Capacity planning at the interface of health and social care: a simulation approach to time-varying resource needs

Delays to hospital discharge create system-wide pressures by reducing acute hospital capacity. As increasing numbers of higher-acuity patients are discharged into home-based care requiring multiple daily visits, modelling capacity at the interface of acute and community care becomes more complex. We introduce a visits-based, time-driven simulation model that incorporates variable daily visit requirements. We compare the simulation with tractable analytic queueing models using a consistent set of parameters, showing how each approach can provide complementary perspectives on system behaviour. This comparison highlights how simplified analytic representations may not reflect congestion dynamics when resource use varies over time, particularly at high traffic intensities. Our model has been implemented in practice by NHS partners for routine planning. We demonstrate how incorporating time-varying resource requirements into visits-based models supports understanding of system dynamics and informs workforce and capacity planning in stretched systems.