The IPACS project aims to investigate what may constitute an optimal balance of capacity along complex discharge pathways and assess how responsive total spend in the local health and social care economy might be in relation to the capacity of domiciliary-based care.

The transfer of patients following an acute hospital admission - either to their own home or to a non-acute bed for a limited period of time - with community health and social care support is a complex process. It requires planning and management that is both efficient (from a system perspective), and effective (in terms of the impact on the health and wellbeing of patients and their families).

The process is often characterised by delays and capacity issues. These are inextricably linked with the availability of suitable care capacity in appropriate locations at the right time, which is a key determinant for access and, inevitably, rationing and queues.

The lack of availability of social care services is a particular contributor to these system pressures as it is often the ‘end point’ of the care chain. Across England, in 2019, around 500,000 acute bed days were lost to discharge delays which were directly attributable to non-availability of social care.

The IPACS project is developing a computer-based decision support tool for managers and planners to gauge the likely efficiency and effectiveness of potential decisions affecting the flow of patients along the complex discharge care pathway.

The model will enable testing of a key assumption that any additional investment in increasing social care capacity might be more than offset through reducing demand in more expensive upstream acute care settings. The premise is that improved capacity distribution throughout the whole system not only improves cost-efficiency of services but also enhances the experience and health outcomes for patients and their families.

Now into its second year, the IPACS focus to date has been on developing initial models for different aspects of the discharge pathway. These are now being piloted and have successfully gained support and interest of local key stakeholders across the different BNSSG health and social care organisations. We also aim to engage patients/ clients and the wider public more directly, through the BNSSG Citizen’s Panel and other initiatives as appropriate.

This 3-year project is funded by HDRUK and is in collaboration with NHS BNSSG CCG, the University of Exeter, and University of Bristol.

A Covid-19 related study using the first version of this model will appear shortly in PLOS One and is available as a preprint.

In addition to numerous conference presentations, more papers will appear in a variety of journals so watch this space!