Health care management-A case for simulation

The NHS reforms and the division of the Health Service into purchasers and providers have led to enormous changes in the structure of both clinical and administrative management. Health care professionals have had to adapt rapidly to changes in the culture and organisation of the NHS. Even those who opposed the reforms, feeling that the ‘supply and demand’ philosophy of the market-place should not be applied to the NHS, would not deny that many parts of the Health Service were inefficiently managed. However these changes are placing health care professionals under ever increasing pressure. For many it has been a step into uncharted territory-the environment is uncertain, the problems are new and complex, and decision-making is fraught with difficulty. The wrong decision could literally be a matter of life and death. The technique of simulation has sometimes had a rather dubious reputation in academic circles. It has been regarded as a tool to be used only ‘when all else fails’, and rarely actually selected as the technique of choice. However there can be little doubt that the current climate in the NHS presents Operational Researchers with an environment tailor-made for the use of simulation. Simulation is above all a pragmatic technique, based firmly in the real world. It is about finding practical solutions to complicated, messy problems; finding these solutions quickly, and then (crucially!) getting them implemented by the decision-makers.