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This paper presents the experiences and perspectives of practitioners involved in the delivery of intermediate care. The findings emerged from three workshops involving therapists, nurses, social workers and managers from across South Yorkshire which were designed to explore service development issues and practitioner roles in intermediate care delivery. It explores the practitioners' interpretations of intermediate care and their vision for the future of the service, and discusses the implications for services, employers and policy makers.

This paper discusses the pressures on intermediate care services to provide a flexible approach to staffing, including a constantly changing policy context, winter pressures and different service remits. It suggests three ways that managers can address the issue of flexibility: the adoption of flexible team structures, flexible worker roles and flexible employment structures.

This paper considers intermediate care as part of a whole‐systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of intermediate care, and that this would also be a welcome feature in future research studies. The paper draws on an evaluation of intermediate care in Cornwall and outlines the central role of intermediate care co‐ordination in the whole system. The example of residential rehabilitation is then used to examine how an individual service relates to the system as a whole. Finally, factors that may also influence local systems such as partnership working and rurality are considered; these are seen as important considerations for any other authorities which might seek to replicate the Cornwall approach to intermediate care.

Intermediate care is emerging as performing an increasingly‐significant function in bridging the care gap between hospital and home. It does not emerge from a policy or service vacuum. Relationships between statutory health and social care services and the voluntary sector have their roots in past practices and separate agendas. The findings from this study indicate that any partnership between the statutory and voluntary sectors in delivering packages of intermediate care will inevitably encounter challenges associated with multi‐level, multi‐professional and multi‐agency collaboration. This article explores these challenges and provides some insight on how to meet them.

Intermediate care has featured strongly in evolving strategy for support provision for older people in England. In Scotland the concept appears to have been rejected in favour of an emphasis on integrated care. This apparent divergence is explored in the broader context of policy variation post‐devolution and against the aspirations for a whole‐system approach.

This paper demonstrates how a single assessment tool can be linked to intermediate care services eligibility criteria to examine referrals and admissions to these services, by reporting on a project in a locality in East Kent. The project involved implementing a standardised patient assessment tool for three months in all intermediate care services, to examine the suitability of patients entering each of these intermediate care services. This paper focuses on the results of the community assessment rehabilitation team (CART), a recuperative care centre and the day hospital. After analysing patient assessments, we found that some patients in all intermediate care services were placed there inappropriately, and this was most evident in the day hospital. The paper concludes with considerations and suggestions for improving the effectiveness of assessment tools in practice.

Purpose – Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. Design/methodology/approach – A discrete‐event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. Findings – A prototype simulation model was developed showing the potential value of this approach. Research limitations/implications – Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. Practical implications – Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services’ traditional post‐acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so‐called “bed‐blocking” problem, a new range of services termed “Intermediate Care” has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. Originality/value – This paper fulfils an identified need to record and evaluate the new post‐acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.

Older people account for a significant proportion of users of health and social care services (Wanless, 2006). Within current constraints on health and social care services, it is essential that interventions such as home visits for older people can be seen to be appropriately deployed resources for facilitating their safe and timely discharge home. This paper discusses the findings of an evaluation project undertaken in 2003/04 within two in‐patient intermediate care services. The service provided short‐term intervention for older people, with an emphasis on rehabilitation to enable a safe return to their own home environment. A government audit report in 2003 concerning effective discharge of older patients from NHS acute hospitals stated that delayed discharges are a significant problem, with 17% caused by delays in assessing patients, shortages of occupational therapists and lack of integrated therapy services (House of Commons, 2003).

This case study gives an example of an integrated intermediate care service providing short‐term, intensive support and assistance combined with the facilities and services offered by extra care sheltered housing. The service is located in the Royal Borough of Windsor and Maidenhead.