News and Comment

How simulations can help to prevent a winter of discontent

Monday 29 July 2013


The preparedness of hospitals to deal with the winter spike in admissions loomed large in the press last week. The Commons health committee report on urgent care and emergency services stated that it “is mindful of pressures which will build during next winter and is concerned that current plans lack sufficient urgency.”

Chair of the committee, Stephen Dorell, went on to say: “It is clear that the structures established 60 years ago are not appropriate for the 21st century. We need to reorganise the way in which emergency and urgent care is delivered.”

At OPM we are currently working in this area, helping acute trusts, CCGs and other health and social care services develop their capability to respond quickly and effectively to urgent care challenges, and to build their capacity to plan for the ‘predictably unpredictable’ as a constant feature of urgent and emergency care.

We find in particular that carefully designed simulations based on contexts which are simplified, but essentially realistic versions of the world outside, are an extremely effective process which enables providers and commissioners to test out the kind of proactive and innovative thinking future challenges will require.

Working with the whole health and social care system in a local area together for a day, participants are able to explore and shape their plans for the management of urgent care in a way which effectively speeds up the usual processes of arranging meetings, building better working relationships based on an understanding of each agency’s contribution and limitations, and using that time together to challenge the usual ways in which seemingly ‘stuck’ problems may be addressed. While the central focus is on urgent care provision, it is no coincidence that other aspects of integration and improved patient experience also receive valuable attention.

By engaging with this process our clients report that the quality of their relationships, the lines of communication, and the negotiations and prioritisation between stakeholders which inform decision-making and corresponding actions, have benefitted by highlighting areas of good practice which can be shared more widely, as well as gaps and omissions which need to be filled.

The need for such preparations is pressing, not least because the Commons health committee has asked the Department for Health to ensure that urgent care plans are put in place for each area of the country before the 30th of September.

We will be blogging regularly about the issues concerning urgent care services over the summer, so please keep a lookout for out latest content.