There is no doubt that intermediate care is not a cheap option and there is some doubt about its effectiveness over other forms of care. A study by Andrea Steiner, senior lecturer in gerontology and health policy at Southampton University, found that intermediate care did not necessarily solve the problem of bed-blocking, nor were its results any better than acute care.

2Her study showed that the model was more expensive than acute care and produced no added benefits for patients. For this reason the DoH is considering research proposals to evaluate the effectiveness of intermediate care. Professor Philp says: 'We do not want information in five years'time. We want information as intermediate care develops on what's working best. '

Judith Lathlean, professor of health research at Southampton University school of nursing and midwifery, is one of a team there which has put in a proposal to evaluate intermediate care.

She says: 'There is very little work which has evaluated the effectiveness of intermediate care. We do not know enough about cost-effectiveness. We do not know enough about efficacy - whether it does provide better care. We do not know enough about service users'and carers'views about it. '

Professor Lathlean is co-author of a directory of intermediate care facilities - Intermediate Care: models in practice, which surveyed some 78 models in 1997.

3Schemes have mushroomed since then. Professor Lathlean thinks a whole range of schemes will be needed to meet the different needs, not only of older people but also of minority groups such as physically disabled children or adults with brain injury.