AbstractThe effective and efficient provision of out-patient services may be assisted by the appropriate use of discrete event simulation. Resource use must be carefully monitored and suitable control actions must be taken, if service level and quality are to be maintained, whilst keeping cost increases to a minimum. In itself, simulation provides no means by which system activities may be identified. The use of soft systems methodology as a tool to aid in activity identification for simulation modelling is being explored. The investigation focuses on the effects the participative nature of soft systems methodology has on the acceptability of a simulation model. This case study forms part of a research objective of developing a generic approach to link soft systems methodology and simulation. Its aim is to provide analysts and managers with a process which may assist in planning strategies for health care.