Outpatient Service Optimisation

South West PeninsulaGeneric Health Relevance
Start Date: 18 Feb 2016

Outpatient Service Optimisation - Optimising the location of Outpatient Services in Cornwall - Phase 1


With a travel bill of approximately £1 million per year, sub-optimal use of its estate, and an agenda to move care closer to home, Royal Cornwall Hospitals NHS Trust (RCHT) has long been keen to better organise its provision of outpatient services across Cornwall. The service is comprised of around 30 clinics and around 250 consultants visiting these clinics. Therefore, mathematical optimisation approaches are necessary in order to try to find optimal configurations.

This project will be the first phase of a three-phase larger project to answer the broader question “What’s the best way to distribute outpatient clinics and clinicians across the existing sites in Cornwall, to minimise travel for patients and clinicians, and maximise usage of the sites where clinics are based?”. This first phase would seek to determine which clinics should be held where to minimise travel distances for patients. A second phase would look at how this configuration would differ if minimising travel distances for consultants. A third phase would use decisions on “optimal” configurations identified through the first two phases to build a scheduling model that looks at how these clinics should be scheduled. If there is significant disparity between the optimal configurations identified in phases one and two, multi-objective optimisation techniques will be used to identify a range of optimal configurations, allowing the collaborators to make trade-off decisions.

Project Aims and Activity

The main aims of this first phase of the project are to answer the following questions:

  1. Based on current activity, which outpatient clinics should be held at which sites in Cornwall in order to minimise travel times for patients?
  2. Is this configuration likely to change based on forecasts of activity in five years’ time?

We will build an Excel-based geographic model that determines the optimal configuration of where to run each outpatient clinic if trying to minimise the travel time of patients who would access those clinics.

For the forecasting, we will use a Seasonalised Linear Regression Trendline to forecast trends in activity, taking into account seasonal fluctuations.

Expected Project Outputs and Impact

The collaborators have been wanting to optimise their outpatient service configuration for some time, and plan to use the results of the larger project in order to redesign their service provision. The results from this phase of the project would be directly used to inform the development of phases two and three.

There is likely significant potential for a research paper to be generated from the larger project outlining how geographic modelling and optimisation methods can be used to optimise resource allocation in the context of outpatient clinics.

Dr Daniel Chalk