Strategic Investment in Public Health Services


We engaged with local partners to explore the strategic priorities for investment in services for people with dementia.  Doing nothing is not an option as growing demand is forecast to outstrip available funding, whilst at the same time there is evidence that changing service configuration can moderate or reverse the increase costs of services for this client group whilst also improving people’s health and their experience of using services when this is necessary.

What was done

The work used a ‘National Dementia Strategy Implementation Simulator’, developed using System Dynamics software and deployed by the Whole Systems Partnership in about a dozen locations to date.  However, whilst the tool provided a depository for the evidence and a local calibration of need, much of the work was done through engagement events and helping people to understand and address the needs of this client group as a whole system.


The work enabled the client to forecast the increased demand on the early recognition service and therefore to scale investment without.  Prior to the engagement there was little appreciation of the extent and timing of this increase and whether or when it would moderate to a new status quo.

Two other investment priorities on the basis of ‘spend to save’ were identified in a short term development of specialist beds for people with dementia required whilst other preventative measures took effect, and a balanced investment in intermediate care services for this client group.


Significant value was gained through the development of partnership working which enabled the local system to address growing demand that would otherwise have resulted in additional annual costs in the order of £9M in 10 years time by both health and social care.  Options to reduce this additional spend significantly, or even to make savings, were clearly presented along with clear ‘first steps’ and a better set of relationships with which to make progress.

Contact and further information

Peter Lacey;
Whole Systems Partnership