Cross-border handshakes: what’s next for digital contact tracing?

As we enter a new year, and a new phase of the Covid-19 pandemic, we are reminded of the need to follow public health advice to stop the spread of the virus. The emergence of new variants of Covid-19, which appear to be more transmissible, has resulted in tougher restrictions across the world. Although the emergence of new variants of Covid-19 can seem frightening, we are not powerless in preventing the spread of the virus; face coverings, social distancing, regular handwashing and self-isolating remain effective.

Additionally, the development and subsequent roll-out of numerous vaccines should provide us all with hope that there is light at the end of the tunnel. However, although vaccines appear to protect people from becoming seriously ill with the virus, there is still uncertainty regarding the impact vaccines will have on viral transmission of Covid-19.

Therefore, the need for those with symptoms to self-isolate, get tested and undergo contact tracing when a positive case is detected is likely to remain. This will become even more important in the months ahead, as we see the gradual re-opening of hospitality, leisure and tourism sectors.

Effectiveness of contact tracing

Contact tracing is a tried-and-tested public health intervention intended to identify individuals who may have been in contact with an infected person and advise them to take action that will disrupt chains of transmission. Prior to Covid-19, contact tracing was often used to prevent the spread of sexually transmitted infections, and has been heralded as vital to the eradication of smallpox in the UK.

According to modelling, published by the Lancet Infectious Diseases, a combination of self-isolation, effective contact tracing and social distancing measures, may be the most effective and efficient way to control the spread of Covid-19.

However, for contact tracing to be at its most effective, the modelling estimates that for every 1,000 new symptomatic cases, 15,000 to 41,000 contacts would have to be asked to self-isolate. Clearly, the logistical burden of operating a manual contract tracing system is high. As a result, governments have chosen to augment existing systems through the deployment of digital contract tracing apps, which are predominantly built using software developed by Apple and Google.

Digital contact tracing

As we go about our day-to-day lives, especially as restrictions are eased, it may not be possible to name everyone you have encountered over the previous 14 days if you later contract Covid-19. Digital contact tracing provides a solution to this issue by harnessing the Bluetooth technology within our phones to help identify and remember potential close contacts. Research by the University of Glasgow has found that contact tracing apps can contribute substantially to reducing infection rates when accompanied by a sufficient testing capability.

Most countries have opted to utilise a system developed by Apple and Google, known as Exposure Notifications, as the basis for digital contact tracing. Public health authorities have the option to either provide Apple and Google with the criteria which defines when an alert should be generated or develop their own app, such as the Scottish Government’s Protect Scotland.

Exposure notification system

In order to protect privacy, the exposure notification system can only be activated by a user after they have agreed to the terms; the system cannot be unilaterally activated by public health authorities or Apple and Google. 

Once activated, the system utilises Bluetooth technology to swap anonymised IDs with other users’ devices when they come into close contact. This has been described as an anonymous handshake. Public health authorities set what is considered as a close contact (usually contact at less than a 2-metre distance for over 15 minutes), and the app calculates proximity measurements over a 24-hour period.

Anonymised IDs are not associated with a user’s identity, change every 10-20 minutes and collected anonymised IDs are securely stored locally on user devices for a 14-day period (incubation period of Covid-19) before being deleted.

If a user tests positive for Covid-19, the public health authority will provide them with a code that confirms their positive diagnosis. This will then provide users with an option to upload collected anonymous IDs to a secure public health authority server. At least once a day, the user’s phone will check-in with this server to check if any of the anonymised IDs collected in the previous 14-days match up with a positive case. If there is a match, and the proximity criteria has been met, a user may receive a notification informing them of the need to self-isolate.

Analysis conducted by the National Institute for Health Research highlights that the use of contact tracing apps, in combination with manual contact tracing, could lead to a reduction in the number of secondary Covid-19 infections. Additionally, the analysis revealed that contact tracing apps identified more possible close contacts and reduced the amount of time it took to complete contact tracing. The analysis concluded that the benefits of digital contact tracing include the ability to trace contacts who may not be known to the infected individual and the overall reliability and security of digitally stored data, rather than an individual’s memory or diary.

Therefore, it could be said that digital contract tracing apps will be most effective when restrictions ease and we are more likely to be in settings where we may be in close contact with people we may not know, for example, when we’re on holiday or in a restaurant.

Cross-border handshakes

Covid-19 naturally does not respect any form of border, and as restrictions on domestic and international travel are relaxed, opportunities will arise for Coivd-19 to spread. In order to facilitate the reopening of the tourism sector, there have been calls for countries which have utilised the Exposure Notification system to enable these systems to interact.

Examples of interoperability already exist internally within the UK, as an agreement exists between Scotland, England and Wales, Northern Ireland, (plus Jersey, Guernsey and Gibraltar), that enables users to continue to receive exposure notifications when they visit an area they do not live in, without the need to download the local public health authority app.

EU Exposure Notification system interoperability, European Commission, 2020

Additionally, the European Union has also developed interoperability of the Exposure Notification system between member states, with a commitment to link 18 national contact tracing apps, establishing the world’s largest bloc of digital contact tracing. The EU views the deployment of linked apps as vital to re-establishing safe free movement of people between member states, for work as well as tourism.

Over the next few months, it is likely that links will be created across jurisdictions. For example, the Scottish Government has committed to investigating how interoperability can be achieved between the Scottish and EU systems. The interoperability of Northern Ireland and Ireland’s contact tracing app highlights that on a technical level there appears to be no barrier for this form of cross-jurisdiction interaction.  

Therefore, as restrictions ease, the interoperability of digital contact tracing apps may become a vital way in which to ensure safe travel, as we learn to live with the ongoing threat of Covid-19.

Final thoughts

Covid-19 has proven itself to be a persistent threat to our everyday lives. However, the deployment of effective vaccines provides us with hope that the threat will be minimized soon. Until then, the need to utilise contact tracing is likely to remain.

As the roll-out of mass-vaccination programmes accelerates, and restrictions are relaxed, we are likely to be in more situations where we will be in contact with more people, not all of whom we may necessarily know. This will be especially true as domestic and international tourism begins to re-open. In these scenarios, the Exposure Notification system, and interoperability between public health authority apps, will become increasingly vital to the operation of an effective contact tracing system.

In short, digital contact tracing may prove to be key to the safe re-opening of the tourism sector and enable users to easily and securely be contact traced across borders.


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Further reading: articles on COVID-19 and digital from The Knowledge Exchange blog

The year of living differently: reviewing The Knowledge Exchange blog in 2020

2020 has been a year like no other. A microscopic virus – 10,000 times smaller than the width of a human hair – has dominated, disrupted and redefined the way we live and work.

Although the pandemic is primarily a public health emergency, its effects have been felt in all areas of public and social policy, from economic development and employment to transport and the environment. Throughout this year, our blog has reflected on the impacts of the coronavirus and the restrictions introduced to prevent its spread.

The COVID-19 knock-on

While the coronavirus pandemic has dominated the news headlines, it has also obscured the knock-on effects on the NHS. In October, we reported on the impacts of delays to preventative healthcare measures, such as screening and routine medical care in the form of pre-planned operations for long-term chronic and non-urgent conditions.

As the blog post noted, the impacts have been wide-ranging, including not only delays in care for case of physical ill health, but also for those seeking treatment for mental health conditions:

“Research suggests that incidence of mental illness during the coronavirus pandemic increased. However, the numbers of people accessing services and being referred for treatment have not increased proportionate to this.”

The ‘hidden epidemic’

Long before the coronavirus pandemic, domestic violence had become known as a ‘hidden epidemic’ in the UK. In September, our blog highlighted the unintended consequences of quarantine for domestic abuse victims.

After the UK entered lockdown in March, calls and online enquiries to the UK’s National Domestic Abuse line increased by 25%. Three-quarters of victims told a BBC investigation that lockdown had made it harder for them to escape their abusers and in many cases had intensified the abuse they received.

Despite additional government funding, the local authorities and charities which support victims of domestic violence have been struggling with the financial fallout from the pandemic. Even so,  important partnerships have been formed between local government, educational institutions and third sector bodies to provide safe spaces for women and their children fleeing violence. Among these was an initiative at the University of Cambridge:

St Catherine’s College formed a partnership with Cambridge Women’s Aid to provide over 1000 nights of secure supported accommodation during the lockdown period.

‘Same storm, different boats’

As the recent Marmot review has stressed, the coronavirus pandemic has exposed and deepened many of the deep-rooted inequalities in our society, including gender, ethnicity and income.  It has also shone a light on more recent inequalities, such as the growth of precarious employment among sections of the population.

In July, we looked at the uneven economic impact of the pandemic, focusing on the heavy price being paid by young people, women, disabled people and Black and Minority Ethnic (BAME) communities.

Women often work in the frontline of care services and have had to juggle childcare during lockdown. BAME communities are over-represented in key-worker jobs, and so were particularly vulnerable to coronavirus.

And although there has been much talk about ‘building back better’, our blog post drew attention to the observations of Dr Sally Witcher, CEO of Inclusion Scotland during a Poverty Alliance webinar:

“She asks whether indeed we should want to build back, when the old normal didn’t work for a large proportion of people, particularly those with disabilities. Dr Witcher also questions ‘who’ is doing the building, and whether the people designing this new future will have the knowledge and lived experience of what really needs to change.”

The impacts of a pandemic

Many other aspects of the impact of COVID-19 have been covered in our blog:

  • How housing providers have embraced the fluidity of an emergency situation, including tackling homelessness, engaging effectively with tenants and addressing mental ill health.
  • Digital healthcare solutions for those with coronavirus and for the continuity of care and day-to-day running of the NHS.
  • Creating and managing a COVID-secure workplace.
  • How COVID-19 is changing public transport, including an acceleration towards contactless payment and mobile ticketing.
  • The additional challenges of the pandemic facing autistic children and young people.
  • The impact of the coronavirus restrictions on the arts.
  • The role of green new deals in tackling climate change and economic inequality as part of the post-Covid recovery.

Beyond the virus

Although the pandemic has been at the forefront of all our minds this year, The Knowledge Exchange blog has also taken the time to focus on other important issues in public and social policy:

We’ve also taken advantage of the ‘new normal’ experience of remote working to join a number of webinars, and to report back on the observations and ideas emerging from them. Most recently, our blogs have focused on a series of webinars organised by Partners in Planning, which included contributions on how the planning system can help address climate change.

Final thoughts

The health, economic and social impacts of the pandemic are likely to be long-lasting – restrictions on travel, work and socialising will continue into the spring, and insolvencies and unemployment numbers are likely to rise. And the continuing uncertainty over the UK’s new trading relationship with the European Union will generate additional challenges.   

But, as a frequently difficult, often challenging and sometimes distressing year draws to a close, there is cause for optimism about 2021. Vaccines to prevent the spread of the virus have been developed with lightning speed. Across the UK people are already being vaccinated, with greater numbers set to receive the jab in the coming months.

Here at The Knowledge Exchange, we’ll continue to highlight the key issues facing public and social policy and practice as we move towards the post-Covid era.

Season’s greetings

It’s with even greater meaning than ever before that we wish all our readers a happy Christmas, and a healthy, prosperous and happy new year.

Best wishes from everyone at The Knowledge Exchange: Morwen, Christine, Heather, Donna, Rebecca, Scott, Hannah and James.


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Virtual reality: a game changer for mental health treatment?

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Demand for mental health treatment in the UK far outstrips supply. And the outbreak of COVID-19 has forced many primary care services to think creatively not only about demand and supply, which has increased further during the pandemic, but also about delivery. GPs and community mental health teams in particular are thinking about more innovative ways to deliver remote support to people with mental health conditions, including the use of Telehealth and virtual reality (VR) platforms.

People are probably most familiar with VR in a digital gaming context, with devices like Oculus headsets offering immersive gaming experiences where players can place themselves “in the game”, but it has been suggested that integrating VR, alongside other telehealth options like apps and videoconferencing into mental health consultation and treatment could make counselling and alternative treatment options more accessible to those living and working remotely. Early research suggests that while discussions about investigating the benefits of this type of delivery of care have been accelerated by the coronavirus pandemic, researchers and practitioners were already beginning to explore how VR and Telehealth could be a tool that could be utilised more regularly in the treatment and engagement of people with mental health conditions, not just during periods where face to face contact is a challenge.

Blended treatments to help improve outcomes

Telehealth encompasses a number of different approaches and techniques, including using platforms like skype for mobile conferencing, or mobile apps to help people manage conditions and to help deliver some treatment options. It has previously been used in other areas of medicine, for example to help those with chronic conditions self-manage, with various levels of success and uptake.

One foundation embracing remote mental health support, even before the arrival of coronavirus, is Greater Manchester mental health foundation trust who use a mobile app called ClinTouch, to support people recovering from psychosis, schizophrenia and bipolar disorder. Although patients will typically see a care co-ordinator monthly, symptoms of a relapse can appear within days; with the app, users are asked how they feel a few times a day, and an alert is generated if a relapse looks likely.  Some NHS organisations have also adopted telepsychiatry – videoconferencing therapy sessions. 

Using VR for remote therapy almost takes telehealth a step further, and involves using a complete virtual environment, with the potential for this to be integrated into treatment plans, so clinicians can, for example, create a setting which looks like the inside of their office, or use virtual environments to model external scenarios that may cause anxiety to help patients practice coping techniques like breathing exercises.

One of the potential extended uses for VR and telehealth in a clinical mental health treatment setting which has emerged is its application for rural populations, or for people who are isolating because of exposure to coronavirus. However, this has raised some additional questions about the potential barriers to uptake exacerbated by digital illiteracy and poor access to digital devices, as well as the problem of poor or slow internet connections, something which will need to be considered by health boards if they decide to offer these treatment options.

Photo by cottonbro on Pexels.com

More research is needed, and is being done

While recent research has shown face-to-face therapy remains the optimal treatment method in mental health care, VR-based therapy has been found to be more effective than Skype-based or phone only counselling. The research also suggests VR-based Telehealth sessions could improve engagement, compared to phone only sessions and greatly reduce dropout rates for clients which in turn can support positive clinical outcomes. It appears the general consensus is that self-service, VR and automated technology, in the form of apps and notifications could support and augment healthcare professionals and help support the delivery of more traditional approaches.

The virtual reality lab at the NIHR-Wellcome Trust-King’s Clinical Research facility aims to improve the understanding of the mechanisms that play a role in the onset and maintenance of mental health problems. They use virtual reality environments to assess and develop treatments to improve the well-being of people with mental health problems.

Research is also being done on the specific reaction to young people of engaging with digitally driven treatment options. There are some suggestions that the delivery of digital interventions to support young people with mental health problems may help them to engage more, in part because they are more familiar with digital platforms and may feel more comfortable using them day-to-day, however there is also a suggestion that young people also prefer the feeling of “distance” and “impersonality” that a digital platform provides which can lead to some feeling more able to express how they are really feeling, compared to a face to face meeting with a clinician which can sometimes be a stressful and intimidating experience.

Where next?

So far in clinical psychology and psychiatry, the primary focus of VR has been its role in treating anxiety and stress-related disordersspecific phobiaspanic disorder, and post-traumatic stress disorder. However the disruption to face to face mental health treatments caused by the coronavirus pandemic has led to clinicians thinking even more creatively about the applications of VR and telehealth options to help support the treatment of people with a wider range of mental health conditions.

While it is clear that virtual treatments should not replace the face to face consultation in mental health treatment entirely, research suggests there is a growing role for VR and Telehealth options in augmenting face to face treatment options and that they could be offered as an option for those who are unable to attend face to face sessions. Telehealth and remote treatments are something which will continue to be explored beyond the coronavirus pandemic and could soon be integrated into practice as part of the standard delivery of mental health care and treatment.


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Skilling up: the case for digital literacy

As technology has advanced, and it has become harder to name simple tasks that have not become digitised in some form, the need for everyone in society to have a basic level of digital skills has markedly increased. From applying for jobs to ordering a coffee via an app, digital technology has undoubtedly changed the way we all go about our day-to-day lives. For those with the appropriate digital skillset, these advances may be viewed as a positive transition to more efficiently operated services. However, for those without the necessary digital skills, there is a risk that they will struggle to access even the most basic of essential services, such as opening a bank account.

Therefore, it is of no surprise that the issue of the digital skills gap is a concern for governments and businesses alike, with a recent report by the House of Commons Science and Technology Committee highlighting that the UK could be missing out on £63 billion in lost GDP each year, due to a general lack of digital skills.

The issue of the digital skills gap has never been more pronounced, as a result of the ongoing Coronavirus pandemic, where various restrictions have required us all to embrace digital technology, in order to work, learn and socialise with our friends and family.

Digital skills at work

The extent to which technology has changed the world of work cannot be overstated, with a recent CBI report stating that the UK is the midst of a fourth industrial revolution, spurred on by advancements in automation, artificial intelligence and biotechnology. Research conducted by the CBI found that 57% of businesses say that they will need significantly more digital skills in the next five years. Therefore, the workforce of the future will need to be supported to gain these digital skills, in order to gain employment and enable British business to benefit from the digital revolution.

Concerns have been raised regarding the ability of young people to access opportunities that will support them in developing transferable digital skills. Grasping key digital skills, such as the ability to navigate Microsoft Office, is undoubtedly necessary, but is no longer enough to meet the needs of employers.  

Digital literacy: the bedrock for a fourth industrial revolution

The ability to not just be able to use digital technology, but to truly understand how it works, is known as digital literacy. A report from the House of Commons Education Select Committee sets out how crucial digital literacy will be to the success of the fourth industrial revolution. The speed with which technology is advancing and changing ensures that within just a few years, digital platforms that we use today may become outdated. Therefore, it is unwise to focus on using a single platform when developing digital skills, as inevitably the platform will either gain new functionalities or become obsolete. Instead, digital skills should be developed in a way that ensures they are future-proofed and will not go to waste when the inescapable next big technological or societal change occurs.

Why do we need digital literacy?

An example of why digital literacy is important can be seen in the way in which many of us have adapted to work from home, as a result of the Coronavirus pandemic. Restrictions on face-to-face meetings forced us to consider new ways to work collaboratively and explore the myriad of platforms that facilitate video-calling, file sharing and instant messaging. Whilst we may have already had experience using existing video-conferencing platforms, such as Skype, it was clear that each organisation had to consider using new software, such as Zoom and Google Hangouts.

Many of us would never have used these software packages before and were expected to rapidly get to grips with it in real-time, and without the usual in-person back-up networks of colleagues and IT support. This highlights the importance of digital literacy: the ability to take insight gained from interacting with one digital platform and apply it to another was vital for business continuity during the initial lockdown. The ability to transfer knowledge gained from one platform to another, is vital to ensure that we harness the opportunities of digital advancements as they occur, and without the need for lengthy additional training.

Developing digital literacy

Developing digital literacy can be difficult. Research conducted by the Nuffield Foundation found that providing access to computers in schools was not enough to encourage the development of digital literacy. Instead, FutureLab advises that computers should be embedded and used across the curriculum. Ideas put forward within FutureLab’s Digital Literacy handbook, include:

  • Support children to make mistakes when using technology, allow them to create content that may not be to the high-standard we would expect and enable them to consider how they can improve the quality of their output.
  • Provide opportunities for children to work collaboratively online, e.g create a wiki or real-time document creation via Google Docs. Use this experience to highlight how anyone can make changes online, and develop critical understanding of how what we see online may not always be entirely trustworthy.
  • Harness the power of technology by going beyond the basics. Most children will be able to conduct a simple online search, then highlight ways this can be improved and advanced through Boolean search terms. Incorporate this into a lesson that discusses the value of critically assessing the value of information.

Final thoughts

Since the widespread adoption of the internet, the way we use technology has changed at an almost frightening pace. Therefore, the digital skills we all need to interact with technology must keep up if we are to truly harness the power and potential of these new advancements.

Ensuring that we are all digitally literate will enable us to take advantage of new digital platforms effectively and could potentially lead to future economic prosperity. Developing digital literacy, will not be easy, but it will be vital to ensure the future workforce have the skills they need to gain employment and play their part within the fourth industrial revolution.



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Plantech and the Singapore experience

The publication in early August of the government consultation on reforming the planning system in England was accompanied by plenty of soundbites on the need for more efficiency and faster decision-making.

Technology, and digital services, were highlighted (once again) as an area which needs improvement: “Reform should be accompanied by a significant enhancement in digital and geospatial capability and capacity across the planning sector to support high-quality new digital Local Plans and digitally enabled decision-making.”

The consultation report goes on to say that “we think the English planning profession has the potential to become an international world-leader in digital planning, capable of exporting world class planning services around the world.”

Running to catch up

Many countries around the world have already made significant investment in digital planning, both technology and skills, and of these, Singapore is often mentioned as a world leader. While the city state’s administrative set-up gives it some advantages over countries with devolved and fragmented systems of regulation and planning powers, there are still lessons to be learned.

A webinar hosted by the Connected Places Catapult last month allowed staff from Singapore’s Urban Redevelopment Authority (URA) to share its work on plantech, and in particular how data science is embedded in planning processes and long-term strategic planning. The journey they have been on over the last decade suggests that the UK has a long way to go.

The Singapore approach

The URA’s Digital Planning Lab was set up in 2013 to bring together planners and data specialists to use digital tools to improve planning processes and outcomes. The approach is holistic, with different professions working together to combine insights. This contrasts with the UK, where local authority budget cuts have led to an erosion of the skills base.

The mission of the Digital Planning Lab is to act as a catalyst – to incubate skills and ideas, to accelerate insights and transformation, and to inspire, through innovation and partnerships. There is a strong focus on building skills and capabilities within government, with the Lab running a data analytics immersion programme twice a year, to train cohorts of government staff on how data can be used in their work.

One output of the Lab has been their digital planning tool, ePlanner, which applies data science to urban planning processes. The one-stop inhouse geospatial tool is accessible to staff in over 50 government agencies and brings together information and analytics on population and demographics, land use, mobility, housing types, planning approvals, enforcement action, parking and public consultations and feedback. Data and maps are layered to allow deeper analysis of individual topics while protecting individual data. The tool also visualises existing site approvals and restrictions which may exist based on strategic planning documents.

The ePlanner aims to identify information and workflow gaps, and improve interagency working. The data analysis also enables a more flexible approach to strategic planning. While in most countries the evidence used in long-term planning is drawn from sources such as 10-year censuses, and uses surveys to gather people’s preferences, the Singapore tools allow for much more nuanced and responsive policymaking based on actual behaviour. It also recognises the complex factors which shape how communities use their infrastructure.

Plantech creates better places

The goal of plantech in Singapore is explicitly to facilitate data-informed, people-centric planning outcomes. A goal which planning reforms in the UK can only currently aspire to achieve.

While the challenges are recognised (such as the protection of individual and health-related data), the Urban Planning Lab approaches their work from the perspective of asking ‘how can we unlock the value of data’ – providing evidence-based insight on trends without exposing raw data. By mitigating risk, Singapore has been able to unlock the possibilities that modelling and simulation, and artificial intelligence, can bring to urban planning.


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Connecting the future: what is 5G?

By Scott Faulds

Over the years, as technology has evolved, the way in which we all use and access the internet has changed dramatically. The devices that can access the internet have shrunk and become portable, from laptops that allow us to work anywhere to smartwatches that we can use to play music from our wrists.

At the same time, as more devices have gained the ability to easily connect to the internet, our usage has changed massively; we now consume a great deal of audio and video online. This has become even more apparent during the Covid-19 pandemic, with many of us turning to video conferencing tools to work from home and keep in contact with our friends and family.

Additionally, in recent years, we have begun to see our homes, cars and cities become ‘smart’ via the power of the internet, enabling a whole new generation of devices that can connect and exchange data.

In response to changes in the way we all use and access the internet, the mobile network infrastructure has evolved to allow for greater bandwidths, lower latency and ultimately faster connection speeds. The next generation of mobile network technology – known as 5G – will facilitate new data-driven technologies, such as, automation, self-driving cars and artificial intelligence.

What is 5G?

5G is the next generation of mobile internet technology, which operates across a broad spectrum of radio waves that will allow for faster, always-on access to the internet. It’s estimated that 5G will enable internet speeds up to 600 times faster than those experienced on 4G networks today. This would allow you, for example, to download an ultra-high-definition movie in 25 seconds. The ability to transfer data at these speeds allows for technologies, such as artificial intelligence and autonomous vehicles, to operate effectively. Some experts claim 5G could lead to a new era of productivity and growth.

However, the physical infrastructure required to build a 5G network can be difficult to deploy. The fast speeds achieved by 5G networks rely upon what is known as millimetre waves, which operate at a higher frequency than our current mobile networks. These waves have a shorter range and can be easily disrupted by obstacles, such as buildings, people and even rainfall. Therefore, to ensure network reliability, a 5G network will have to operate across low, medium and high frequencies. Each of these frequencies will require separate network infrastructure and will have various trade-offs, in terms of speed and service area.

As a result of the distance and obstacle limitations of 5G, there will be a need for a dramatic increase in the amount of physical infrastructure required to ensure reliable service, particularly in built-up urban environments. According to a recent report by McKinsey, a 5G network will require 15 to 20 network access points per square kilometre in densely populated areas, compared with 2 to 5 network access points required for existing mobile networks. Subsequently, the cost involved with establishing this new infrastructure ensures that in the short-term, we are unlikely to see the launch of nationwide 5G coverage anytime soon.  

The power of data

The ability to exchange large amounts of data at speed can have a significant positive effect on our economy. Research from Barclays, indicates that the deployment of 5G has the potential to increase annual UK business revenues by up to £15.7 billion by 2025. Additionally, the ability to exchange data at speed opens up new opportunities for us to improve the efficiency of the operation of our cities.

The advent of the smart city, where everything from streetlights to trains can communicate with each other, can only truly come to fruition when combined with the data speeds facilitated by 5G networks. The main benefit of establishing a fully-fledged smart city is the ability for cities to become sustainably more efficient, through the extrapolation and analysis of data. For a smart city to be at its most efficient, the collection and analysis of this data will have to occur in almost real-time and will rely heavily on artificial intelligence and automation. 

A study conducted by Massachusetts Institute of Technology (MIT) found that in New York City congestion could be reduced by up to 75% through the deployment of a ride-sharing algorithm built using real-time data generated by taxis and incoming requests. The system would allow drivers to work shorter shifts, create less traffic, reduce air pollution and shorten commutes (with an average wait time of 2.7 minutes).

The creation of smart cities, underpinned by 5G, could potentially allow us all to live in cities which are more efficient and responsive to changes in our behaviour. Analysis conducted by Cisco, has revealed that the efficiencies generated by smart city technology could result in cost savings of up to $2.3 trillion globally.

Therefore, it could be said that 5G technology has the potential to allow businesses and governments to make costs savings and generate new forms of revenue.

Final thoughts

The deployment of 5G networks will provide the base for the technology of the future to operate and enable innovation to thrive. It is likely that the speeds and reliability offered by a fully-fledged 5G network could generate economic benefits and allow governments to make cost savings by leveraging big data to make our cities operate in a more efficient manner.

However, the deployment of 5G will be a complex and potentially costly undertaking, and it will be a long time before we see the establishment of nationwide 5G coverage. Therefore, although there is a wide range of benefits associated with the establishment of a 5G network, it should not be seen as a silver bullet that will generate instantaneous economic benefits.

Ironically, the future of high-speed internet, will take time and will require a great deal of investment before the benefits are realised.


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Knowledge from a distance: recent webinars on public and social policy

During the national lockdown, it’s been impossible for most of us to attend conferences and seminars. But many organisations have been harnessing the power of technology to help people share their knowledge, ideas and experience in virtual seminars.

In the past few weeks, the research officers at The Knowledge Exchange have joined some of these webinars, and in today’s blog post we’d like to share with you some of the public and social policy issues that have been highlighted in these online events.

The liveable city

Organised by the Danish Embassy in the UK, this webinar brought together a range of speakers from Denmark and the UK to consider how our cities may change post COVID-19, including questions around green space, high street recovery, active travel and density and types of residential living accommodation in our towns and cities.

Speakers came from two London boroughs, architectural design and urban planning backgrounds and gave examples of experiences in Newham, Ealing and Copenhagen as well as other more general examples from across the UK and Denmark. The seminar’s website also includes links to presentations on previous Liveable City events in Manchester, Edinburgh, Bristol and Glasgow.


What next for public health?

“Healthcare just had its 2008 banking crisis… COVID-19 has generated a real seismic shift within the sector and I don’t think we will ever go back”

This webinar brought together commentators and thought leaders from across the digital health and tech sectors to think about how public health may be transformed by our experiences of the COVID-19 pandemic and the significant shift to digital and online platforms to deliver care.

The speakers discussed data, privacy and trust and the need to recognise different levels of engagement with digital platforms to ensure that specific groups like older people don’t feel unable to access services. They also discussed the importance of not being driven by data, but using data to help us to make better decisions. The webinar was organised by BIMA, a community of businesses, charities and academia across the UK.


Green cities

This project, organised by the Town and Country Planning Association (TCPA), included 3 webinars each looking at different elements of green infrastructure within cities, including designing and planning, assessing the quality of different types of green infrastructure and highlighting the positive impacts of incorporating more good quality green spaces for mental and physical health, as well as for environmental purposes.


Rough sleeping and homelessness during and after the coronavirus

Organised by the Centre for London, this webinar brought together speakers from across the homelessness sector within London, including St Mungos, the Greater London Authority (GLA) and Croydon Council to explore how the COVID-19 pandemic was impacting people who are homeless or sleeping rough in the city.

Each speaker brought insights from their own experiences supporting homeless people in the capital (so far) during the COVID 19-pandemic. They highlighted some of the challenges, as well as some of the more positive steps forward, particularly in relation to co-operation and partnership working across different levels of government and with other sectors such as health.

They also commended everyone involved for the speed at which they acted to support homeless people, particularly those who were vulnerable or at risk. However, concerns were also raised around future planning and the importance of not regressing back into old ways of working once the pandemic response tails off.


Poverty, health and Covid-19: emerging lessons in Scotland

This webinar was hosted by the Poverty Alliance as part of a wider series that they are hosting.  It looked at how to ‘build back better’ following the pandemic, with a particular focus upon addressing the long-standing inequalities that exist throughout society.

The event included presentations from Dr Gerry McCartney, Head of the Public Health Observatory at Public Health Scotland, Dr Anne Mullin, Chair of the Deep End GPs, and Professor Linda Bauld, Professor of Public Health at University of Edinburgh.

A key message throughout was that while the immediate health impacts of the pandemic have been huge, there is an urgent need to acknowledge and address the “long-term challenge” – the impact on health caused by the economic and social inequalities associated with the pandemic.

It is estimated that over 10 years, the impact of inequalities will be six times greater than that of an unmitigated pandemic. Therefore, ‘building back better’ is essential in order to ensure long-term population health.


Returning to work: addressing unemployment after Covid-19

This webinar was also hosted by the Poverty Alliance as part of their wider webinar series on the pandemic.

The focus here was how to address the inevitable rise in unemployment following the pandemic – the anticipated increase in jobless numbers is currently estimated to be over three million.

The event included presentations from Kathleen Henehan, Research and Policy Analyst at Resolution Foundation, Anna Ritchie Allan, Executive Director at Close the Gap, and Tony Wilson, Director of the Institute for Employment Studies.

The webinar highlighted the unprecedented scale of the problem – noting that more than half of the working population are currently not working due to the pandemic, being either unemployed, furloughed or in receipt of self-employment support.

A key theme of the presentation was that certain groups are likely to be disproportionately affected by unemployment as the support provided by the government’s support schemes draw to a close later this year.  This includes women – particularly those from BAME groups, the lower paid and migrants – and young people.  So it’s essential that the support provided by the government in the form of skills, training, job creation schemes etc addresses this, and is both gender-sensitive and intersectional.


Supporting the return to educational settings of autistic children and young people

The aim of this webinar, provided by the National Autism Implementation Team (NAIT), was to offer a useful overview of how to support autistic children and young people, and those with additional support needs, back into educational settings following the pandemic.

Currently around 25% of learners in mainstream schools have additional support needs, and it is generally accepted that good autism practice is beneficial for all children.

The webinar set out eight key messages for supporting a successful return, which included making anticipatory adjustments rather than ‘waiting and seeing’, using visual supports, providing predictability, planning for movement breaks and provision of a ‘safe space’ for each child.  The importance of listening to parents was also emphasised.


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Ellisland Farm, Dumfries. “P1050381.JPG” by ejbluefolds is licensed under CC BY-NC 2.0

Burns at Ellisland

Our Research Officer, Donna Gardiner has also been following some cultural webinars, including one that focused on the links between Scotland’s national poet and the Ellisland Farm site. The webinar was led by Professor Gerard Carruthers, Francis Hutcheson Chair of Scottish Literature at the University of Glasgow and co-director of the Centre for Robert Burns Studies.

Robert Burns lived at Ellisland Farm in Dumfriesshire between May 1788 and November 1791, and is where he produced a significant proportion of his work – 23% of his letters and 28% of his songs and poems, including the famous Tam O’Shanter and Auld Lang Syne.

The presentation looked at how Robert Burns was influenced by the farm itself and its location on the banks of the River Nith.  It also touched on his involvement with local politics and friends in the area, which too influenced his work.

It was suggested that the Ellisland farm site could be considered in many ways to be the birthplace of wider European Romanticism. The webinar also included contributions from Joan McAlpine MSP, who is chair of the newly formed Robert Burns Ellisland Trust. She discussed how to help promote and conserve this historic site, particularly given the impact of the coronavirus on tourism.


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Digital Housing Week: How coronavirus is affecting housing

Throughout this week, Inside Housing magazine has been providing a series of webinars offering debate, learning and innovative thinking on how housing providers are responding to present-day challenges and preparing for future demands.

One of the webinars focused on the ways in which Covid-19 has accelerated the move to agile working for housing associations (HAs) and council staff, and how housing providers can tackle the  mental health and wellbeing issues experienced by staff and residents.

Responding to the new normal

Anita Khan, from Settle Housing Association in Hertfordshire explained how her HA responded to lockdown by mobilising its continuity plan. Settle’s first responsibility is to engage with and support its customers, and once the plan was enacted, agile behaviour took root.

Anita described how automated contacts with HA customers enabled it to identify which people were in isolation or shielding. At the same time, methods of enforcement had to change, as the UK government banned evictions. Anita explained that once the HA stopped sending messages warning customers of enforcement of the rules on rent payments, the residents started to engage more positively with it.

Working practices at Settle also changed substantially, with a move away from a face-to-face culture towards remote working. Anita described the process of change HA staff experienced, from relief at not having to make long commutes, followed by fatigue from too many video conferences, and more recently recalibrating to a situation that works.

Agile working in the age of coronavirus

Tony Morrison, an agile working consultant, described the measures taken by Newham Council  to modernise the way the local authority worked. He explained that in 2019, Newham got a new leadership team, and deployed a plan to make the first investment in IT for eight years. The aim was to make sure everyone was mobile by default, and to pivot a local authority with 14.5 million pieces of paper towards a paperless organisation. The plan was already under way when the lockdown was imposed.

Immediately, the council had to adapt to the new situation. Around three thousand members of staff didn’t have effective ways of working from home, and so the council identified who most needed assistance, and delivered laptops and mobile devices to these 500 individuals.

At same time, the council deployed Office 365 and migrated Skype for Business, and enabled staff to communicate with customers using Zoom.

Newham has now rolled out a further 2000 devices to staff, and it’s clear that the lockdown experience has demonstrated the possibilities of remote working.

The council is already looking to the post-pandemic period when it might not require so much expensive office space. Tony explained that now would not be the right time to consider disposal of offices because so many other organisations are in the same position. Instead, Newham is looking at alternative uses for its property estate, including cohabiting with other organisations, pop-up spaces and conversion to affordable housing.

Housing on the frontline of a mental health crisis

There’s now little doubt that the coronavirus pandemic is having a significant effect on mental health. With the loss of lives and livelihoods, and the growing demands for support from already overburdened health services, the fallout from the pandemic is likely to be on an unprecedented scale.

During the Inside Housing webinar, consultant psychiatrist Raj Persaud talked about the unique role housing can play in tackling mental health issues among staff and residents.

He noted that housing staff may be among the first to identify signs of mental illness among residents, because fewer people have been attending GP surgeries during the pandemic.

He suggested that housing staff in this position should raise such issues with community mental health teams. He also highlighted the importance of contacting NHS services by letter. Because letters are legal documents, health professionals are more likely to pay attention to issues raised in this way.

Raj highlighted a key issue housing staff can focus on when dealing with people who have mental health problems:

“Too often, the aim has been to concentrate on the causes of mental illness, but that misses out on the coping skills people have used in the past. The right skills can make a person super resilient, and so it’s always useful to engage in conversation about coping skills people have used for previous life events.”

All of the speakers in the webinar stressed the importance of the human factor in tackling the challenges raised by the coronavirus pandemic. Raj Persaud noted that, in the absence of the water cooler, the pub or the staff room, physical locations have to be recreated virtually. Doing this may feel clunky at first, but even if things don’t feel right, housing staff and others should persist until they find a method that suits them, and enables people to feel they are less isolated.

Final thoughts

One thing is certain: post-Covid will be very different from pre-Covid. But this webinar demonstrated that housing providers are embracing the fluidity of this situation. In an age of thinking differently, those who consider alternative solutions to the problems of the present may be better equipped for the challenges of the future.


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Digital infrastructure supporting health care during the COVID-19 pandemic

Healthcare is a key frontline service in the response to the COVID-19 outbreak. The NHS has had to react at pace to plan and deliver services in new and innovative ways.

Digital healthcare solutions are at the fore of ensuring not only the delivery of acute care for those patients suffering from COVID-19 but are also supporting the successful continuity of care and the day to day running of a health service which still needs to maintain “normal service” as well as its pandemic response. Digital infrastructure is helping the NHS and other partners to adapt and to meet the demand for health and care in a number of ways.

Supporting the delivery of care

In many ways, the NHS and frontline care in particular were already making inroads towards transitioning to digital and online platforms before the pandemic emerged. Many GP surgeries allow online appointment booking, and where appropriate, monitoring of those with long term conditions can be done remotely through at-home testing facilities, such as home heart monitors or monitors to help people monitor their diabetes.

Many care providers also already offer telehealth solutions for clients, and patient records are now stored online. However, in many ways the COVID-19 pandemic has catalysed uptake of digital solutions to healthcare diagnosis and delivery, with an increase in online consultations, greater use of the NHS Digital and NHS24 online and app platforms and a rise in the development of digital solutions to better support care in the community.

Support and training for frontline staff

In addition to supporting the direct delivery of care to patients, digital health infrastructure is also being adapted and used to deliver training and support to staff on the frontline. Blogs and online forums, including social media groups are enabling people to share experiences and best practice, and to create a sense of community among healthcare workers. In addition, virtual and e-learning opportunities are being developed to enable staff to access educational activities remotely. These include supporting the rapid education of the healthcare workforce in how best to manage the respiratory conditions encountered, as well as providing education to staff who may have been redeployed to other departments or settings as a result of the pandemic response. Online learning has also been used to help train volunteers and help the public to keep up to date with the latest developments across the health service.

Beyond healthcare to support the response to the pandemic

Artificial intelligence and data analytics also have a vital role to play in helping prevent the spread of coronavirus and other infectious diseases as digital solutions look to be developed to help beyond acute healthcare responses.

Predictive analytics and scenario modelling can be used to help identify those populations who are at risk of spreading the virus and of falling most severely ill to help support shielding campaigns and protect vulnerable groups as lockdown measures ease.

A project run by UK firm Biobank is looking to use samples collected by volunteers to map genetic sequencing in order to identify whether certain genetic characteristics make people more predisposed to become seriously ill, or more likely to contract the virus in the first place. This may help in the development of a vaccine and can also help identify those groups who will be most vulnerable when lockdown conditions are lifted so that they can be monitored more effectively.

Modelling and analytics can also be used to try and project any potential “second waves”. It is hoped that AI, analytics and machine learning will be able to help organisations learn from events such as the SARS epidemic, as well as quickly creating new knowledge from the millions of data points being generated in this outbreak.

Final thoughts

The significant humanitarian response to this global pandemic is being underpinned by a digital infrastructure, the extent of which we have never had at our disposal before. This digital support, of care delivery, communication, analytics, and modelling is being used in conjunction with insight from health and scientific specialists to try and help us find a path through this pandemic, deliver care, aid recovery and prevent re-emergence.

Making best use of the data and digital capacity we have throughout our health and care infrastructure will be a key part in preparing and meeting the needs and challenges that communities are facing.


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Further reading: articles on COVID-19 from The Knowledge Exchange blog

How smart is your city?

Photo by Peng LIU on Pexels.com

by Scott Faulds

In recent years, cities across the UK have begun to explore how they can best capitalize on technological advances to help to create places which operate in a more efficient and sustainable way. The concept of the smart city is relatively wide-ranging; in basic terms, it can be described as an urban area that uses various forms of technology to gather data that can then be analysed to reveal insights about how citizens engage with their environment. The advent of smart city technology, and its ability to be installed in numerous forms across existing city infrastructure, means that it can often be challenging to assess and understand the success of its deployment.

A recent article published in Emerald Open Research UK smart cities present and future: An analysis of British smart cities through current and emerging technologies and practices aims to address this issue by providing an overview of the progress of 26 UK cities which are currently deploying smart city technology. The article attempts to analyse the current state of the smart city roll-out and evaluate the types of technology that are being installed. As the concept of the smart city is one that is fluid, each city’s implementation of the technology can vary, as can the success of the integration.

Designing a smart city evaluation framework

In order to understand the current state of the smart city rollout, the article employs a framework that can be used to assess what types of technology have been deployed and the current state of the deployment.

The following categories are used to classify smart city technology:

Essential services 5G, full-fibre internet, Internet of Things

Smart Transportation digital ticket booking, smart cards, electric vehicle charging points

Broad Spectrum retrofitting buildings, digital social inclusion schemes, hackathons

Business Ecosystem innovation hubs, co-spaces, tech entrepreneurial networks 

Open Data Provider urban dashboards, urban models, big data

The state of the rollout of smart technology is evaluated on the following scale:

0 – no measures underway

1 public announcement of plan

2 study in advanced stages/detailed roadmap

3 testing/trials

4 installation of technology on smaller scales

5 fully established and integrated into the city

By analysing relevant documents/news reports and applying the aforementioned framework, the article finds that the most common type of smart city infrastructure installed in cities across the UK is technology which enables the collection of open data. In particular, a group known as Smart Cities Scotland has been found to have one of the most advanced implementations of open data technology. This is due to the creation of an open source data platform which allows anyone to access the data collected and develop smart city technology that directly responds to the needs of these cities.

Approaches to deploying smart city technology

Through the application of the framework, London and Bristol were discovered to be the cities in the UK with the most advanced implementation of smart city technology; this was largely due to the widespread use of all of the categories. However, the authors also suggest that the steps taken by smaller cities, such as Dundee and Peterborough, are often of more interest, as they clearly show the two prevailing approaches to the implementation of smart city technology.  

The approach taken by Dundee is one in which cities select one or two smart city categories and focus on getting these technologies to become fully integrated and widespread. For example, Dundee has chosen to focus on the integration of open data (via Smart Cities Scotland) and smart transportation technologies, in a bid to create a fully sustainable transport network. An in-depth focus on these areas has enabled Dundee to become a leader in the switch to zero-carbon transport, through the creation of the Mobility Innovation Living Lab and the electrification of 20% of the local taxi fleet. However, whilst the implementation of open data and smart transportation technology places Dundee as a leader in these categories, their implementation of essential services or broad spectrum technology is poor when compared to other cities in the UK.

Peterborough, on the other hand, has taken an almost diametric approach and is focused on deploying a broad variety of smart city technologies, that will allow them to reach their goal of becoming a gigabit city and establishing a circular economy. The city has deployed a variety of online platforms, designed to engage citizens and business alike, to come together and share resources that will allow Peterborough to support and empower everyone in the city to minimize waste.

The future of the Smart City

As well as analysing the current state of the smart city rollout, the article also discusses the future of the smart city and sets out its expectations for the next decade. A key theme discussed is the concept of a more connected city, powered through 5G and increased network capacity, which will allow for city infrastructure to communicate and easily respond to changes in the way citizens are engaging with the urban environment. However, the article concludes that we are unlikely to see any major visual changes to our cities, apart from an increase in electric vehicles and their accompanying infrastructure. A great deal of the smart city technology currently being deployed in UK cities tends to occur behind the scenes, but, these changes will allow councils to harness the power of data to make better decisions about the future day-to-day workings of our cities.

To conclude, this article provides one of the first overviews of the state of the smart city rollout across the UK, allowing for a comparative analysis of the different approaches cities have taken to implement various forms of smart city technology. Establishing a framework of how to evaluate this progress allows those interested in smart city technology to assess which smart city technologies are most prevalent and which cities are at a more advanced stage of the rollout.

In short, this article will be extremely informative for anyone with an interest in learning more about smart city technology and its deployment in the UK.


Further reading
Articles on smart cities on The Knowledge Exchange blog

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