Modelling toolkit to assist with introducing a stepped care system design in mental health care

Abstract

We describe a modelling toolkit that was developed with the aim of assisting those responsible for introducing stepped care systems to local mental health services in the UK. The toolkit was pre-populated with real patient flow data collected from four sites that piloted the stepped care system design. Two analytical models were developed and coded as part of the toolkit to provide insights concerning workload, patient throughput, and changes in waiting times and waiting list size. An interface was built to allow users to specify their own stepped care system and input their own estimates or data of service demands and capacities at different steps. Despite the challenges and limitations, the use of modelling to inform the design of new service configurations is an important step in the right direction and we would recommend this as a reasonable way forward.

Keywords:

• health service
• decision support systems
• queuing
• practice of OR

Acknowledgements

The study was funded by the NIHR-SDO (08/1504/109). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR-SDO programme or the Department of Health. The UCL Clinical Operational Research Unit receives funding from the UK Department of Health. David Richards acknowledges funding from the National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care. We thank the site-based NHS audit clerks who collected and collated the data on patient throughputs and to Kerry Cipriano and Joanne English who provided administrative support. We acknowledge the contribution of the NHS clinical staff, patients, managers and commissioners who were involved in testing the toolkit.