Rethinking Intermediate Care: From Fragmentation to Flow
UK Healthcare Provider (NHS)
Challange
Intermediate care had become overly fragmented, more than 20 separate services operating in silos, leading to duplication, delays, and poor patient flow. The system was reactive, with efforts focused on hospital discharge rather than proactive support to keep people well at home. Leaders across the local NHS and council recognised the need for a fundamental reset: to simplify the model, reduce inefficiencies, and deliver joined-up care built around people, not process.
What we did
Axsys facilitated a full-system redesign, working hand-in-hand with local health, care, and commissioning teams to co-produce a new intermediate care model. We undertook a comprehensive diagnostic of current provision, mapped demand and flow, and built a future-state model rooted in a “home first” ethos. Over the course of 12 months, we supported implementation: aligning governance, enabling workforce change, streamlining access, and helping secure new investment to underpin the model’s sustainability. Our work created the foundation for more preventative, person-centred intermediate care.
Outcomes
Single integrated model across health and care
Home First approach with 33% reduction in bed base
1.8 day reduction in hospital length of stay