The application of computerised modelling techniques in manufacturing system design

The absence of a definitive approach to the design of manufacturing systems signifies the importance of a control mechanism to ensure the timely application of relevant design techniques. To provide effective control, design development needs to be continually assessed in relation to the required system performance, which can only be achieved analytically through computer simulation. The technique providing the only method of accurately replicating the highly complex and dynamic interrelationships inherent within manufacturing facilities and realistically predicting system behaviour. Owing to the unique capabilities of computer simulation, its application should support and encourage a thorough investigation of all alternative designs. Allowing attention to focus specifically on critical design areas and enabling continuous assessment of system evolution. To achieve this system analysis needs to efficient, in terms of data requirements and both speed and accuracy of evaluation. To provide an effective control mechanism a hierarchical or multi-level modelling procedure has therefore been developed, specifying the appropriate degree of evaluation support necessary at each phase of design. An underlying assumption of the proposal being that evaluation is quick, easy and allows models to expand in line with design developments. However, current approaches to computer simulation are totally inappropriate to support the hierarchical evaluation. Implementation of computer simulation through traditional approaches is typically characterized by a requirement for very specialist expertise, a lengthy model development phase, and a correspondingly high expenditure. Resulting in very little and rather inappropriate use of the technique. Simulation, when used, is generally only applied to check or verify a final design proposal. Rarely is the full potential of computer simulation utilized to aid, support or complement the manufacturing system design procedure. To implement the proposed modelling procedure therefore the concept of a generic simulator was adopted, as such systems require no specialist expertise, instead facilitating quick and easy model creation, execution and modification, through simple data inputs. Previously generic simulators have tended to be too restricted, lacking the necessary flexibility to be generally applicable to manufacturing systems. Development of the ATOMS manufacturing simulator, however, has proven that such systems can be relevant to a wide range of applications, besides verifying the benefits of multi-level modelling.

GPs' perspectives on managing the NHS Health Check in primary care:a qualitative evaluation of implementation in one area of England

OBJECTIVES: To evaluate the implementation of the National Health Service (NHS) Health Check programme in one area of England from the perspective of general practitioners (GPs). DESIGN: A qualitative exploratory study was conducted with GPs and other healthcare professionals involved in delivering the NHS Health Check and with patients. This paper reports the experience of GPs and focuses on the management of the Heath Check programme in primary care. SETTING: Primary care surgeries in the Heart of Birmingham region (now under the auspices of the Birmingham Cross City Clinical Commissioning Group) were invited to take part in the larger scale evaluation. This study focuses on a subset of those surgeries whose GPs were willing to participate. PARTICIPANTS: 9 GPs from different practices volunteered. GPs served an ethnically diverse region with areas of socioeconomic deprivation. Ethnicities of participant GPs included South Asian, South Asian British, white, black British and Chinese. METHODS: Individual semistructured interviews were conducted with GPs face to face or via telephone. Thematic analysis was used to analyse verbatim transcripts. RESULTS: Themes were generated which represent GPs' experiences of managing the NHS Health Check: primary care as a commercial enterprise; 'buy in' to concordance in preventive healthcare; following protocol and support provision. These themes represent the key issues raised by GPs. They reveal variability in the implementation of NHS Health Checks. GPs also need support in allocating resources to the Health Check including training on how to conduct checks in a concordant (or collaborative) way. CONCLUSIONS: The variability observed in this small-scale evaluation corroborates existing findings suggesting a need for more standardisation. Further large-scale research is needed to determine how that could be achieved. Work needs to be done to further develop a concordant approach to lifestyle advice which involves tailored individual goal setting rather than a paternalistic advice-giving model.