FLEXIBLE ESTATE


constrained home delivery service – such as take-aways to your door – but in this case, the important new coding was done by a single person.


Modelling The modelling story started in March 2020 with a simple Excel-based simulation of the COVID epidemic and its potential impact in East Birmingham. The results were shocking, because they predicted a peak of infections at Easter 2020, which was just four weeks away, and while all eyes were on hospitals, the bigger tsunami of worried sick would be in the community. The urgent need was for a high-volume, no-queue, COVID-safe drive-through assessment capability to be designed, built, and opened, in less than four weeks. The system design took three days, and used an award-winning complex physical system simulator. It had to be right first time, and it was: the pipelined flow design worked exactly as the model predicted.


A ‘pit-stop’ design When it came to the later design of the permanent facility at Bourne Road, the first choice was a pit-stop design inspired by Formula One, where patients would drive into the facility, and clinical staff would come to them. The activities were simulated using a series of models that were based on the existing drive-through sites, and were populated with data measured at those sites. This model was used to identify and


mitigate the flow constraints, predict the maximum throughput, and inform the architectural design. Finally, the final version of the model was run to configure an online booking system to ensure that clients arrived at the correct rate to avoid queues, while making efficient use of the staff time. The new drive-through care facility opened on 25th October 2021, and, once again, worked exactly as predicted.


Where next? This combination of patient-bookable, logistics-empowered, information-backed care is exceptionally powerful. Once the information networks and ‘cookie cutter’ plan exist, units can be deployed within weeks at the heart of populations needing care – whether through a pandemic, or migrations of workers, as the industrial and business landscape changes. This model can certainly be used for diagnostics, minor procedures, and to support people with a range of long-term conditions. The ability to sprint from one minimum viable product as a service to the next, will, once embraced by the NHS, undoubtedly bring better care closer to those that need it, and cost us all a great deal less. This is the future: it’s great medicine, it’s great care, and it makes great economic sense.


Alan MacDonald


Alan MacDonald studied at Nottingham Trent University, and has a BSc (Hons) in Biomedical Science. He worked for the Badger Group as an out-of-hours primary care team leader, and later became a data analyst. Following the start of the COVID-19 pandemic in March 2020, he became directly involved with the development of a multi-lane drive-through COVID Referral Centre at the NEC Birmingham. Instrumental in the deployment of other temporary drive-through clinics across Birmingham, he has also been actively part of the original team that successfully applied this concept to ‘the first purpose-


built drive-through clinic in the UK’. He is frequently involved in new and novel projects within the out-of-hours primary care sector, and is currently studying Health Care Systems Engineering.


Terry Young


After sixteen and half years as a research engineer, Divisional Manager, and Business Development Director, Terry Young became a Professor at Brunel University London for 17 years. He has a BSc in Electronic Engineering and Physics, and a PhD in laser spectroscopy, both from the University of Birmingham, and is a Fellow of the BCS. His research has been in health technology, health services, and information systems. He has taught information system management, project management, and e-Business. His awards include the Operational Research Society’s Griffiths Medal, 2021, for analysing the return simulation methods offer when used to improve healthcare services. Prof. Young set up Datchet Consulting in 2018 to support innovation on the borders of academia, health, and industry – of which he says the project reported on here is an excellent example.


Simon Dodds


Simon Dodds studied medicine and digital systems engineering before following a career in general, and then vascular, surgery. In 1999 he was appointed as a consultant surgeon at Good Hope Hospital in North Birmingham, and applied his skills as an engineer and a clinician in the re-design of the hospital’s vascular surgery clinic and the leg ulcer service. In 2004 the project was awarded a national innovation award for service improvement. This experience led to the design, development, and delivery, of the Health Care Systems Engineering (HCSE) programme.


Fay Wilson


Fay Wilson trained in Birmingham, practising as a GP there since 1985. Her extensive national and local portfolio includes NHS HA Non Exec, GMC fitness-to- practise chair, and associate postgraduate dean at Health Education West Midlands. She has served on the council of the BMA and other bodies. She brings people together to develop new models of care, a notable success being the Birmingham Multifund co-operative, a pioneering nurse-led walk-in centre and a prototype GP provider-at-scale ahead of its time in the mid-1990s. Dr Wilson is medical director and co-founder of Badger, a GP social enterprise that since 1996 has provided out-of-hours and urgent primary care. COVID-19 introduced her to systems engineering, new people, and new ways of thinking.


April 2022 Health Estate Journal 27


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