The CABE Experiment and housing design: where have all the leaders gone?

Housing development in Melton Mowbray by Persimmon

Guest blog: Matthew Carmona and Lucy Natarajan

Here at The Bartlett, UCL we recently completed a major study of the eleven years of publically funded CABE, the Commission for Architecture and the Built Environment. We evaluated the work, history, and impact of the organisation, and the ‘tools’ it used to promote good urban design across England. When it came to housing design CABE had real impact and, as we argue here, the leadership it provided is sorely missed. But there are ways that planners, urban designers and the government can draw on the CABE Experiment, which will be increasingly important in light of the intended increase in the volumes of housing being built.

CABE was never well understood. External perceptions were often of a monolith swallowing up huge dollops of tax-payers’ money to conduct design review. As we reported in our book Design Governance: The CABE Experiment, the organisation was tiny by government quango standards, and only around a fifth of its staff were dedicated to design review. The rest of the staff worked on lower profile but typically highly regarded and effective activities such as: enabling within local authorities; its research projects; the work of its public spaces and parks arm (CABE Space); production of its very well used guidance and website; and various educational enterprises such as its summer schools.

These ‘informal tools’ of CABE were not mandatory or statutory and instead influenced and guided the professions. Yet they created a culture that improved design, for housing as for many other aspects of place. The work of CABE even reached some, although not all, of the volume house builders. Such progress will easily ebb away without continued efforts and leadership.

But how did improvement happen?

The answer is relatively simple: CABE’s tools were flexible and the activity was coordinated across the country, with the voice of government behind them. CABE addressed the issue of housing design from different angles, with:

  • national housing audits to embarrass the housebuilders with a stark national picture of the generally poor standards of their products
  • case studies and guidance to demonstrate principles and help raise aspirations
  • training for local authority staff
  • ‘enablers’ within local planning authorities working directly with councils, assisting with policy frameworks and large-scale applications
  • hundreds of design reviews were conducted on residential-led masterplans around the country

In addition, the Building for Life consortium helped establish nationally acceptable standards and an awards system for the best housing designs. And last but by no means least, government strengthened national policy, including on highways design in residential areas.

So where are we now?

Since CABE’s demise we have seen a large scale withdrawal of government, at national and local levels from engaging in design, and a fragmentation of the non-governmental design governance services that remain.  We have also seen a retrenchment of house builders, highways authorities, and planning authorities across the country back to the old ways of doing things.  Respectively, these are based on standard (and inappropriate) housing types, rigid and over-engineered highways standards, and planning authorities without the time, skills or confidence to challenge the house builders.

This is not to imply that nothing is happening. The Place Alliance provides a forum for ‘grassroots’ exchange and, bubbling up from these connections, UDL initiated and lead the work to produce a collaborative and comprehensive guide: The Design Companion Planning & Placemaking. This publication demystifies the principles behind ‘good places’ and explains with detailed examples how planners and placemakers can deliver the highest standards in urban design. In addition the largest metropolises particularly benefit from local leadership, particularly the Mayoral SPG for new build in London and Manchester’s City Council’s guide. However without the national coordination of such initiatives, housebuilders can and surely will cherry pick where they build quality homes.

But learning the lessons from the CABE era…

What should the government do now?

  • Show leadership: Minsters should speak out when residential design is poor and celebrate it when it is not, and appeal decisions where residential schemes were rejected on design grounds can provide rich illustrations for that work.
  • Support proactivity in local authorities: LAs can move away from reliance on generic policies in local plans and prepare simple non-statutory site-specific frameworks and design codes for housing sites.
  • Promote design review: This constructive peer-based checking and refinement mechanism should be made compulsory in the forthcoming revised National Planning Policy Framework (NPPF) for all major housing schemes.

Speaking up for better places and better homes will help those who are working on the ground, and as Design Governance: The CABE Experiment shows, this can have a great effect.  With little cost and no new legislation we can once again drive design quality up the national agenda.

 

References

Carmona M, De Magalhães C, Natarajan L, (2017) Design Governance: The CABE Experiment. London: Routledge

UDL (2017) The Design Companion Planning & Placemaking. London: RIBA.


The Place Alliance were winners of the Sir Peter Hall Award for Wider Engagement in 2016’s RTPI Awards for Research Excellence. This award was sponsored by the Idox Information Service.

Planning for the digital economy

The digital tech sector is the UK’s fastest growing sector.    Recent statistics show that it is growing as much as 50% faster than the wider economy.  In London alone, a new tech business starts up every hour.  Beyond London, digital tech clusters across the country are driving the economic resurgence of many cities and city regions.

The rapid growth of the sector means that its spatial footprint has become increasingly evident in towns and cities across the UK.  In May, the Royal Town Planning Institute (RTPI) published guidance on how town planning can respond to and guide the future development of the digital economy.  It makes recommendations for planners in two areas:

  • how to encourage the growth of the tech sector in their local area; and
  • how to make best use of the opportunities provided by the tech sector for the planning system

What is the tech sector?

The digital tech sector is increasingly diverse, and there is no straightforward definition.  The 2016 Tech Nation report identified 16 different sectors, some of which include:

There are currently around 58,000 active digital tech businesses in the UK.  It employs 1.64 million people, and job growth is more than double that of other sectors.  Roles are generally highly skilled and well paid, compared to other sectors.  Indeed, the average salary is 44% higher than the national average!

Location preferences

Digital tech, as a sector, thrives off well-planned spaces with access to good local infrastructure.  Tech firms and their employees tend to prefer easily accessible, walkable, multi-use districts. This results in the creation of ‘clusters’ of similar firms in central urban locations.

Clustering has a number of advantages for digital tech businesses – including easy access to large talent pools and the ability to network and exchange ideas face-to-face with local, likeminded businesses and employees – a key driver of innovation.

London, Manchester and the Greater South East have some of the largest digital tech clusters in the UK; however, the Tech Nation 2017 report mapped 30 significant clusters across the length and breadth of the UK – from Dundee to Exeter.

Facilitating the growth of the sector

The recent growth of the sector has already led to a number of economic policy responses, including the development of enterprise zones, innovation and business centres, and ‘innovation districts’.  The RTPI guidance also highlights a number of smaller-scale responses that can be utilised to attract and foster tech industry growth, including:

  • ‘de-risking sites’ by making sure that planning requirements are “practical, clear and known in advance of specific proposals coming forward
  • using public money for assembling and servicing sites that are more challenging
  • the provision of Wi-Fi in specific locations
  • making districts pedestrian and cycling friendly
  • leveraging Public Private Partnership models to build digital infrastructure

In addition to these responses, the RTPI makes three recommendations for planners on how they can create an environment that is attractive to digital tech firms.

First, it suggests that planners should monitor the local economy to get a sense of what local growth industries are.  Policies can then be adapted to local economic conditions.  Some local authorities already do this using company registration data.  For example, Camden Borough Council use this data to inform a quarterly ‘Business and Employment Briefing’.  It covers a range of measures, including business size and type, employment in the borough, commercial property, unemployment, worklessness and qualifications.

In order to attract and assist the growth of the digital tech sector, it is important for local planning teams to have a proper understanding of the sectors’ spatial preferences.  This is particularly important when drawing up local plans.  Therefore, the second recommendation made by the RTPI is that local authorities should employ someone to engage with local tech firms to find out how planning could help to better facilitate their growth. The roles of The Dublin Commissioner for Startups and the Amsterdam Chief Technology Officer are potentially interesting models for this.

Third, the RTPI recommends ensuring that there is sufficient housing, office space and transport infrastructure to meet capacity.  These three elements are the “fundamental ingredients for an economically and socially successful city”.  Without them, no amount of other interventions will attract firms to an area.

The Tech Nation 2017 report found that 30% of digital tech community members cited their local transport infrastructure as a ‘business challenge’.  Tech London Advocates report similar concerns, whilst also highlighting the challenges posed by digital infrastructure: “It has become increasingly clear that a fundamental challenge facing tech companies in London is infrastructure. The tech sector has grown so fast that the provision of office space and digital connectivity is having to play catch up”.

The digitisation of planning

The growth of the digital tech sector not only creates jobs and generates wealth; it creates opportunities for improved efficiency in other sectors too.  In planning, digitisation can free up time and resources, and create new tools for planners to utilise.  From the adoption of  geographic information system (GIS) software for mapping, to experimental trials of 3D modelling software and virtual reality in plan making and community engagement, technology has and continues to present a number of opportunities to improve the planning system.

Beyond planning, innovations in the digital tech sector aid the creation of ‘smart cities’ – where information and communication technology (ICT) and ‘Internet of Things’ (IoT) technologies are integrated to manage cities’ assets, with the overall aim of improving efficiency.  Examples of potential usage vary considerably, from supporting people with disabilities or chronic illnesses, to the provision of real-time traffic data, controlling streetlights and monitoring environmental data.

As such, a final recommendation made by the RTPI is to make use of local firms’ skills and resources to address cities’ infrastructural challenges.

Addressing inequality

Despite the rapid growth of the digital tech sector and its contribution to job and wealth creation, there is an increasing recognition that the benefits created by the sector can be insular and often do not spill over to the local economy.

Indeed, studies have found that the higher the share of tech employment in a city, the more income inequality there is.  On this basis, the digital tech sector has been criticised for its potential to create a ‘two-tier economy’.  There are also concerns about the gentrifying effects of digital tech clusters on local areas.  In London, for example, tech growth has increased the cost of living in some parts of the city, displacing smaller firms and lower income families.  It also poses a potential threat to innovation as startups are priced out of successful digital tech clusters.

Clearly addressing these issues poses some significant challenges for policymakers.  Last year, the RTPI made a number of recommendations in this regard, including helping local people to develop the skills needed by local tech companies.

Successful planning

The digital tech sector has enormous potential to enhance economic growth.  Through its ability to create the optimal conditions for the digital tech sector to thrive, planning can help to encourage this growth.  Understanding local economic trends, consulting with digital tech businesses about their needs, and ensuring that local infrastructure has the capacity to meet these needs, are vital to successful planning for the digital tech sector.  At the same time, ensuring that this growth is sustainable and benefits wider society are key challenges for planners.

Working longer – the reality ‘behind the headlines’

Senior businessman in office working on laptop

By Heather Cameron

With no shortage of headlines highlighting the record employment rate in the UK, and the increasing number of older workers widely reported, it may seem that the outlook for the ageing workforce is a rosy one. But do these headlines hide the reality?

Recent analysis from Age UK argues that the headline employment rate doesn’t tell the whole story about working longer, “making it an insufficient – and even misleading – tool for public policy decision-making”.

The statistics

The most recent official figures show that the employment rate (the proportion of people aged from 16 to 64 who are in work) is the joint highest since comparable records began in 1971, at 74.8%, while the unemployment rate is the joint lowest since 1975.

Data also shows that the employment rate for people aged 65 and over has indeed increased since the 2008 recession. It is currently at 10.4%, up from 7.3% in 2008.

Age UK has also recognised the increase in employment rates for older people, noting that, in fact, the older the age group, the greater the increase in employment. However, the average number of hours worked has declined since the recession, indicating a more complex and perhaps less reassuring situation than the one portrayed in the media.

The biggest drop was for 50-54 year old men, whose average hours declined by 29%. For men aged 60-64, the average number of hours declined by 8 hours (over 22%), while women aged 50-54 experienced a fall of 18%.

The only age group not to see a decline was women aged 60-64, which is likely to be as a result of the raising of the State Pension age.

Choice or necessity?

The change in the State Pension age was justified on the grounds that it gave people more choice and more scope to continue working if they wished to.

A recent CIPD survey found that the most common reason for wanting to work past 65 is that employees believe it will help keep them mentally fit, followed by wanting to be able to earn a sufficient income to continue to do the things they enjoy.

As Age UK suggests, it may be that the reduction in working hours is a good sign if it is due to older workers choosing to wind down their hours, maybe to enable them to juggle other responsibilities such as caring for their grandchildren, while still earning a wage.

However, the research suggests it may be less through choice and more as a result of the changing labour market such as increasing underemployment (working less hours than they would choose to) or increasing insecure working practices driven by the rise in self-employment and the ‘gig economy’.

As it is likely working fewer hours will mean less income, this could be a cause for concern since it will be more difficult for older workers to maintain their standard of living until they meet the State Pension age and for them to save enough for retirement.

Another issue highlighted by the CIPD, is that most employees don’t believe their organisations are prepared to meet the needs of the over 65s, suggesting that there is a need for employers to also review their practices in terms of managing older workers.

Final thoughts

It is clear that while, for some, choosing to work beyond the traditional retirement age will be a lifestyle choice, for many it will be a necessity. Any substantial reduction in working hours for these older workers could consequently pose a real issue.

It would therefore make sense for policy makers to heed the warning from Age UK not to rely on the headline rate of employment for older workers, and rather look beyond it to the reality of many struggling to get and keep the secure, well paid jobs they want and need.


If you enjoyed reading this, you may be interested in reading our previous post on the pros and cons of the gig economy.

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Maggie’s Centres: wellness through building design and the environment

In March 2017, the 20th Maggie’s Centre was opened in the grounds of Forth Valley Royal Hospital in Falkirk. Designed by architects Garbers & James, it is expected to receive 3000 visits in the first year.

Maggies Centre Forth Valley, Garbers and James

Maggie’s provides free practical, emotional and social support to people with cancer and their family and friends, following the ideas about cancer care originally laid out by Maggie Keswick Jencks and co-founded by her husband Charles, who is a landscape architect. Among Maggie’s beliefs about cancer treatment was the importance of environment to a person dealing with cancer.

She talked about the need for “thoughtful lighting, a view out to trees, birds and sky,” and the opportunity “to relax and talk away from home cares”. She talked about the need for a welcoming, reassuring space, as well as a place for privacy, where someone can take in information at their own pace. This is what Maggie’s centres today aspire to.

A number of high profile architects have designed Maggie’s Centres across the UK – from the late Zaha Hadid to Frank Gehry, Richard Rogers and Rem Koolhaas.

The Maggie’s Centre in Kirkcaldy, Zaha Hadid Architects

Promoting wellbeing through the natural environment and effective design

Drawing on research which considers the significant impact that environment can have on wellbeing, Maggie’s Centres are designed to be warm and communal, while at the same time being stimulating and inspiring. The interiors are comfortable and home-like. Landscape designers and architects are encouraged to work closely together from the beginning of a project as the interplay between outside and inside space, the built and the “natural” environment, is seen as an important one.

A building, while not wholly capable of curing illness, can act as “a secondary therapy”, encouraging wellness, rehabilitation and inspiring strength from those who move around it.”

Each of the centres incorporates an open kitchenette where patients can gather for a cup of tea, airy sitting rooms with access to gardens and other landscape features, and bountiful views. There are also private rooms for one-on-one consultations; here Maggie’s staff can advise patients on a range of issues relating to their condition, whether that is dietary planning, discussing treatment options (in a non-clinical setting) or delivering classes such as yoga.

Spaces to promote mental wellbeing as well as physical healing

Maggie’s Centres are also about offering spaces to people to help improve their mental wellbeing. As well as quiet tranquil spaces for reflection and meditation, there are also central areas, focused on encouraging the creation of a community between the people who use the centre. Wide-open spaces, high ceilings and large windows, with lots of opportunities to view the outside landscaping and allow natural light to enter are a key feature of many of the Maggie’s Centres.

The locations also try as far as possible to provide a space free from noise and air pollution, while remaining close enough to oncology treatment centres to provide a localised base for the entire treatment plan of patients.

Fresh air, low levels of noise and exposure to sunlight and the natural environment, as well as designs that provide spaces that promote communal interaction to reduce feelings of isolation and loneliness, have all been shown to improve mental as well as physical wellbeing. In this way, the physical attributes and design of the Maggie’s buildings are helping to promote mental as well as physical wellbeing of patients and supplement the care being given by the cancer treatment centres located nearby.

Interior of the Maggie’s Centre in Manchester, Foster and Partners

Award-winning architecture and design

In 2017 Maggie’s Manchester was shortlisted for the Architects’ Journal Building of the Year award. And many of the individual centres have won regional design awards for their innovative use of space and incorporation of the natural environment into their designs.

A Maggie’s garden was also featured at the 2017 Chelsea Flower show, highlighting the importance of environment, and the role of the natural environment in rehabilitation and promoting wellness among those who are ill.

Final thoughts

How design and landscape can aid and empower patients is central to Maggie’s Centres. They are a prime example of how people can be encouraged to live and feel well through the design of buildings and the integration of the surrounding natural environment. These environments are the result of a complex set of natural and manmade factors, which interact with one another to promote a sense of wellness, strength and rehabilitation.

They demonstrate how the built environment can contribute to a holistic package of care – care for the whole person, not just their medical condition. Other health and social care providers can learn from them in terms of supporting the wellbeing of patients, carers and their families.


You can find out more about Maggie’s Centres though their website.

Keep up to date with what is interesting our research officers on Twitter.

Read more about innovative building design in our other blog articles.

General Data Protection Regulation (GDPR): what the public sector needs to consider

Graphic design image: three padlocks in front of a futuristic city.

By Steven McGinty

In March, the Information Commissioner’s Office (ICO) published the results of a survey into local government information governance as part of their preparations for the General Data Protection Regulation (GDPR), which comes into force on 25 May 2018.

Although the ICO notes that many local authorities have good data protection policies, there are still councils where work needs to be done. The survey findings include:

  • A third of councils do not undertake Privacy Impact Assessments (PIAs)
  • 26% of councils do not have a data protection officer
  • 50% do not require data protection training before accessing systems

Under the new GDPR the above findings could constitute a breach, and result in the ICO taking action against the offending council. Recently, the ICO fined Norfolk County Council £60,000 (under the Data Protection Act) for failing to dispose of social work case files appropriately.

What impact will Brexit have on the GDPR?

The UK Government has finally triggered article 50 of the Lisbon Treaty, starting the process for leaving the European Union (EU). However, this does not mean that the UK will escape the European Commission’s GDPR. Digital minister, Matt Hancock, has confirmed that it is in the UK’s best interests to ensure the ‘uninterrupted and unhindered flow of data’, stating that the GDPR would be fully implemented into UK law, even after we leave the EU.

Is the public sector exempt from the GDPR?

There have been reports that some public sector bodies believe that they are exempt from the GDPR. This assumption is based on the regulation’s special conditions and derogations, which allow member states to restrict the GDPR’s scope to safeguard the public interest (some countries, such as Denmark, already have exemptions for public sector bodies). Additionally, fining a public sector body has also been viewed as making little sense – taking from one public sector budget and placing it in another.

However, both of these assumptions are flawed. As the GDPR has been designed to enhance the rights of EU citizens, it would be against the spirit of the regulation to introduce blanket exemptions for the public sector. And it is certainly not unheard of for regulators to fine public bodies, such as the recent Norfolk County Council case, or the Hampshire County Council case in August 2016, where the council was fined £100,000 by the ICO for leaving social care case files in a disused building.

How does the GDPR differ from the Data Protection Act?

The GDPR has been described ‘as the most important change in data privacy regulation in 20 years’, providing greater rights to citizens and harmonising data privacy laws across Europe. However, to achieve this, new requirements have been placed on organisations. These include:

  • Personal dataArticle 4(1) of the GDPR includes a broader definition of ‘personal data’ than previous legislation. It states that any information relating to an individual which can be directly or indirectly used to identify them is personal data. Specifically, it refers to ‘online identifiers’, which suggests that IP addresses and cookies may be considered personal data if they can be easily linked back to the person.
  • Privacy by designThe concept of ‘privacy by design’ is not new, but Article 23 of the GDPR makes this a legal requirement. In essence, it means that public sector bodies will have to consider data protection at the initial design stage of product development. This could involve adopting technical measures such as pseudonymisation – the technique of processing personal data in such a way that it can no longer identify a particular person.
  • Data Protection Impact Assessments (DPIAs) – As the ICO’s research highlights, a third of councils do not undertake any form of privacy impact assessment. From May 2018, public sector organisations will have to carry out DPIA’s for certain activities such as introducing new technologies and when processing presents a high risk to the rights and freedoms of individuals. In the latter case, organisations will need to consult the ICO to confirm they comply with the GDPR.
  • Appointment of a Data Protection Officer (DPO)Article 35 of the GDPR states that public bodies must have a designated Data Protection Officer. This can be an existing employee, as long as there is no conflict of interest, or a single DPO can represent a group of public sector bodies. As the ICO research suggests (26% of councils do not have a DPO), this is one of the main areas where councils need to improve.
  • Data portability– Public sector organisations must ensure that personal data is stored in a ‘structured, commonly used and machine readable form’, so that individuals can transfer data easily to other organisations. For instance, suitable formats would include CSV files.
  • Strengthening subject access rights– Individuals can now request access to their data for no cost and must be responded to within 30 days (this is a change from the Data Protection Act which requires a £10 fee and there is 40 days to respond). For complex cases, this can be extended by two months. However, individuals must be notified within one month and be provided with an explanation. These requests could prove time consuming and costly for public sector bodies, and as such, supports the case for introducing digital services that allow individuals access to their data.
  • Right to be forgotten – The right to erasure (its official name) allows individuals to ask an organisation to delete all the information held on them – although this would not apply if there was a valid reason to hold that data. This principle was established in the high profile case involving technology giant Google.
  • Failing to comply and breaching the GDPR – When there is a breach, public sector bodies will have an obligation to inform their national regulator (the ICO in England) “without undue delay and, where feasible, not later than 72 hours after having become aware of it.” These requirements could present challenges for public sector bodies, who are often engaged in providing vital public services with limited resources. However, policies will have to be introduced to ensure breaches can be reported promptly, particularly as the new penalties for data breaches are significant, with public sector bodies liable for fines of up to €10,000,000. In addition, individuals also have the right of redress and may seek compensation if they feel their rights have been breached.

What should public sector bodies be focusing on?

Although May 2018 may seem a long time away, the ICO research suggests some local councils (and the wider public sector) need to make several changes to ensure compliance with the GDPR.

Most importantly, organisations need to start reviewing the new regulation and considering how it applies to them. Evidence of a clear strategy – including the appointment of a Data Protection Officer, the use of privacy impact assessments, and staff training – will go a long way towards demonstrating an organisation’s intent to comply with the GDPR.


Follow us on Twitter to see what developments in public and social policy are interesting our research team. If you enjoyed this article, you may also be interested in: 

Moving stories: how poetry is carrying the message about mobility challenges facing older people

All too often, valuable results from research reports receive an initial burst of publicity before being shelved and then largely forgotten.  But one project has been keeping its research in the public eye by taking its findings onto the streets.

A three-year study led by researchers at the University of York’s Centre for Housing Policy has been investigating the links between mobility and well-being among older people. The “Co-motion” project has been working with older people in York, Leeds and Hexham to explore how changes in their lives, such as losing sight, becoming a carer and starting to use a mobility scooter, have affected their mobility.

Poetry in Motion

One innovative strand of the project involved a six-month collaboration between the researchers and the award-winning poet, Anna Woodford. Anna has written a series of poems that reflect on the travel challenges of older and disabled people. In keeping with the spirit of the Co-Motion project, the poems have themselves become mobile. Earlier this year, buses serving passengers in and around the city of York began displaying Anna’s poems.

The Co-Motion project leader, Dr Mark Bevan, from the Centre for Housing Policy, explained that one of the key messages emerging from the research was the need to raise awareness among service providers and the wider public about the diverse travel needs of people later in life.

“The aim of Poetry in Motion is to encourage people to think differently about how they travel and the needs of others.”

The research findings provided inspiration for Anna Woodford: “Many of the things that older and disabled people find difficult are often very simple daily travel actions that most of us don’t even think twice about. Parking your car on the pavement instead of fully on the road or using priority seating on public transport, are just some of the things study participants cited as being a challenge.”

Future plans, future poems

First York, which provides public transport services in York, was happy to showcase Anna’s poetry as part of the project. Rachel Benn, Business Delivery Manager at First York, said: “We are proud to support our local communities, and when we heard about this project, we were keen to help raise awareness of this important research.”

The Co-Motion project is one of seven Design for Well-being projects looking at ageing and mobility in the built environment, funded by the Engineering and Physical Sciences Research Council (EPSRC), the Economic and Social Research Council (ESRC) and the Arts and Humanities Research Council (AHRC).

There are now plans for an exhibition of the Co-Motion poems at York Explore library and at Newcastle City library in autumn 2017, and it’s also hoped that the project will expand to look at people living with mental health issues.

Transport and art collaborations

Poetry in Motion is in keeping with a strong tradition of the arts and public transport working hand-in-hand.  For over thirty years, passengers on the London Underground have been able to enjoy a range of poems showcased in Tube train carriages across London. The success of the programme has inspired similar initiatives across the world.

Meanwhile, in China, a London-based artist has taken the art and transport theme even further. Mira Calix created a moving museum on a bus, enabling passengers to take in sonic and visual art installations as part of their journey.

And in New York City, photographs by the American artist Andres Serrano have appeared in subway stations to highlight the existence of homeless people on the streets. Although Andres doesn’t see himself as a crusader, he hopes that his images will make people stop and think.

I feel like it’s enough for me to just bring it to your attention, and then after that it’s up to you to decide what to do with it.”

Final thoughts

Public art can be appreciated on different levels – for its own sake, and to provoke reflections about its deeper meanings.  The work of Anna Woodford, Andres Serrano and many other artists enables the travelling public to look with new eyes on the challenges facing vulnerable people, such as the elderly, the disabled and the homeless.

A poem or a photograph, a painting or a story might not change the world, or even an individual. But if it causes people to pay attention, and to reflect on how it makes them feel, the artwork will have done its job.


Follow us on Twitter to see what developments in transport, mobility, the arts and wellbeing are interesting our research team.

Creating sustainability in health and social care

The question of the sustainability of funding for health and social care services has been in the spotlight recently. The Conservative Party manifesto contained proposals around making individuals pay for more of their social care costs, to deal with the “challenges of an ageing society”. Meanwhile, figures suggest that NHS Trusts in England overspent by £770m last year despite a focus on efficiency savings.

However, creating and maintaining sustainability in health and social care is much broader than financial sustainability. It means considering other factors, including environmental, training and project management issues. This takes planning, commitment and an understanding of the aims and expectations of staff and senior management.

A research symposium earlier this year (hosted by Healthcare Improvement Scotland and partners) explored these issues further, looking at the evidence underpinning ways to create sustainable health and care systems.

Environmental sustainability

Environmental sustainability is something which all organisations are being asked to address and improve. The issue of climate change has led to a focus on behaviour change and a more sustainable use of resources.

  • Buildings – This includes the planning of new healthcare buildings, as well as adaptations to existing structures to make them more energy-efficient. Alternative building materials and designs have been used in new projects to improve energy efficiency, with some buildings even incorporating wind turbines, solar panels and geothermal capture centres. Reducing waste water and improving temperature regulation through heat capture and insulation techniques are also being adopted. While these may be costly initial spends for many, the long-term cost savings are also significant, as well as ensuring that the buildings meet minimum national requirements for energy efficiency and contribute to emissions reduction targets.
  • Resource, waste and recycling management – In many offices and clinical centres, individuals are encouraged to be personally responsible for their own reduction in waste and improved use of recycling facilities; however, this must also be facilitated at an organisational level. Clearly labelled recycling bins, promoting reduction in of the use of disposable water and coffee cups, and encouraging employees to use less paper when report writing (printing double sided for example, or going paperless where possible) are all simple ways in which environmental sustainability can be promoted in health and social care settings. Innovative techniques such as reusing water in internal plumbing, or creating bespoke recycling facilities to help reduce the amount of clinical waste incinerated, are being developed.
  • Remote monitoring and the use of technology – There have been major advances in the use of remote technology to host meetings, video-conferences, follow up appointments and assessments for those in receipt of reablement care via tele-health. Remote monitoring of patients, as well as the use of tele-health and other digital platforms can allow consultations and routine check-ups to take place without either party having to leave the house or office, thereby reducing vehicle emissions used in transport. In social care, remote meetings and cloud-based reporting can allow front-line social workers to remain out on visits instead of having to return to the office to fill out reports, again reducing vehicle emissions.

Sustainable resource management

In the face of more limited funding, joint working between health and social care is being heralded as a new way of cost saving, making the most of ever-depleting resources in the face of ever-greater demands. Being efficient with resources, through effective planning and management is one of the key ways to ensure resource sustainability in the long term, especially for the NHS and local authority social care teams.

Approaches include:

  • Making full use of the entire health and care ecosystem – This means using the entirety of the health and social care ecosystem, its capacity, expertise, resources and the end-to-end care it can provide. It means engaging carers, GPs, nurses, and pharmacists to improve efficiency, make better use of resources, spread the workload and improve satisfaction levels and outcomes for service users.
  • Using careful and well-managed commissioning models  This means making good decisions about commissioning and outsourcing to make best use of funding and other available resources. It also means allocating to appropriate projects, being mindful of the possible consequences of payment by result frameworks, and getting the best value possible.

Sustainability in practice

The final level of sustainability in relation to health and social care practice involves the sustainable implementation of programmes. This means finding ways to ensure that implementation is carried out in ways that ensure long term success and positive outcomes. It involves understanding context, and the culture of the organisation and makes reference to something discussed previously in our blog on implementation science.

Ensuring sustainability in practice requires multiple efforts including:

  • Making sure that practice becomes embedded into everyday work
  • Sharing best practice
  • Maintaining motivation among your workforce
  • Using robust, local evidence in a way that is clear and concise.

Understanding what kind of evidence leads to sustainable programme implementation is also important: economists prefer cost-based strategies, chief executives want one-page summaries, professionals want examples of other organisational based programmes and what was required to implement effectively, and councillors want case studies based around the positive impact on services users. Case studies can at times actually be the least helpful because even in a failing programme there is usually one example you can use to find positives.

Another issue with evidence is the reluctance to report on issues or challenges, or failed projects, when actually some of the greatest insight can be gained from this. All of the learning that can be gained from failures could be useful when trying to make programmes more resilient so they can be more sustainable.



Final thoughts

The concept of sustainability in health and social care cuts across many areas of organisational management and personal practice and behaviour. Encouraging and participating in sustainable practice can mean anything from being more environmentally friendly by digitising reports, recycling paper or changing to energy saving lightbulbs to promoting sustainability of resources through efficient and effective management, utilising the skills, expertise and resources of the entire health and social care ecosystem.

These approaches to sustainability should not only help health and social care as a profession to be less impactful on the environment but will also allow organisations to save money, improve efficiency and ultimately improve outcomes for patients and service users as a result.


* The 5th Annual Research Symposium: Evidence for sustainability – exploring the current evidence underpinning ways to create sustainable health and care systems was held on 16 March 2017. It was jointly hosted by Healthcare Improvement Scotland, Health Services Research Unit and the Health Economics Research Unit at the University of Aberdeen, and the Nursing, Midwifery and Allied Health Professions Research Unit at the Chief Scientist Office.

If you enjoyed this blog, you may also be interested in other articles on implementation theory and commissioning in health and social care.

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Local authority housing companies: getting back into building

Last December, research by Inside Housing magazine found that more than a third of English local authorities have already – or are planning to – set up their own housing companies.

The research showed that 98 out of 252 councils were considering the establishment of a private housing development company, or had already established one.  That’s a significant increase on the seven housing companies that existed in 2014.

The factors driving council housing companies

The 2011 Localism Act gave local councils the powers to establish their own private companies, enabling them to borrow money more cheaply and avoid government-imposed restrictions. A mixture of motives is now prompting local authorities to enter the housebuilding business. Some see the new companies as sources of additional revenue. In addition, homes built by these private companies are not liable to right-to-buy. The Inside Housing research also found that a number of councils want to target income generated on tackling homelessness in their area.

At the same time, councils are facing funding pressures. “Local authority budgets are biting more and more,” Croydon Council’s director of development Colm Lacey explained to The Architects’ Journal in February.

“For example, in Croydon we’ve lost more than half of our central government budget since 2010. That’s a slow drip-drip of a loss of resource. Quite quickly, you come to realise that you need to throw something else in to meet the gap.”

Most companies are being established as wholly owned subsidiaries of councils, while some are solely management companies, letting stock built by their parent local authority. Many are funded by councils borrowing money from the Public Works Loan Board at low rates and then lending it to the company at a market rate.

Early adopters

The types of councils establishing housing companies are very varied, from rural to urban, and across the political spectrum. There is also a wide geographical spread, with a growing number located in London.

Among the councils pioneering their own housing companies is Newham Council in east London, which established its Red Door Ventures company in 2014 to provide homes at market rents, with a third of profits to be invested in social or affordable housing. The company’s properties are built on land bought from the council by the company using a local authority loan. Already, three developments have been built, and planning permission has been given for two more.

Another council-established private development company is Brick by Brick, set up by the London Borough of Croydon Council in 2016. The borough owns a significant amount of land, but has found that procuring agreements with developers has rarely generated benefits to the council in terms of increased land values or development returns. In an interview with Local Government Chronicle, Croydon’s Colm Lacey explained the reasoning behind Brick by Brick:

“The model allows the council as land-owner, sometime finance provider and sole shareholder to extract value from the core components of development activity – funding, building and selling. It maximises both affordable housing supply and return from development activity to Croydon residents, and allows the council to reinvest in core services.”

 Learning from the pioneers: the upside and the downside

As more local authorities move towards establishing their own housing companies, they can learn from the experiences of early adopters, who can advise them on what to watch out for. This includes analysing council powers in relation to the establishment of a company, provision of funding, transfer of land, decision-making arrangements and potential conflicts of interest (for example in relation to planning).

At a time of acute housing shortages, the creation of house building companies takes on increased significance. Chartered Institute of Housing deputy chief executive Gavin Smart agrees that housing companies can help council deliver more homes, but warns:

“The downside is that the need to cross-subsidise might mean that their ability to produce new homes at genuinely affordable, social rents can be limited. It’s vital that they continue to prioritise building new homes at social rents.”

A rising tide or a drop in the ocean?

The trend towards council housing companies shows no sign of waning.

  • Cambridge City Council set up its housing company in January 2016, and the following May the company handed over its first rental property to new tenants.
  • The first of 128 new homes built by Gloriana – Thurrock Council’s housing company – will be completed this year in Tilbury. The development has been created to keep up with demand for homes from increasing numbers of people coming to work in the area, mainly in freight and retail.
  • Meridian Homestart is a company set up by the Royal Borough of Greenwich to offer high-quality homes for local working families to rent. These homes are let at 20% below local market rent levels in order to help working families who would otherwise find it hard to buy or rent on the open market.
  • A shortage of private accommodation has prompted Bracknell Forest Council to use its housing company to provide better and cheaper housing for homeless people.

At the moment, the contribution of council housing companies towards tackling the housing crisis is relatively small. Barking and Dagenham’s housing company, Reside, has so far delivered around 600 homes; while Blueprint, a joint venture between Nottingham Council and Igloo Regeneration, has completed 245 homes. That’s a drop in the ocean when compared to the House of Lords Economic Affairs Select Committee recommendation of 300,000 new-build homes each year.

Even so, housing companies have come a long way in a short time, and their rapid growth signals a much bigger long-term vision. As Sir Robin Wales, Mayor of Newham explains:

“We’re trying to correct 30 to 40 years of failure in the housing market, but it will take time.”


If you enjoyed this post, take a look at some of our other housing blog posts: