Commissioning for complexity: exploring the role of system dynamics in social care

Introduction

NIHR SSCR Methods Reviews 14 in relation to System Dynamics Modelling identified that the methodology had potential within a wide range of social care inquiry, including population change, ageing, long-term conditions, health and social care integration, resource allocation across a pathway, policy analysis, workforce planning, and options appraisals. In particular it was seen as relevant to exploring complex, dynamic problems, and recommended small-scale projects be commissioned to encourage collaboration between social care researchers, social care practitioners, service users and carers, and system dynamicists.

Objectives

System Dynamics uses computer modelling and simulation techniques to facilitate understanding of (or learning about) how complex systems behave over time.

This scoping project sought to explore the potential contribution of System Dynamics to social care commissioning through testing its application within services for people with a learning disability.

Methods

The research team worked with social and health care commissioners in one local authority area to explore the potential impacts of introducing a community-based intensive support service for people with a learning disability and complex behavioural needs. In particular, the commissioners wanted to understand the impact on admissions to residential care and in-patient treatment facilities.

The initial overview of the model was developed through a stakeholder workshop and then refined through discussions with the commissioners. Data from the locality, national data sets and research were then used to populate the model. A second workshop enabled stakeholders to provide further comment and to test out different service configurations in light of the anticipated needs and demand.

Findings

Key points from the review included:

• System Dynamics provided a conceptual framework through which commissioners could gain an overview of the services within the system and how they interrelate
• Iterative group model-building by stakeholders provided a way of achieving consensus with the emergent model structure
• The interactive nature of the model enabled commissioners to feed in data on future needs and test different combinations and capacities of services
• The availability of relevant and accurate data was a key issue that must be considered before developing a model. If not available then time must be built into the project to gather the
  required data
• System Dynamics could make a positive contribution to social care commissioning if used on a medium-long-term basis to allow for development of data sets and potential scenarios.

Resources

Commissioning for complexity: exploring the role of System Dynamics in social care – Key elements of the model (PDF)