Diagnosis of dementia remains a national priority in the UK, and clinical commissioning groups have responsibility for delivery. The current national target is for 66% of people with underlying dementia to have a confirmed diagnosis, however, the time frame for achieving this diagnosis is not mandated at an individual patient level. A target of 6 weeks from referral to diagnosis has been suggested, but it is unclear how this may impact on local capacity for delivery.
CLAHRC Wessex Data Science Hub collaborated with Wessex network and NHS England in the development of a computer based model of the diagnosis pathway. A discrete event simulation model of the dementia diagnostic process was developed. Factors within the diagnostic pathway potentially influencing diagnostic capacity were added to the model, including referral rates and resource constraints. The model was parameterised with data from regional commissioning groups and dementia clinics. Several different scenarios involving events within the diagnostic pathway were simulated in the model.
The simulation model was useful in predicting the effects of altering flows at different points in the pathway. The model allows users to conduct a “what if” scenario analysis to help decision makers better identify the challenges across the local health economy in delivering the new standard. The outputs inform the resource indications of the proposed standard including future CCG commissioning strategies, requirements of workforce, and provider service models.
Based on this approach we would be able to show the effect of change in referral rates on diagnosis time frame, as well as impact of an increase in referral of complex cases requiring various diagnosis tests on achieving the 6 weeks’ target.