Developing open source tools and support materials to measure geographical accessibility to screening and cancer support services
Computing software tools such as Geographical Information Systems (GIS) have advanced the ability to measure accessibility to healthcare facilities. There are multiple methods which have been proposed in academic institutions but are often not applied in practice. The aim of this PhD is to create free and open-source (FOSS) accessibility tools which can be utilised by non-experts in the field and provide meaningful insights into the provision of cancer services in Wales. The objectives of the project are to investigate the use of accessibility methods within healthcare with a particular focus on chemotherapy and cancer services, to provide real insight into current levels of accessibility to cancer services, to use case studies to propose alternative locations and to perform user studies to provide a tool which is proven to be fit for purpose. Multiple strategies have been used to gain access to data sets which have been used as supply, demand and network characteristics. Software solutions were investigated to establish an understanding of the current FOSS GIS available. A case study showed potential locations for additional chemotherapy resources. Modelling scenarios were implemented to investigate the effects of scale on the adopted solution in order to visualise the impacts on patterns of accessibility to inform a cost:benefit decision on planning cancer services. Results showed multiple routes for implementation with strengths and limitations associated with each potential solution. Case studies showed that there were multiple locations which could be proposed to improve access to chemotherapy, and that a small amount of resource in key areas could have a large impact on the accessibility scores of the region. A user study was conducted with members of the Tenovus team, and this provided a real insight into how a non-expert may use these types of systems, and assisted in creating user-friendly tools to implement these models. The study presents a software solution which offers non-GIS experts advanced accessibility methods with which to plan the location of cancer services. The system developed has the potential to change the way in which treatment is provided by allowing non-experts to calculate and visualise current and potential accessibility maps using several advanced methods. The project has investigated the impact of changes in scale, precision (network data, algorithm) and methods (variants based of floating catchment area (FCA) methods) using FOSS GIS and their networking capabilities. This tool has the potential to be used by many organisations who need to plan the provision of services in relation to changes in potential demand.
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