In this research, we are looking at how decisions at patient level and in primary care settings affect secondary, acute and social care settings.

At present there is no standardised approach to the management of Atrial Fibrillation across the West of England. We have a wide range of approaches from anti-coagulation services which are predominantly GP led, through to those where INR outpatient clinics in acute hospital settings are the main provider.

Our long term aim is to develop a modelling toolkit for use nationally by local communities and commissioners to help with decisions around the organisation of anti-coagulation and stroke prevention services in terms of patient outcomes including patient safety and likely impacts at local health economy level.

This particular project is proposing to conduct a proof-of-concept study of developing novel whole-system models representing different options of organising anti-coagulation services in the South West. The models will be used to evaluate the likely impact of different options on patient and system-level outcomes by means of computer simulation experiments.