we cannot also do it for mental health services. Indeed, as I say, it should become easier. Now that we are moving to the tariff payment system and payment by results, information systems around activity and disaggregated costs are being collected more comprehensively. These figures can highlight issues, for example, related to patients who may be well but who are unable to move on because of accommodation shortages. They also show us where the pinch points are in our systems so we can allocate staff to the most stretched areas.

Modelling is also vital for any service to gain the firm attention of senior managers. They need choices to be laid out in a digestible, accessible form, including all the opportunity costs. It’s the route to sound management and can only help mental health services to achieve the priority to which they are entitled in the hierarchy of service delivery.

Dr Julie Hankin is Consultant Psychiatrist and Clinical Director (Service Improvement) for Avon and Wiltshire Mental Health Partnership NHS Trust.

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