{"response":{"docs":[{"system_create_dtsi":"2021-10-27T23:37:56Z","system_modified_dtsi":"2021-10-28T15:21:55Z","has_model_ssim":["PublishedWork"],"id":"000099613","accessControl_ssim":["04d9de2c-8b84-489d-99c0-7fecbea5c856"],"hasRelatedMediaFragment_ssim":["8g84mm284"],"hasRelatedImage_ssim":["8g84mm284"],"depositor_ssim":["batchuser@example.com"],"depositor_tesim":["batchuser@example.com"],"title_tesim":["Routes for social and health care :  a simulation exercise."],"date_uploaded_dtsi":"2021-10-27T23:37:56Z","date_modified_dtsi":"2021-10-28T14:26:56Z","isPartOf_ssim":["admin_set/default"],"biblionumber_tesim":["99613"],"abstract_tesim":["The Routes project was commissioned by The King’s Fund in partnership with the Joseph Rowntree Foundation, the Social Care Institute for Excellence, the Association of Directors of Adult Social Services and the Local Government Association.","The health and social care system is currently tackling three inter-related challenges: coping with rising demand and reduced funding; handling NHS restructuring; and transforming social care. How can these challenges be seen as an opportunity to achieve fundamental change to the system? The Routes project, a simulation exercise created by Loop2, allowed senior managers and thought leaders from across the NHS, local government and the third sector to test out a remodelling of the health and social care system in a safe learning environment. Routes for social and health care: A simulation exercise focuses on Crafton – a hypothetical metropolitan borough in central England – and sets up a number of routes to managing change. During the simulation two contrasting viewpoints emerged. One group took a strongly managerial perspective that recognised the need for immediate decisions to reduce expenditure, while putting in place the conditions for a radical transformation in the way that people receive care and support in the longer term. The other group took a more ‘devolutionist’ approach, arguing that the financial challenges across health, social care and housing could not be managed through a top-down approach; they proposed a radical acceleration of personalisation and community engagement. 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But just how the NHS will respond to this is uncertain. To test how those in the system might respond, we used a behavioural simulation - Windmill 2009, designed by Loop2. From this event, and discussions with policy-makers, regulators, commissioners and providers, managers and clinicians, we developed an analysis of what will be required if health and social care systems are to respond effectively to the major challenges that lie ahead. We identify key themes and recommendations for action in each of these. 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