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

Miller R, McKelvie D


NIHR SSCR Methods Review 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.

This scoping review deployed System Dynamics Modelling in relation to the out-of-borough placements of people with a learning disability. Despite national policy expectations, good practice guidance and considerable action in local areas the necessary improvement in the care these people receive has been difficult to achieve. They therefore present a research case study of a ‘complex dynamic system’, but also one that should in principle be amenable to modelling as (in comparison to other user groups such as older people) they are a relatively stable population with changes in need being reasonably predictable (through for example young people moving into adulthood). Responding to their needs also requires multi-agency and multi-disciplinary working, which provides an additional dimension to the modelling. Following the events at Winterbourne View, providing positive local support for people with a learning disability with complex behavioural and / or health needs is a priority for national and local policy makers and therefore the outcomes of the research should have considerable interest for these stakeholders.

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