Forecasting Length of Stay and Cost

What is FLoSC?

FLoSC (Forecasting Length of Stay and Cost) assists local councils to analyse the patterns of length of stay (LOS) for publicly funded residents in institutional long-term care (LTC); and forecast cost of a council’s existing, known commitments for a period of time. The term known commitments refers to the group of publicly funded residents currently in residential care and nursing care.

Why forecast length of stay in care?

Local councils in England have a legal obligation for the placement and finance of all publicly funded residents in institutional LTC. Furthermore, the ability to discharge elderly patients to LTC is essential in the planning and running of acute hospital care. As our population is ageing, it is generally believed that LTC will become an important issue for an ageing society.
Residential and nursing care cost councils with social services responsibility in England an average of £45m per year in 2005/06 – 47% of total spending on adult social care. Given limited resources available, local authorities have a keen interest in knowing the behaviour of the LTC system, in particular, how long residents stay in the system, and ultimately, how much the system will cost. However, local councils face real challenges when it comes to annual budget planning for funding the system of LTC.

Uncertainty about the long-term cost of caring for current residents in the system, in addition to unknown future admissions, have made the tasks of local council budget managers very complex and demanding. FLoSC is a software implementation of a novel forecasting framework developed by researchers at the Health and Social Care Modelling Group (HSCMG) of the University of Westminster to assist local council budget planners involved in long term care. It aims to quantify the source of uncertainty related to known and unavoidable commitments and forecasts the resulting financial impact.

How can it help?

Knowing the projected cost associated with known commitments is of particular interest to local councils as it corresponds to the burden that they cannot escape. This information will enable local councils to identify the fraction of their budget that is already committed due to past admission decisions. Given this information, local councils will have a fair idea about the resources available for new admissions in a financial year. FLoSC can also be used to compare forecasts under different cost scenarios, which may reflect possible future changes in pricing or costing policy. These functionalities are of crucial importance to the planning of a successful budget for LTC at local authority level.

How does it work?

FLoSC extracts high level patterns of residents’ LOS and movements in institutional LTC based on data routinely captured by local councils, such as date of admission, date of discharge, destination of discharge, etc. Further, average weekly cost for each type of care, namely residential care (RC) and nursing care (NC), is incorporated to give a forecast of the cost arising from looking after the known commitments.
More detailed information on the methodology behind the toolkit can be found in the Methods section.

Who developed FLoSC?

FLoSC was developed by the Health and Social Care Modelling Group (HSCMG) of the University of Westminster for the Care Services Efficiency Delivery (CSED) Program of the Department of Health.


FLoSC is provided to assist local councils with their planning of social care. It should be noted that the results obtained will be dependent on the completeness, accuracy and validity of the input data. Past patterns of LOS may change as a result of council actions or extraneous factors. Councils will need to make their own judgements on the credibility of the forecasts. Demand can be monitored against the forecast results to detect changes in trends.
Neither the Department of Health nor the University of Westminster can be held liable for any consequential damages resulting directly or indirectly from the use of FLoSC.