Intermediate health care in a British inner city: An exercise in multiprofessional systems design

Abstract

Health care in England is divided into the acute- and primary-care sectors. In the inner city the primary-care sector suffers from a number of ills that would be relieved by the introduction of a form of health care intermediate to it and the acute sector. This paper illustrates how members of the Department of General Practice at the University of Liverpool set about exploring the problems of the inner city and its health-care provision, as a means of arriving at a preliminary design for an intermediate-care service provision. The design was to form the basis for negotiations with other interested parties over the introduction of intermediate care in the inner city. The approach adopted was based on the soft systems methodology of P. B. Checkland. However, a number of variations on the traditional soft systems methodology were introduced, not the least of which was the introduction of new systemic metaphor into the root definition and conceptual modeling stages.