Modelling NHS England 111 demand for primary care services: a discrete event simulation

Area of Science:

• Health Services Research
• Health Informatics
• Simulation Modeling

Background:

• The National Health Service (NHS) 111 service handles numerous calls, with many patients triaged to primary care.
• Timely access to primary care is crucial for efficient healthcare delivery and patient outcomes.
• Current system pressures may impact the ability to provide prompt primary care services.

Purpose of the Study:

• To model the current healthcare system for patients using NHS 111 and triaged to primary care.
• To simulate the impact of reconfiguring the system to ensure timely primary care contact.
• To assess potential changes in emergency service utilization and emergency department (ED) attendances.

Main Methods:

• Discrete event simulation was employed to model the healthcare system.
• The study utilized data from a single NHS 111 call centre in Yorkshire.
• Model validation involved comparing simulated data with real-world quarterly counts of service usage.

Main Results:

• The current system simulation predicted 39,283 primary care contacts, 2,042 emergency (999) calls, and 1,120 avoidable ED attendances.
• Reconfiguring for timely primary care access increased contacts by 196.1% but decreased 999 calls by 78.0% and ED attendances by 88.1%.
• Avoidable ED attendances decreased by a mean of 26 cases.

Conclusions:

• Ensuring timely primary care contact in the simulated model significantly reduced emergency calls and ED visits.
• The required increase in primary care provision (nearly doubling current capacity) may be impractical.
• Further research into cost-effectiveness and clinical/patient acceptability is warranted.