Isle of Wight NHS Trust gains 17% bed capacity for inpatients using simulation

Case study

NHS Isle of Wight improves bed management and planning using SIMUL8: helping clinician and commissioner decision-making and increasing capacity by 17% from the existing bed base.


Using SIMUL8 simulation software, NHS Isle of Wight achieved:


Reconfiguration of beds allowed for increased bed capacity for medical patients by 17%

Increased community bed capacity based on identified need through the redesign of existing surplus capacity

Reduced hospital admissions by providing a home care packages delivery services to people in their own homes and in localities

Moving beyond planning bed management based on averages



As the sole provider of integrated acute, community, mental health and ambulance health care to an isolated offshore population of 14,000, Isle of Wight NHS Trust are continuously in search of creative and unique ways of improving and developing this challenging and often complex healthcare system.

Established in 2012, Isle of Wight NHS Trust is based at the heart of the island. St Mary’s Hospital forms the main base for acute service delivery with 246 beds and over 22,685 admissions per year.

The Trust strives to maximize patient flow across the entire Health and Care system to improve the delivery of urgent and elective care and ensure people stay as independent as possible.

NHS Isle of Wight utilized SIMUL8’s Bed.P.A.C. simulation tool to rapidly test a wide range of bed management scenarios to maximize efficiency and drive success. Using simulation has allowed the Trust to involve and engage their CCG, consultants and clinicians throughout the process to develop a comprehensive bed management solution that was everyone trusted and was invested in executing.

The NHS Isle of Wight Decision Support Team wanted to move beyond using simple deterministic spreadsheet calculations and planning on averages, to incorporate real world variables into bed management and planning analysis to provide more accurate and reliable results.


There were 7 key questions that the team hoped would be answered using SIMUL8's Bed.P.A.C. tool:


  • What impact will variations have on the planned number of beds needed for all specialties for 2016-2017?

  • What is the effect of winter pressures on inpatient beds?

  • What effect will inpatient bed utilization have on reducing delayed discharge patients?

  • How can mixed sex accommodation breaches be reduced?

  • Is there sufficient capacity to meet demand for a New Step Down Unit within the current footprint and what will be the frequency of medical outliers to this unit?

  • What is the downstream capacity constraint of community nursing beds?

  • How can we increase performance objectives, such as ED wait times, by using short term predictions to show where inpatient bed capacity problems may arise over the next 7 days?

"Bed.P.A.C. has stood up to scrutiny from clinicians and managers within the Trust; consequently the results output have led to constructive discussions about solutions to issues rather than ongoing debates about the integrity of the modeling."

Iain Hendey, Deputy Director - Information Finance & Performance Information Service Isle of Wight, NHS Trust

How Isle of Wight used simulation to forecast inpatient bed demand


To begin their analysis, The Isle of Wight used their Trust Demand tool to forecast arrivals of elective and emergency patients across each specialty.

The forecasts taken from this tool, along with 12 months of historical data of arrivals, length of stay and discharge times were imported in to Bed.P.A.C.

This automatically created daily patient arrival patterns and profiles of typical length of stay, taking into account both the time and day of arrival and specialty.

Bed.P.A.C’s simulation engine generated both individual specialty and aggregated results. From these findings, the team could identify the impact of demand on:

  • Hourly capacity of emergency and elective beds separately ‘unconstrained’
  • Hourly capacity if beds were constrained to the actual beds available, for emergency and electives together and separately
  • Patients who would need to be placed in another specialty having waited 12 hours for a bed

Results were grouped into four main areas which represented the main departments in the hospital including Trauma & Orthopedics, Surgery, Medicine and ITU.

All results from Bed.P.A.C were directly shared with the clinical staff in each team and workshops were then used to encourage discussion around bed allocation. From these workshops and also individual meetings, the team devised and investigated many ‘what if?’ scenarios.

These sessions enthused, motivated and engaged clinical staff in the overall process and consequently they provided invaluable insight which could be effectively incorporated into the further discussions.

The accuracy and sophistication of Bed.P.A.C’s report gained the immediate respect of the team and enabled productive and proactive discussions about the current state of processes and how they could then be improved.

“Consultants have been particularly impressed by our ability to recognize the maximum bed requirements and how often a certain number of beds will be utilized rather than referring to average bed requirements. Bed.P.A.C. has given our commissioners assurance on capacity that exists to deliver agreed demand plan with the exception of specific identified areas.”

Iain Hendey, Deputy Director - Information Finance & Performance Information Service Isle of Wight, NHS Trust

What were the results of the project?


Using SIMUL8’s Bed.P.A.C’s simulation tool, it was evident that in order to meet the Isle of Wight’s demand, more beds were required. With the insight provided, constructive system wide discussions via the systems resilience group could be had to resolve bed capacity issues.

Isle of Wight have been able to use simulation to reconfigure beds in hospital, allowing for increasing bed capacity for medical patients by approximately 17%.

It was also identified that these beds did not necessarily have to be within the hospital but instead could be placed within the community or even in the homes of patients with additional support.

Bed.P.A.C has excelled in helping the Isle of Wight NHS Trust manage and maintain the complex balance between acute and community care.

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