Terminales del sistema: MEOLUTs y balizas

This study makes four main contributions to knowledge and research.

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1. This study combines Operational Research techniques with an understanding of Gerontology, in particular demography and social policy. It is important to have a combined approach to gain a better understanding of the future implications of an ageing population in Hampshire.

2. The OR literature contains many papers relating to health care, but there are far fewer dedicated to social care issues. This study aims to fill this gap as it addresses the provision of social care in the home and community for a specific region of England, Hampshire.

3. This research is novel as it combines a population model with a discrete-event simulation model. There are no papers related that uses the hybrid approach in the area of social care or involving a contact centre.

4. The findings of the cell-based model are being used by the Adult Services

Department in HCC to help plan the provision of long-term care in Hampshire. The findings of the hybrid model are being used to assist with future planning of the contact centre; the results should help inform this process.

The hybrid framework has made both an academic contribution and has had a practical impact for Hampshire County Council. There are no existing papers of the hybrid approach in the area of social care or modelling of contact centres. There has been a lot of research dedicated to the modelling of contact centres but they take a short-term view of the contact centre. The hybrid framework allows a long-term view to be taken. All the papers dedicated to research in the application of social care look at the impact of cost or future changes in the number of disabled people. None of existing research looked at the impact of demographic change upon an operational part of the system for long-term care.

This research looks not only at the changing demographics of Hampshire but models the impact it has on the contact centre. It allows for a more sophisticated demand profile to be created instead of simply inflating call arrival rates. The research allowed for the inclusion of feedback created from abandoned calls from the previous month. As well as this, the demand profile excluded people with no incapacity when creating the change in the number of callers on a month by month basis. Cell-based models and discrete-event simulation models alone have been proven to work successfully across many

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application areas but this research shows that by having a combined framework a more robust modelling technique can be formed. The new framework has all the strengths of the original methodologies but also allows the researchers to address new questions that could not have been answered with one model alone. In this research, a discrete-event simulation model study of the contact centre would have only looked at the performance of the contact centre today and would not have studied the impact of changing

population demographics and increased numbers of disabled people in the Hampshire population.

The hybrid framework can be potentially extended beyond social care to other problem areas. For example, hospitals in England face increasing pressure to meet many targets, one of which is that a patient who is admitted to an accident and emergency (A&E) department must be served within four hours. A discrete-event simulation model could be used to model the A&E department and a compartmental model could model the local population. This allows the modeller to consider factors outside the control of the hospital that would impact upon the number of patients needing support from the A&E department. In this research, contact centre demand was impacted by changes in the number of disabled people. An example of a factor impacting the A&E department could be changes in the incidence of influenza. The wider application of the hybrid framework will lead to the creation of more robust models that can answer many more questions than could be by previous models.

The two standalone models can potentially be useful for Hampshire County Council.

The Adult Services Department have taken ownership of the cell-based modes and are using it as an additional piece of evidence in the planning of future services. The data provided the Council with a set of information they did not have before and the results of the model has the potential to improve decisions both in the short and long term. The discrete-event simulation was useful as a standalone model. The model was run for a number of scenarios where the number of call handlers was altered. For example, one scenario showed the impact of Swine Flu which meant that a number of staff could not work. The combined framework of both models is being used to help plan the future of the contact centre. The data allows the decision makers to make long-term decisions supported by evidence. The results of the hybrid framework are being used by the

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Programme Manager within the Adult Services Department to access the number of resources required to run the service in the future.