Extensive simulations of AO performance for several E-ELT instruments (including EAGLE, MOSAIC, HIRES and MAORY) have been ongoing using the Monte-Carlo Durham AO Simulation Package. We present the latest simulation results, including studies into DM requirements, dependencies of performance on asterism, detailed point spread function generation, accurate telescope modelling, and studies of laser guide star effects. Details of simulations will be given, including the use of optical models of the E-ELT to generate wave- front sensor pupil illumination functions, laser guide star modelling, and investigations of different many-layer atmospheric profiles. We discuss issues related to ELT-scale simulation, how we have overcome these, and how we will be approaching forthcoming issues such as modelling of advanced wavefront control, multi-rate wavefront sensing, and advanced treatment of extended laser guide star spots. We also present progress made on integrating simulation with AO real-time control systems. The impact of simulation outcomes on instrument design studies will be discussed, and the ongoing work plan presented.