ORAHS2025
Abstract Submission

24. Exploring the drivers of unsustainable pressures in health and social care: A qualitative system dynamics approach.

Invited abstract in session TD-2: System dynamics, stream Sessions.

Tuesday, 15:30-17:00
Room: NTNU, Realfagbygget R8

Authors (first author is the speaker)

1. Le Khanh Ngan Nguyen
Management Science, University of Strathclyde
2. Holly McCabe
Health Improvement Scotland
3. Susan Howick
Dept of Management Science, University of Strathclyde
4. Itamar Megiddo
University of Strathclyde
5. Soumen Sengupta
South Lanarkshire University Health and Social Care Partnership
6. Alec Morton
Management Science, University of Strathclyde

Abstract

Health and social care systems face substantial pressures arising from intricate interdependencies between system elements. While theoretic perspectives like "complex adaptive systems" and "sociotechnical systems" exist to characterise this complexity, translating them into coordinated action remains challenging. This research presents an innovative application of qualitative system dynamics through Causal Loop Diagrams (CLDs) to uncover underlying structural patterns driving persistent issues and policy resistance. Developed through stakeholder interviews in Scotland and corroborated with UK-wide evidence, our CLD illustrates how well-intended interventions create unintended cross-sectoral effects. Organisational silos and time delays obscure feedback complexities, while competing perspectives and reactive coping strategies generate emergent system characteristics that challenge the simplified concept of "whole system working”. We identify a paradox: cross-sector collaboration initiatives can undermine personalised care delivery when strategic and political objectives conflict. Our research advances system dynamics methodology by integrating individual and cascaded system archetypes, improving policy-insight communication clarity while preserving essential feedback loops. This provides decision-makers with an accessible tool to understand complex system behaviour, engage stakeholders through iterative model refinements, and guide systems toward a more equitable states.

Keywords

Status: accepted


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