The Care Life Cycle: Responding to the Health and Social Care Needs of an Ageing Society

The UK's population is ageing, and this presents a major problem for government since older people are the major users of health and social care services. As well as increasing the demand for care, population ageing is affecting the supply of care professionals, as the health workforce itself ages. However, ageing is only one factor in a complex set of issues influencing both the supply of and demand for health and social care. These include changes in the profile of disability and disease, the development of new technologies, and changes in levels of income and wealth. The workforce is influenced by many demographic, political and economic factors. The challenges in forecasting the future health workforce have been frequently highlighted, but no research to date has dealt comprehensively with both the demand and supply side of health and social care. To achieve this will require more than simply adding together models of the different sub-systems - what is important is the way that these sub-systems interact and feedback on each other. In order to make progress on understanding the whole system, a complexity science approach must be taken. Complexity science is an emerging discipline that attempts to model, understand and manage systems that combine scale and connectivity of the kind exhibited by the UK's health and social care systems. It has very broad application to biological, environmental, and physical systems, but here we are interested in applying it within a social science domain that poses unique challenges.In this research programme, we shall bring together teams of researchers from both social science and complexity science in order to work side by side to develop models of the socio-economic processes and organisations implicated in the UK's health care and social care systems. This research addresses the key challenges of developing effective novel modelling tools and techniques, and encouraging more sophisticated ways of carrying this science forward to inform policy on this vital real-world problem. In general then, the pay-off for complexity science offered by this research is to be found partly in the new tools and methodological advances that will be generated in the course of building, analysing and understanding the proposed models, and the pay-off for social science is to be found partly in the new understanding of health and social care that the models generate. But there will also be significant pay-off for both fields in the discoveries made at the interface between modellers and policy makers. In particular, there is a real opportunity to make progress on how complexity scientists can direct, present, and describe their work to maximum effect, something that the field has not always been able to do.Our ambitious programme of work aims to meet the research challenges described above, integrating rigorous empirical studies, sophisticated modelling and reflective engagement with relevant policy makers and planners, under a single framework informed both by modern complexity science and a long-standing track record in the social sciences. We will deliver a step change in the degree to which our understanding of the health care cycle can inform policy change in the form of models, papers, datasets, theory, public engagement and knowledge exchange, PhD and post-doctoral training, conferences and workshops. Simultaneously, we will make progress in developing the fundamental tools, concepts and methodologies of complexity science, particularly in the context of policy making for real-world multi-scale social systems.

Who will benefit from this research, how, and what will be done to ensure their engagement? Two broad groups of beneficiaries can be identified: 1) Users from the voluntary sector, local government (especially local social services departments and Primary Care Trusts) and national government (especially the Department of Health and the NHS Work Force planning team). The research questions being addressed are by their very nature relevant to policy makers and planners, particularly within the fields of health care and social care. The empirical research findings along with the modelling tools produced will assist local governments in planning services for a range of different client groups including new migrants and older people. The views of key stakeholders will be explicitly sought throughout the programme of work and incorporating these expert opinions into the policy tools is an integral part of the programme of research. The research findings will be made accessible to lay audiences through briefing papers, user workshops and presentations. We will also pay special attention to engaging with the media, as new research comes on-stream. 2) The wider public. The research is also highly relevant to people's everyday lives. An improved understanding of the drivers for health and social care will led to more efficiency in service delivery, which will in turn have a positive impact on the health and well-being of older people and their families. The informed general public will be able to access the project's findings through the website and through briefing papers. The Centre for Research on Ageing has a longstanding partnership with the Southampton Pensioners Forum and will work with them to ensure the involvement of older people themselves. Track record in User Engagement: The broader research group will benefit from the extensive experience in engaging with the policy and user communities amongst the Social Scientists. Prof Falkingham sits on the DWP Modelling Advisory Board; Prof Evandrou has excellent links within the user community, having been Vice-Chair of Age Concern London and Governor of the Centre for Policy on Ageing and a member of the Department of Health modelling advisory group. Prof Williams currently acts as an expert advisory for the Home Office and Prof sally Brailsford has long-standing links with a range of Primary Care Trusts. The research team will also benefit from links with the Centre for Population Change's partners in Scotland and excellent links with the devolved administration in Edinburgh (the Scottish government are funding a link person between CPC and the Scottish Executive). Timeframe for benefits to be realised: The benefits to policy makers and planners and to the wider public will begin to be realised during the project as the research results feed into changes in policy and practice. However the main benefits will be after the project as the new methodologies and tools incorporating complexity science are adopted for planning and policy making.