Citation for Companion of OR 2012
Professor Peter Millard
Peter Millard FRCP is Emeritus Professor of Geriatrics, St George's, University of London and President of the UK Nosokinetics Group. He coined the word Nosokinetics in his 1992 PhD thesis: Flow rate modelling: a method of comparing performance in departments of geriatric medicine. Peter is in active retirement a Health Advisor to the National Pensioners Convention and has been co-supervisor of doctoral students modelling health care systems at the Universities of Ulster, Westminster and Adelaide. He has over 120 publications on different aspects of modelling health and social care systems, in addition to numerous publications in the medical literature.
Peter qualified in Medicine in 1960. In 1968 he was the first consultant in geriatric medicine appointed to St. George's Hospital (London). From 1968-1984 he collected a unique longitudinal data set, including data on all geriatric patients in the hospital during the period; this data set has proved an invaluable resource and has formed the basis of much of the work in the following decades. Between 1993 and 1999 he was the Eleanor Peel Professor of Geriatric Medicine at St. George's Hospital Medical School (London), where his research interest in modelling and new methods of measuring activity in hospitals began. With no background in Mathematics or Operational Research, Peter intuitively realised the need to analyse his data to understand the processes at work and provide modelling and planning tools to provide better services for the elderly. As such, Peter extensively analysed his data set and in particularly realised that heterogeneity of length of stay of patients in hospital can be described by a two (or more) term mixed exponential distribution, thus characterising short-term (acute) and long-term patients. Thus began a long collaboration between Peter and a series of OR professionals.
In 1989, Peter visited the College of Charleston, USA and together with Gary Harrison (an applied mathematician) developed and published “Balancing acute and long-term care: the mathematics of throughput in departments of geriatric medicine” in Methods of Information in Medicine. The next year he met Professor Sally McClean, an operational researcher working in the University of Ulster, with whom he published widely, extending the model to stochastic as well as deterministic representations of patient flow. Between 1993 and 2002, he was a visiting professor to the Department of Mathematics at the University of Ulster where he co-supervised several successful PhD's (Gordon Taylor, Adele Marshall, Lalit Garg and Jennifer Gillespie, to date). Peter has also been a visiting professor to the University of Westminster for many years, where he collaborated extensively with Professor Thierry Chaussalet and Dr Elia ElDarzi, contributing extensively to a large number of MSc projects and co-supervising various successful PhDs (Christos Vasilakis, Revlin Abbi) in the area of Healthcare Operational Research. Other significant collaborators have been Dr Mark McKay and Professor Malcolm Faddy in Australia, Dr Brendan Rae in New Zealand, Professor Florin Gorunescu in Romania, not to mention various collaborations with OR and medical researchers in Europe, particularly Spain and France, where he has spent a sabbatical leave with Professor Alain Franco in Grenoble. Peter has also co-organised a large number of conferences, workshops and conferences to promote his work, principally the Health and Social Care Modelling conferences (Adelaide, 2006 and Portrush, 2008) and the recent workshop on “Maths and Medicine: Measuring and Modelling Patient Flow in Healthcare” held in St. George’s, April 2012.
Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems. Nosokinetics brings together the Greek words for noso: disease and kinetics: movement and Nosokinetics, (analogous to Pharmacokinetics), and seeks to develop dynamic methods which measure and model the process of inpatient care. The aim is to develop a science base to underpin the planning of sustainable health and social care systems. In 2004 the Nosokinetics group newsletter was established, with Peter as Editor and an extensive circulation to both the OR and the Medical communities. Peter writes about Nosokinetics : "If the random forces of wind and tide can make such a beautiful statue (referring to an iceberg), how much better could mankind do if a new science was developed which explains the complex processes of health and social care. Until new methods of planning health and social care services to meet the needs of an ageing population are introduced, service delivery will stumble on from crisis to crisis. The world population is ageing and sustainable systems of health care need to be developed." This has led to the establishment of the Nosokinetics group of interested researchers. The group collaborates to organize conferences and disseminates news of Nosokinetics and related research and practical use of modelling to enhance decision making in health and social care systems. The Nosokinetics group comprises interested people in many countries including Australia, UK & Egypt, from different disciplines ranging from health care providers to management scientists.
Peter has previously been recognised by the Medical community. For example, in 1999, he became an expert advisor to the Council of Europe. Honours include President of the British Geriatrics Society, and President of the Geriatrics and Gerontology section of the Royal Society of Medicine. It is timely that he should also be recognised by the operational research community, which as a member of The OR Society and the Blackett Club, he would really appreciate. The importance of OR Healthcare is becoming increasingly recognised with the setting up and funding of numerous initiatives such as MASHNET, RIGHT, MATCH, HaCIRIC, and the Cumberland Initiative. Health Services are in crisis and the need to optimise and economise is imperative. However most of the efforts to introduce OR methods to healthcare have come from the OR side with poor understanding and buy-in from the NHS and other healthcare systems. In the midst of this environment Peter has been an outstanding champion for the cause of operational research in Healthcare for many decades. As such he is a very worthy candidate for the award of the Companionship of Operational Research.