Modelling TIA clinics in Cornwall


We are reviewing the provision of TIA clinics in Cornwall and Scilly, and so asked Selective Analytics to model a number of alternative arrangements for us.

Selective Analytics gave us a detailed breakdown of over 20 different options, all compared against the current clinic arrangement.

We are very pleased and impressed with the thoroughness and level of detail of the work, which is helping us shape the future service provision.

Peter Curnow, Associate Director of Commissioning, NHS Cornwall and Isles of Scilly

Current demand for stroke clinics in Cornwall

NHS Cornwall and Isles of Scilly was reviewing the provision of  stroke services, especially their TIA (Transient Ischaemic Attack) clinics. The current scheme has TIA clinics rotating around different locations each weekday, with a central location at the weekend.  While this seems like a ‘fair’ approach there was a need to check mathematically that this was indeed fair, and how other arrangements would impact patient access.

Analyse current situation

The first stage was to analyse the current patient clinic attendances against the different stroke risk factors. This showed that there was a growth in high-risk referrals that had to be seen within 24 hours. This is important when considering future capacity planning.

Other analysis allowed current geographic attendance patterns, the number and type of TIA categories seen and patient travel times. This detailed information helps the client to understand the current situation before any changes are considered.

Modelling options

NHS Cornwall and Isles of Scilly asked us to model two new arrangements, i.e. using two or three weekday clinic locations instead of the five currently employed. We modelled twenty five different combinations of low and high risk clinics and ranked them against the effect on patient access times. We also compared these results with the current arrangement to highlight the effect of any change on the patient.

Comparing patient access for all possible combinations

Evidence-based decision making

The analysis and modelling produced a range of detailed information on TIA clinic attendance, both on the trends and possible options. This allowed the stroke team to evaluate the possible effect of new arrangements on patient access before deciding on any change.

The analysis was independent and mathematically-based. However no model can include all the factors, such as staff or equipment availability. Therefore our modelling uses a ranking system to present the best options which the allow the local team to consider all issues before making the final decision.