Intensive Community Support

It really brought the figures to life

About the Intervention

Intensive Community Support (ICS) offers an alternative to traditional hospital care for adults requiring intensive nursing and therapy input within their own home to patients registered with a GP within one of the three Leicester, Leicestershire and Rutland Clinical Commissioning Groups. These virtual beds are split across five teams with the West North ICS team hosting (an indicative) fifty five of the 256 beds.

The ICS team comprises registered nurses, occupational therapists and physiotherapists with support from health care assistants, technical instructors and administration staff. The ICS team also works closely with Local Authority Social Services departments.

The aim of this service is to respond to patients wishes for care to be delivered in their own homes. In addition this service facilitates enhanced care requested by GPs.

About the Evaluation Aim/Challenge

The step-up service was included in this evaluation. The step-up service is for patients referred by their GP or by the East Midlands Ambulance Service. The evaluation formed part of its ongoing development, in order to establish whether the ICS service is successful in reducing avoidable admissions to hospital, and to identify delays or problems in the current and potential pathways.

Model Results

The findings of the model showed that the effect of the step up ICS service on hospital services is positive and demonstrates that the service is able to reduce pressure on A&E. However, the results of the model showed that there are some bottlenecks relating to first and follow up visits that affect ICS average Length of Stay (LoS) and overall service performance.


The model was then used to identify the scenario that improves the waiting times for the first visit and the average LoS by reviewing how the first and follow up visits are treated as well as the ways that delays in discharge can be reduced.

With simulation software you can quickly try out ideas/scenarios without the cost of trying them in the real world. And, because you can try ideas quickly and get practical feedback very quickly, you can gain insights and generate new ideas into how to run your organization more effectively.

The following suggestions were made:

  • Treat the first visit as a quick intervention/assessment and improve the quality of the second visit, making sure that it is made by the right speciality (i.e. nurse or therapist);
  • Spend longer with patients on follow up visits to meet their needs as soon as they are identified;
  • Standardise the service across Leicester, Leicestershire and Rutland.
  • Raise awareness of the outcome of the evaluation with GPs to give them confidence in making referrals.


See the model here


Read the report: