Active Public Health & Healthcare Mathematics & Statistics

AHP WRaP: Prototype simulation model for AHP workforce interventions

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Allied health professionals—physiotherapists, radiographers, dietitians, and others—make up a quarter of the NHS clinical workforce, yet no simulation model exists to predict how changes in their staffing will affect patient care across the UK. The problem is that healthcare systems are complex. Adding more podiatrists in one region might improve diabetic foot care there, but could inadvertently pull staff from another region or shift patient demand in unexpected ways. Without a model, policymakers have no way to test these knock-on effects before implementing expensive workforce interventions. A 2020 systematic review found no dynamic simulation models for the allied health professions (AHP) workforce anywhere in the UK. This project will build a prototype simulation model—a digital sandbox—that lets researchers and NHS planners explore what happens when they change staffing levels, training pipelines, or patient populations. The model will be built using established health-economics guidance and will incorporate both effectiveness and equity outcomes. If successful, it will give the NHS a practical tool to anticipate the consequences of workforce decisions before they are made, reducing the risk of unintended harm to patients or wasteful spending on ineffective staffing changes.

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Background and justification: AHP workforces operate in complex healthcare delivery systems. Dynamic simulation models may help identify and understand critical aspects of these systems and act as an evaluative tool to suggest the intended and unintended effects of potential interventions and other system- or population changes. A systematic review published in 2020 identified system dynamics simulation models applied to workforce demand but none on the AHP workforce in the UK. Following the ISPOR SIMULATE guidance, we will build a prototype simulation model capable of providing insights into the distribution of workforce and patient populations and explore the potential effects of natural and planned experiments on AHP workforce. We will apply the model to explore the consequences of the interventions that we evaluate in later phases. i) Consultation with Partnership CIE stakeholder group to agree model’s scope and perspective. This will narrow down the scope with a focus on specific AHP professions, settings and focus. ii) Scoping review to understand existing evidence, models, and model components within the specified scope and perspective. iii) Construction of the dynamic model in appropriate software (e.g. R Shiny App) reflecting best methodological practice and capturing a meaningful abstraction of the real-world environment including patient populations served. The model will be built to assess the impact of the staffing interventions considered in the overall programme of work and be amenable to conventional and distributional health economic evaluation looking at both effectiveness and equity considerations.

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Related Research

Grants with similar aims, by meaning.

AHP WRaP: Exploration of AHP Workforce Retention and Interventions
Allied Health Professions Workforce Research Partnership: supporting a sustainable and effective Allied Health Professions workforce in rural and coastal regions and in deprived urban areas
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AHP WRaP: Service and System Impacts of Level 6 Apprenticeship Training
Planning for Frailty: Optimal Health and Social Care Workforce Organisation Using Demand-led Simulation Modelling (FLOWS)

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