Title: Planning for Frailty: Optimal Health and Social Care Workforce Organisation Using Demand-led Simulation Modelling (FLOWS)
Funder: Department of Health and Social Care

Abstract: Research Question: What is the present, and expected, size and composition of the health and social care workforce required to provide care for the frail older population? Background: As the population ages, robust workforce planning to meet future demands for health and social care by older people is needed. A lack of evidence in this areas has led to a mis-match between the health and social care demand from the ageing population and the current workforce capacity. The proposed study will use demand-led simulation modelling of the workforce required to address the specific challenge of providing health and social care for the growing numbers of older people living with frailty. Aims & Objectives: The aim of the study is to use simulation modelling to explore long-term trends in frailty-related health and social care use in the ageing population and its implications for future workforce size and competencies to support high quality care. The primary objective of this study is the creation of a simulation model that will inform service and workforce planning to meet health and social care needs associated with frailty. Methods: The study will use a System Dynamics design to develop and test the simulation model. Work packages comprise a scoping review, gathering of public and professional perspectives on service provision via a survey and stakeholder engagement activities, and analysis of linked health and social care data, all of which inform the simulation modelling work package and development of a workforce planning toolkit. Timelines for delivery: The scoping review will be completed in year 1. Routine health and social care data specification and extraction will occur in year 1, as will service mapping and classification and survey preparation. Survey data collection and analysis will occur in year 2. Simulation modelling will commence in year 2, with validation, sensitivity analyses and scenario modelling in year 3. Development of workforce guidelines and toolkit will occur in year 3 Stakeholder engagement, including patient public involvement, will run throughout the study, reviewing study results and informing development of the other work packages. Anticipated impact & dissemination: This study will provide new, direct evidence about the impact of frailty on health and social care workforce requirements within the ageing population The improved understanding of workforce requirements offered by this study will inform workforce planning for frailty services across health and social care, ensuring future benefit for patients through provision of timely and appropriate care and a workforce planning toolkit to support local decision-making.

Lay abstract: The purpose of this research is to aim to predict the numbers and types of health and social care staff that will be needed to care for older adults living with frailty in the future. Why this research is important? Older people with complex health problems are described as frail. Frailty is more common in older people, affecting 44% of adults aged 65 and older in England. Better care for people living with frailty is essential to improve health and quality of life and help the NHS to be more efficient. The NHS needs to ensure that they have the right number of staff, with the right skills. To do this, organisations delivering health and social care need to know more about what services are required by people living with frailty, and the numbers and type of health and social care staff needed to run those services. In previous research, we developed a tool (a computer model) to predict the numbers of adults living with frailty and their use of health care services. We now need to expand this model to be able to predict the staff numbers and skills that are needed to provide the best care for these patients. The aim of this research will be met by: • Reviewing evidence to understand how services for adults with frailty are staffed. • Analysing routinely available health and social care information from patients and care providers to understand current service use and staffing. • Gaining input from a variety of people working in frailty and social care, patients, and carers to better understand different care services and the staff and skills required. • Gaining information on the number and type of staff required through a national survey and consultations with Service(s) and Health and Social Care Commissioning staff. • Using all this information to expand our current decision tool (computer model) to better predict numbers and type of staff needed in the future. We have worked with national organisations involved in workforce planning to develop this research. The research will be carried out by a team with expertise in analysis of routine health and social care patient and workforce data. We will involve the public by: continuing to work with our core group of patients and carers to develop our current model and research on frailty. They have highlighted that there are particular services that are helpful for them in living with frailty, but waiting times are often long due to insufficient staff. They have also told us about gaps in services and staffing. This group will continue to collaborate with us to ensure that services discussed, and decisions made, include their perspectives. They will also help with plans for sharing the research. We intend to ensure that members of the public who are not often heard from are included, and we are working with local community groups to achieve this. We will share the study by: creating a toolkit based on the computer model for the people who plan health and social care services, so they can work out what type and number of staff they will need to look after people with frailty in years to come. We will share this through national networks and organisations. In addition, we will work with organisations, voluntary services and support groups relevant to people with frailty to share the work. Our group members have suggested that we use local diverse radio stations to create discussion and reach out to communities that may not otherwise hear about research.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE