Advanced Care Research Centre


What is Systems Engineering and Thinking to Transform Transitions (SET4) in Health and Social Care?

What will we be doing?

‘Systems Engineering and Thinking to Transform Transitions (SET4) in Health and Social Care’ is a newly funded project by National Institute for Health and Care Research (NIHR) and Engineering and Physical Sciences Research Council (EPSRC). The aim of the funding is to improve the design of health and social care services, while incorporating systems engineering and thinking into health and social care pathways for vulnerable older adults with multiple long-term conditions (MLTCs). Funding is through a two-stage process; the initial development award (mentioned here) and further hub funding (2025 onwards).

Research and personal stories tell us that navigating health and social care can be difficult, especially for people who have MLTCs. Some transitions in care yield poorer experiences and outcomes for people with more complex health and care needs. The aim of SET4’s initial development phase (2023/2024) is to engage people with MLTCs, their carers and the staff involved in care transitions to identify obstacles to successful care transitions and how the human experience can be improved.

Two older people and younger person

Systems Engineering and Thinking are widely used in industry to design change that produces improvements in performance. This is achieved through a deep understanding of systems, the interconnectedness of elements within those systems, and the multitude of ways that people interact with, and can be affected by them. Using a systems approach within the health and social care setting, the current project will fully characterize the problems people with MLTCs face during care transitions, producing a framework that can be used for future re-engineering of corresponding care transition pathways. This will ultimately involve mapping, modelling, simulating, implementing, and evaluating current and re-engineered care transitions, all achievable within a future Innovation Hub.

jigsaw puzzle

The aim is to successfully implement a hub that places people at the centre of the solutions, making health and care transitions for people with MLTCs safer, healthier, and more efficient, while also enabling a more positive experience for all involved.

How will this be done?

This important work is being carried out in partnership with health and social care practitioners, geriatricians, the public, systems engineers, and designers across Southeast Scotland and Northeast England. This ensures that the expertise brought to bear on the project is both geographically distributed as well as highly multidisciplinary, inclusive of a wide range of expertise and care settings. In addition, the work is being performed in collaboration with a multitude of industry partners. Through the development stage the project team is:

  • Listening to a wide variety of stakeholders and analysing key transitions;
  • Exploring how the team can reach those whose voices are not often heard, involving them meaningfully in the co-design process;
  • Mapping services, transitions and building frameworks using novel methodologies;
  • Building capacity, expertise and connections including health and social care partners, charities, services, local organisations, and the public;
  • Addressing key transitions that are ready for solution-focused development, implementation and evaluation as part of the launch of the full Innovation Hub.

What are the aims for the SET4 HUB in the future?

We aim to deliver:

measurable positive change for people with MLTC and those involved in their care, including through directly addressing health inequalities

systems efficiency to make the best use of limited resources

novel methodological research that expands both healthcare and SE fields, and includes robust evaluation of interventions following implementation

• new platform tools and technologies for the development of SE interventions with the capability to be adapted to varying health and care challenges

• a vibrant education and capacity-building programme to embed SE skills across health and care professionals in our region in partnership with industry experts

industrial and innovation collaborations to accelerate adoption of SE into wider health and care systems beyond our region

• an established hub, sustainable beyond initial funding