Operational research modelling: Transferring ENT/audiology services into a community setting Cardiff and Vale University Health Board

The Cardiff and Vale University Health Board team piloted a satellite facility within a GP practice, to enable 5,000-7,000 people to receive ENT and audiology secondary care services within a primary care setting. Their aim was to explore the benefits to patients and the health economy of shifting care closer to home.

The team also developed a new model to support accurate planning of service specifications including:

• a decision-making tool to optimise the value of service redesign
• a travel time calculator covering more than 20,000 postcodes
• a value calculator that determines the value of current services along with the value and impact of any historic changes.

The model was developed with input from ENT and audiology staff, but can be applied to any specialty.

Who was involved

The project was run by Cardiff and Vale University Health Board, with clinical leadership provided by a consultant otolarygologist and research support from Cardiff University’s School of Mathematics.

Outcomes

• ‘Do not attend’ rates reduced from 13% to under 1%.
• 62% reduction in patient travel time.
• 67% reduction in patient travel distance.
• 60% reduction in patient travel costs - a saving of £4.80 per appointment.
• Patients gave the move an average score of 9/10, with 70% giving a 10/10 rating.

Challenges

There was a lot of interest in the mapping tool which created extra work for the team. Insights gained from patient stories also led to more work, including a roll-out to additional patients and the co-ordination of patient focus groups.