University of Hertfordshire

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Original languageEnglish
Pages (from-to)793-812
Number of pages20
JournalThe International Journal of Health Planning and Management
Early online date15 Feb 2021
Publication statusPublished - 1 May 2021


Demand for neonatal care in the United Kingdom (UK) has increased in recent years. This care is provided by neonatal services, which are chronically saturated due to years of budget austerity in the UK. The aim of this paper is to investigate the possible impact of increasing resources to these services to improve their operational performance and alleviate the pressure they are facing. To achieve this aim, a System Dynamics (SD) simulation model was built and validated in a UK neonatal unit. The SD model was used initially to evaluate the impact of increasing resources on the unit performance and the results showed that this policy will have a limited effect on performance. The model was then extended to predict the effect of reducing the length of stay (LoS) in conjunction with increasing resources. These joint interventions will have a positive impact on the unit performance if LoS is reduced for all care categories and resources are slightly increased. Results’ implications and SD’s modelling usefulness to guide decision making in complex health settings are discussed.


© 2021 John Wiley & Sons Ltd. This is the accepted manuscript version of an article which has been published in final form at

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