Facilitating end user involvement and uptake of PathSimR NHS Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group

An Advancing Applied Analytics project by NHS BNSSG explored how system-level data analytics can meet patient flow challenges. It involved building an analytical tool that can accommodate interconnected services along a given patient pathway.

The resulting tool, PathSimR, is an open source R-based tool designed to model patient flow and capacity along clinical pathways. This Evidence into Practice project further promoted the tool and embedded its use in NHS organisations. Three case study projects were identified for applied use of PathSimR.

The first was a mass COVID-19 vaccination project whereby the project team used modelling to inform the design and set up of a vaccination site in Bristol. Using PathSimR, modelling determined the safe maximum number of daily bookings and necessary staffing for the centre. This influenced the design of the centre and ensured effective operation during the crucial early stages of the mass vaccination effort.

The second project involved applying PathSimR to support decision making for a major stroke service reconfiguration. Modelling was used to calculate the ‘flex capacity’; the additional beds that might be needed at peak times. Insights were provided that would not have been possible without the PathSimR model, and the results informed the business case, which was approved in early 2022.

The third project involved using PathSimR to study how out-of-area mental health psychiatric intensive care unit placements could be reduced. Patient flow was modelled to determine the optimal capacity. The results helped service managers to understand how potential demand and capacity mismatches may produce pressure on services, and have been used as part of a wider review of mental health services.

The case studies have helped promote use of patient flow modelling among analysts, clinicians and service managers. Going forward, this will result in improved awareness and understanding of the dynamics of patient pathways, and better planning for meeting demand.

Contact details

For more information, please contact Dr Richard Max Wood, Head of Modelling and Analytics, NHS Bristol, North Somerset and South Gloucestershire CCG.