Social network analysis for modelling integrated social care services for older people with complex needs: a feasibility study

From 2016, implementation of the Social Services and Wellbeing (Wales) Act (2014) (SSWWA) will require Local Authorities to provide integrated care services for older people with complex needs.

As integrated services are complex systems characterised by dynamic patterns of inter and intra-activity among organisations there is a need to develop a systematic, valid and reliable methodology that will allow description, measurement and comparison of integrated social care models to inform the development and improvement of services for older people with complex needs.

This research will test a Social Network Analysis (SNA) methodology to provide quantitative information on organisations that are not routinely available in social care and health datasets.

The aim of this proposed research is to test the feasibility of applying SNA in an integrated social care setting in order to model the complex systems that deliver care services to older people with complex needs.

This will be explored by two main research questions:

1- What organisational links currently exist for the provision of integrated social care services for community dwelling older people with complex needs?
2- What are the gaps, barriers and enablers in linking services as perceived by key service stakeholders?

The main objectives of the proposed research are to:

- Assess inter-service and intra-service collaboration in delivering social care to people aged over 65 years, who have been assessed as having critical or substantial care needs (as defined by the Fair Access to Care Services Framework), by mapping integrated social care, health and third sector networks utilised by community dwelling older people with complex needs to support their overall health and wellbeing (as defined under Section 2 of the SSWWA).

- Identify organisational gaps, barriers and enablers in social care, health and third sector services to developing effective integrated social care services for community dwelling older people with complex needs by capturing key stakeholders' perceptions using semi-structured interviews.

A mixed methods case study design will test the feasibility of using Social Network Analysis (SNA) to model integrated social care services for older people with complex needs within a bounded network. The research comprises three overlapping modules:

(1) Systematic Rapid Evidence Assessment (SREA);
(2) Whole Systems SNA and;
(3) In-depth interviews with key service stakeholders.

Findings from the SREA will inform the development of a topic guide for the semi structured in-depth interviews conducted with key network stakeholders in Module 3.

Data from the interviews will be analysed using a thematic analysis approach. A whole systems network analysis of the bounded network using measures of density and centrality will be undertaken in Module 2. An interpretive analytic framework will be used to bring together the data sources from Modules 1, 2 and 3 to develop recommendations for service providers and commissioners.

If effective, this methodology will provide evidence of organisation gaps and potential links in the network which can be addressed to drive innovation in integrated care service and delivery to improve the health and wellbeing of older people with complex care needs.