Health secretary reports on winter crisis

Forecasting demand of emergency care

This paper describes a model that can forecast the daily number of occupied beds due to emergency admissions in an acute hospital. Out of sample forecasts 32 day days in advance. have an RMS error of 3% of the mean number of beds used for emergency admissions. We find that the number of occupied beds due to emergency admissions is related to both air temperature and PHLS data on influenza like illnesses. We find that a period of high volatility, indicated by GARCH errors, will result in an increase in waiting times in the A&E Department. Furthermore. volatility gives more warning of waiting times in A&E than total bed occupancy.

A simulation study of the winter bed crisis

The winter bed crisis is a cyclical phenomenon which appears in British hospitals every year, two or three weeks after Christmas. The crisis is usually attributed to factors such as the bad weather, influenza, older people, geriatricians, lack of cash or nurse shortages. However, a possible alternative explanation could be that beds within the hospital are blocked because of lack of social services for discharge of hospital patients during the Christmas period. Adopting this explanation of why the bed crisis occurs, the problem was considered as a queuing system and discrete event simulation was employed to evaluate the model numerically. The model shows that stopping discharges of rehabilitating patients for 21 days accompanied by a cessation of planned patients for 14 days precipitate a bed crisis when the planned admissions recommence. The extensive "what-if" capabilities of such models could be proved to be crucial to the designing and implementation of possible solutions to the problem.