Rescheduled, delayed, cancelled: the knock on impact of the pandemic on routine health care

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Recently published figures show that waiting times for some non-urgent care across the UK have risen dramatically with the pandemic squeezing the already stretched resources of the NHS. Figures from Public Health Scotland, published in June 2021 found that when comparing to pre-pandemic levels, the waiting list size is 30.3% higher than the 12-month average prior to the onset of the pandemic (Mar 19 – Feb 20), while in England figures published in August 2021 showed NHS waiting lists in England reached a “record” 5.45 million people.

In addition to strains on acute NHS care services on the frontline, there are warnings about the additional public health impacts of delays to preventative healthcare measures like screening and routine medical care as well as concerns about a surge in demand when people who have delayed seeking non-urgent diagnosis and treatment return to hospitals.

At the outbreak of the pandemic many hospitals took the decision to delay or stop entirely routine pre-planned surgeries and preventative screening and diagnostics. Some even suspended treatment for more urgent care like cancer treatment on a short-term basis. While many of these services have resumed since the beginning of the pandemic, albeit with a backlog of patients now to be seen, significant strain on the NHS as we come into the winter months because of coronavirus is still anticipated.

In many areas this has led to a backlog of care, both for those patients already in the system awaiting routine surgeries, as well as those who are yet to be diagnosed but would have been through preventative screening programmes run by the NHS.

Delays in healthcare and routine screening

Even before the coronavirus pandemic took hold, many NHS hospital trusts were under criticism because of the significant length of waiting times for people who required routine operations. Doctors across the UK are now warning that these delays could be increased further unless the NHS receives additional support to increase capacity across all areas of care not just urgent care in the coming months.

It has been suggested that delays in diagnosis and routine treatments could lead to an increased number of hospitalisations further down the line, requiring higher levels of care, longer lengths of stay, and increased hospital readmissions.

And despite the recent announcement of a new arrangement for health and care funding, commentators are quick to stress that the £1.4bn the new funding programme is expected to generate may not be enough to suitable address all of the concerns across health and social care, which they highlight has been chronically underfunded for a significant number of years, even before the pandemic exposed the frailty of parts of the system.

A reluctance to visit hospitals and use primary care services

Research from the Health Foundation found that there had been a significant reduction in the number of GP consultations since the start of the pandemic which has led to concerns about the care of non-covid patients, patients with long term health conditions and also the potential for delayed diagnosis. Primary care consultations also reduced and have remained low consistently since the beginning of lockdown.

Figures have also shown a reduction in the number of referrals, medical tests, new prescriptions and immunisations. While some of these reductions are the result of advice to delay routine referrals to free up capacity for hospitals to deal with the potentially large number of cases of Covid-19, routine referrals have still not recovered to pre-lockdown levels.

These figures, and other contributions from commentators and researchers suggest that government messages to ‘protect the NHS’ may have had the unintended consequence of discouraging people from seeking urgent medical care when it was required for fear of using services unnecessarily or for fear of contracting the virus when attending hospital or primary care settings.

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A potential future crisis for the NHS

Commentators are now warning that the treatment backlog which has been caused by the coronavirus pandemic, in addition to diagnostic delays and screening programmes, may lead to a future crisis of care or significant delays in care for people waiting to receive more routine treatment.

Delays in care have not only been reported in cases of physical health. There have also been significant delays in referrals for those seeking treatment for a mental health condition, an area of the NHS which was already facing significant delays in referral and transfer of care even before the pandemic. 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. People with mental health conditions may have been unable to access appropriate support through primary care pathways, which could potentially impact on their long-term health and care.

Finally, concerns have been raised about the wider social determinants of health such as employment and poverty. Public Health England (PHE) published a monitoring tool which looks at the wider impacts of the Covid-19 pandemic on population health, and it is likely that the knock-on impact of the virus could have far reaching consequences for public health in the future as the health implications of lockdown, lack of social interaction and rising unemployment could be significant. 

Where next?

While the NHS delivered some elective treatment during the course of the pandemic, the pressure of caring for large numbers of patients, many of whom were seriously unwell with COVID-19 has led to longer delays for the growing number of patients on waiting lists. Figures also show that access to elective treatment fell further in the most deprived areas of England during 2020. Tackling the backlog, and working towards the “levelling up” agenda to reduce health inequalities, both of which have been significantly exacerbated by the pandemic will be a key component of the work in health and social care over the coming months and years.


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Covid-secure workplaces revisited: how businesses can help people get back to work

This is the first in a series of republished blog posts from The Knowledge Exchange. These articles will revisit important topics with ongoing relevance for public policy and practice, as well as for communities and wider society. The first revisited post covers the workplace, and focuses on the ways in which employers can ensure their employees can return to Covid-secure places of work. At the end of the republished article, we’ve updated the post to report on recent developments.

As well as being a public health emergency, the coronavirus (COVID-19) has had wide-reaching economic implications. It’s something of an understatement to say that it has had dramatic effects on all our working lives.

And while successive lockdowns have helped in reducing the number of COVID-19 cases, business cannot remain on hold forever. Gradually, carefully, workplaces have been reopening, and growing numbers of workers are preparing to return to their jobs in offices, shops, schools and construction sites.

In 2020, a White Paper produced by The Knowledge Exchange explained how the workplace has to change in response to the COVID-19 pandemic.

A redefined workplace

Before the pandemic, the workplace landscape was already changing. But now it is being totally redefined. Organisations of all shapes and sizes, in all sectors, are facing hard decisions. And how to reopen their workplaces, in a way that protects the health and wellbeing of their employees, is a key challenge.

The White Paper focuses on what employers have to consider when thinking about how to reduce the spread of the coronavirus. The most important challenges concern:

  • social distancing, including areas where this is more difficult, or not possible;
  • organising the workplace, including the location of desks and the installation of additional features, such as screens and hand-drying facilities;
  • cleaning and sanitising, including what needs cleaning, who will do it and when.

As well as complying with guidance, employers have to make sure their staff are confident in the plans for reopening workplaces. A survey for the Chartered Institute of Personnel and Development in May 2020 showed that almost half (44%) of respondents were concerned about catching COVID-19 at work.

How businesses can prepare for reopening

Every organisation needs to introduce sensible measures to control risks. Therefore, before reopening a workplace, it is vital to conduct a COVID-19 risk assessment, in line with guidance from the Health and Safety Executive.

A risk assessment should:

  • identify what work activity or situations might cause transmission of the virus;
  • think about who could be at risk – paying attention to whether the people doing the work, or those they live with, are especially vulnerable to COVID-19;
  • decide how likely it is that someone could be exposed;
  • act to remove the activity or situation, or if this isn’t possible, control the risk.

During the risk assessment, it’s essential  to consult with workers and afterwards to share the results. Different industries and sectors may require specific measures. On construction sites, for example, access between different areas may need to be restricted, and high traffic areas may have to be regulated to maintain social distancing. The UK government has published guidance covering a range of different types of work in places such as offices, factories, shops and outdoor working environments.

Actions to make the workplace COVID-secure

The UK government and the Scottish, Welsh and Northern Ireland devolved administrations have provided guidance on how to work safely. This gives practical advice on how the guidance can be applied in the workplace.

In planning to reopen their workplaces, every organisation should translate this guidance into the specific actions it needs to take, depending on the nature of their business. At the same time, employers must also ensure that everyone in the workplace continues to be treated equally. Discrimination against anyone because of a protected characteristic, such as age, sex or disability is against the law, and employers also have particular responsibilities concerning disabled workers and new or expectant mothers.

The White Paper contains a checklist of actions which all organisations need to take. These include

  • developing cleaning, handwashing and hygiene procedures;
  • helping people to work from home;
  • maintaining social distancing;
  • managing transmission risk where social distancing is not possible.

CAFM Explorer: an invaluable support tool for getting back to work

Much of the workload involved in ensuring a safe and effective return to work will be taken on by facilities managers. Keeping workplaces clean, managing shift patterns, ensuring availability of personal protective equipment and creating procedures for inbound and outbound goods are just some of the many considerations to be made.

The White Paper highlights the value of the CAFM Explorer software solution to help organisations manage and consolidate information on the vital elements of a COVID-secure workplace, such as one-way systems, desk spacing, cleaning, staggered hours and hand sanitising stations.

Developed by Idox, a trusted supplier of digital software and services, CAFM Explorer can also trigger work orders as a result of an action – for example, ensuring a desk is cleaned once it has been booked – as well as providing processes to support working at home.

Final thoughts

It is too early to say what lasting effects the coronavirus will have on UK society and business, but it’s likely we will all be living in the shadow of COVID-19 for the foreseeable future. It’s essential, therefore, that organisations make themselves aware of the steps necessary for preparing, implementing and managing the Covid-secure workplace.

To receive your free download of the Getting Back to Business White Paper, please visit the CAFM Explorer page or email marketing@idoxgroup.com.

What happened next

When this blog first appeared, in June 2020, lockdown restrictions in the UK were being lifted, and there were signs that more people who had been working remotely were ready to return to their usual places of work. However, in the autumn the emergence of a more infectious strain of the coronavirus – the Delta variant – forced governments to reimpose restrictions. For most of 2021, many people have continued to work from home, although this benefit has not been available to people working in key sectors such as health, public transport and retail.

The development of vaccines to prevent the worst effects of Covid-19 has resulted in governments again relaxing restrictions. Although, the guidance on returning to work from the administrations in England, Wales, Scotland and Northern Ireland may differ, the increasing numbers of people who are double-vaccinated indicates that by the end of 2021 more people will have returned to their usual place of work, at least for some of the working week.

While some employers are urging their staff to return to the workplace, others are stressing that no pressure is being put on their workers to go back to the office right away. In the United States, some employers may be planning to cut the pay of those who continue to work from home, while others are trying to lure their workers back with incentives. At the same time, as the UK government’s furlough scheme comes to an end, many employers must consider whether they can continue to employ their workers, or make them redundant.

It’s now clear that the Covid-19 virus will be part of our lives in the long term. What’s not yet clear is how we can learn to live and work with it. So, the guidance on returning to the workplace that was highlighted in our original blog post and our White Paper still stands. And the CAFM Explorer solution remains an important tool in ensuring that, when the time is right, people can return to their workplaces safe in the knowledge that they are Covid-secure.


Further reading: articles on employment and the workplace from
The Knowledge Exchange blog

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The Knowledge Exchange remains open for business and continues to provide current awareness and enquiries services to our clients. If you have any questions, please get in touch.

How have health librarians been responding to the Covid-19 pandemic?

The impact of the coronavirus pandemic over the past 18 months has highlighted the vital role of information and knowledge services in supporting health and social care, public health, and medicine.

Last month’s Annual CILIPS Conference included a presentation about #HealthLibrariansAddValue – a joint advocacy campaign between CILIPS and NHS Education for Scotland (NES) which aims to showcase the skills of health librarians and demonstrate the crucial role of health libraries.

Library and knowledge services in the health sector have faced increased pressures and a multitude of challenges throughout the pandemic as they have continued to develop and deliver vital services and resources to colleagues under unprecedented restrictions and changed working practices. With the demand for trustworthy and reliable health information higher than ever, it is clear that well-resourced, coordinated and accessible knowledge services are essential.

Supporting the frontline

Throughout the pandemic, the work of health librarians has been vital in supporting frontline workers including doctors, nurses, pharmacists, and social workers. Hospital library services have been directly involved in medical decision-making, providing evidence and resources to support patient care and the training of medical staff. As the information needs of the medical workforce have changed through the course of the pandemic, health libraries have had to be fast and flexible to provide time sensitive and urgent information to those on the frontline.

A project undertaken by the NHS Borders Library Service saw the creation of a new outreach service for local GPs, which involved the delivery of targeted current awareness bulletins, resource lists, and Covid-19 research updates, all of which directly informed the provision of primary patient care and helped to keep GPs up to date on emerging knowledge about the coronavirus.

Health Education England’s (HEE) Library and Knowledge team adapted their services to meet changing workplace needs, ensuring 24/7 access to digital knowledge resources, gathering evidence on how to keep staff safe while working, and developing training programmes to support virtual working practices for healthcare staff.

Supporting decision-making across sectors

Health librarians have played a major role in informing the UK’s pandemic response at a national level, aiding public health decision-making and facilitating partnership working across sectors.

Librarians from Public Health Scotland’s (PHS) knowledge services have worked closely with PHS colleagues to coordinate Scotland’s response to the pandemic. Their work included the creation of daily Covid-19 updates for PHS’ guidance teams, distributing the latest and most relevant research on key topics, and adapting these updates in line with PHS’ changing priorities (for example as their focus shifted from virus transmission to vaccine efficacy). Librarians at PHS have also been involved in creating evidence summaries to support specific Covid-19 research projects, such as an investigation into the relationship between Covid-19 and vitamin D. The evidence gathered by knowledge services helped PHS to formulate their response on the issue and make national recommendations relating to vitamin D intake.

On 12 July 2021, PHS launched their Covid-19 research repository, which is managed and maintained by the library team and collects, preserves, and provides access to Scottish Covid-19 research. This project aims to support policymakers, researchers, and the public by bringing together Scotland’s Covid-19 research in one place and making it easily accessible for all who need it. It is also aimed at reducing duplication of effort, which health librarians had recognised as a concern during the pandemic.

Similarly, Public Health England (PHE)’s library aimed to tackle the duplication of effort across England by creating their ‘Finding the evidence: Coronavirus’ page which gathers emerging key research and evidence related to Covid-19 and makes it accessible in one place. Many resources on the site are freely available and include a wide range of resources including training materials, and search and fact checking guidance.

Health libraries have also been informing decision-making across the social care and third sectors, with NES librarians facilitating digital access to research and evidence via the Knowledge Network and Social Services Knowledge Scotland (SSKS), and providing training and webinars to help users make the most of such services. NES librarians have been involved in partnership working with organisations such as the Care Inspectorate, SCVO, and Alliance.

Keeping the public informed

A key challenge for health librarians during the pandemic has been in dealing with the information overload and spread of harmful misinformation around Covid-19.

Library and information professionals have had a key role to play in providing trustworthy information to patients and the public, helping people to make informed choices about their health and wellbeing. As previously mentioned, librarians have helped agencies like PHS to deliver clear, meaningful, and authoritative guidance to the public, as well as making up-to-date and reliable Covid-19 research centralised and widely accessible to the public.

The World Health Organization (WHO) emphasises the importance of health literacy in enabling  populations to “play an active role in improving their own health, engage successfully with community action for health, and push governments to meet their responsibilities in addressing health and health equity”. Health librarians have been at the forefront of efforts to promote and improve health literacy during the pandemic.

NES’ knowledge services have been delivering training and webinars to health and social care staff on how to improve people’s health literacy, and health librarians working with HEE have created targeted Covid-19 resources for specific groups such as older people and children and young people.

Final thoughts

Clearly, the work of health librarians has been crucial to the UK’s pandemic response and recovery so far, and advocacy campaigns like #HealthLibrariansAddValue are central to highlighting this important work and demonstrating its impact.

Looking forward, it is clear that innovative and high-quality knowledge services will be essential in a post-pandemic world as they continue to aid recovery, promote health literacy and support the health and social care workforce. As set out in HEE’s Knowledge for Healthcare framework, investment is required at a national and local level to build expertise and support the digital knowledge infrastructure which will be required.


Further reading: more on health from The Knowledge Exchange blog

Supporting our communities when they needed it most: how the VCSE sector has navigated the coronavirus pandemic

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Throughout the course of the pandemic many people have been reliant on the voluntary and community sector to provide support. With local authorities stretched, services in higher demand than ever and individuals making use of support in greater numbers than ever before, the voluntary, community and social enterprise (VCSE) sector has been a lifeline for many.

However, the sector is not immune from the pressures caused by the pandemic. They themselves have been stretched with demand for services increasing, and with income streams having beeen limited many are now facing significant challenges to survival. 

The same storm but different boats 

The VCSE sector is a varied and vibrant sector, often providing bespoke and specialist support to people in greatest need. Diverse, specialised and adaptable, the sector was quick to respond and able to offer support at the outset of the pandemic. But the sector has also been shown to be vulnerable in the face of tightening finances, reduced volunteer availability and increased demand for services. 

Research carried out by NCVO in March 2021 reported that charities and the voluntary sector have had vastly different experiences during the coronavirus pandemic, with the impact of the pandemic being reported across the sector as “uneven and unpredictable”. The research showed that while some organisations have expanded their service offer, others have seen their income shrink drastically, or have found delivering services increasingly difficult due to the restrictions being imposed during the national lockdowns. 

Key findings from the research include: 

  • Nearly half (46%) of those surveyed reported demand on their services increasing, versus just 19% seeing a slowdown. 
  • 35% say their costs have increased in the past year, while for 34% they have decreased. 
  • 46% of organisations have had to use their cash reserves to cope with the impact of covid-19 on their organisations. 
  • 44% of respondents say they could rely on their cash reserves for more than six months, while 9% either have no cash reserves or not enough to last them a month. 

A report by Equally Yours, commissioned by the Funders for Race Equality Alliance in April 2021 highlighted the challenges facing the Black and Minority Ethnic voluntary and community sector. This sector has historically experienced specific challenges (such as a high number of organisations being eligible to apply for only a small number of available funds). The research suggests that the pandemic has exacerbated their financial pressures, but also highlighted other challenges, such as regional inequalities in the availability of funding and support, the precarious position of many smaller charities and voluntary organisations who have not been able to access government support, and the challenges of short-term funding, which makes it difficult to create long term plans.

These sentiments were echoed in a separate report from researchers at Centre for Regional Economic and Social Research (CRESR) which looked at the value of smaller charities in responding to the crisis.

A new-found appreciation for the sector 

The voluntary sector made up a key part of the UK’s economy before the pandemic, not only as businesses and specialists within their fields, but also as part of the wider fabric of the communities in which they operate. Many within the sector would probably argue that they were not valued enough. Their expertise, flexibility and resilience in the face of challenging funding environments, have characterised the sector long before the pandemic.

During the pandemic, collaboration has been essential. In many areas the VCSE sector have been part of the vanguard of support for the most vulnerable in society, helping to organise local responses to the pandemic and fostering community resilience in the process. 

Research published in People, Place and Policy  in November 2020 observes that, at the local level, the pandemic has led to a strengthening of pre-existing ‘complementary’ relationships between the VCSE sector and local authorities, with voluntary organisations finding themselves further embedded in local systems of decision making, co-ordination and service provision. The research suggests that there is a newly visible and increasingly ‘complementary’ local role for previously ‘supplementary’ voluntary and charity-based organisations, responding to the needs of vulnerable members of the community.

Supporting the sector to move forward

Grantfinder is the UK’s leading provider of funding information for the VCSE sector in the UK. During 2020 we provided information on emergency Covid-related funding on our website and also offered all local authorities in the UK a free portal to signpost funding support to small businesses in their communities.

As the country starts focusing on recovery, we have recently launched a new funding portal that helps charities and community groups to find funding. My Funding Central is a simple to use tool, which provides users with regular news updates and tailored funding alerts. Annual subscriptions start at £50 and are free for small organisations, offering an affordable way of searching for available funding and connecting to potential funders. Over 1500 charities are already signed up and benefiting from being signposted to funding they may not have been aware of.

The impact of the voluntary sector is threaded through the wider fabric of our communities. As we come to terms with the social and economic trauma of the pandemic, these organisations will have a significant role to play. Ensuring that the sector is suitably valued and resourced will enable it to play as full a role as possible and help communities on the road to recovery. 


GrantFinder and the Knowledge Exchange are part of Idox Funding and Information Services.

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Levelling up: can charities get a piece of the action?

Horizon Europe goes live

Horizon Europe goes live

Horizon Europe is finally a reality. After months of false starts, soft launches and stalled negotiations, 22 June saw hundreds of funding calls published on the European Commission Funding and Tenders Portal. Researchers, institutions and other organisations can now access the seven-year, €95.5 billion research and innovation programme.

Horizon Europe is the ninth European Research and Innovation Framework programme (2021-2027). In the wake of the COVID-19 pandemic, it is one of the key instruments of the European Union’s efforts to steer and accelerate Europe’s recovery, preparedness and resilience.

The initial work programme covers the period 2021-2022 and consists of €14.7 billion in funding, which will be allocated based on competitive calls for proposals.

Around €5.8 billion in total will be invested in research and innovation to complement the European Green Deal and the EU’s commitment to become the world’s first climate-neutral continent by 2050. Supporting the EU’s goal of making the 2020s ‘Europe’s Digital Decade’, core digital technologies will receive around €4 billion over 2021-2022. Finally, direct investments of around €1.9 billion will be made towards helping repair the immediate economic and social damage brought about by the COVID-19 pandemic.

Mariya Gabriel, Commissioner for Innovation, Research, Culture, Education and Youth, said:

“With 40% of its budget devoted to making Europe more sustainable, this Horizon Europe work programme will make Europe greener and fitter for the digital transformation. Horizon Europe is now fully open for business: I would like to encourage researchers and innovators from all over the EU to apply and find solutions to improve our daily lives.”

Associated Countries: UK in, Switzerland out

Although the European Commission has yet to secure final agreements with non-EU countries on participation in Horizon Europe, a 17 June document revealed a list of 18 countries where association negotiations are ‘being processed or where association is imminent’.

The 18 provisionally associated countries are: Albania; Armenia; Bosnia and Herzegovina; Faroe Islands; Georgia; Iceland; Israel; Kosovo; Moldova; Montenegro; Morocco; North Macedonia; Norway; Serbia; Tunisia; Turkey; Ukraine; and the United Kingdom.

Most notably, while the UK is in, Switzerland has been excluded. Reports cite Swiss government officials as saying the European Commission did not give any notification of its intention to exclude the country from provisional access to Horizon Europe.

Writing on Twitter, Senior Policy Officer at the League of European Research Universities (LERU) Laura Keustermans described the move as not only bad news for Switzerland ‘but also very bad news for everybody involved in EU Research and Innovation’. LERU President Kurt Deketelaere also responded, urging the Swiss Government to work to gain access for the Swiss research and education sector, ‘which benefited greatly from association to EU programs in the past’.

UK Research and Innovation (UKRI) is urging researchers to start applying for Horizon Europe funding, with UK researchers and companies eligible for all Horizon Europe calls, apart from applying for equity funding from the European Innovation Council (EIC). The UK will also have to reach agreement with the Commission on rules for participating in sensitive projects in quantum and space technologies.

Free events mark programme launch

To mark the official opening of Horizon Europe, the European Commission arranged two free-to-air conferences for all citizens and stakeholders.

The European Research and Innovation Days, the Commission’s annual flagship Research and Innovation event, was held on 23-24 June. Policymakers, researchers, innovators, and other stakeholders took part in over 70 sessions and workshops to discuss the future European research and innovation landscape. Sessions included ‘tips and tricks’ for writing Horizon Europe proposals; an overview of the Commission’s Funding & Tenders Portal; discussions over lessons learnt from the COVID-19 pandemic; and an overview of the Africa Initiative in Horizon Europe. Recorded sessions from the event can be accessed via the event platform.

Running from 28 June to 9 July, the Horizon Europe Info Days will provide an in-depth overview of some of the main funding channels provided under Horizon Europe. The sessions will specifically focus on the six Clusters under Pillar II – Global Challenges and European Industrial Competitiveness, ­as well as the Marie Skłodowska-Curie Actions, Research Infrastructures, and Widening Participation and Strengthening the ERA (European Research Area) strands of Horizon Europe. With the exception of the Cluster 3 – Civil Security for Society session on 30 June, the event is open for participation without prior registration, and attendees will have the opportunity to ask questions, find out what is new in Horizon Europe and obtain further details about how the programme will operate. Interested parties can access the event’s online portal here.


ResearchConnect: the essential source of research funding information

This post was written by our colleagues in ResearchConnect, a specialist research funding database built for and designed by the international research community.

ResearchConnect’s up-to-the-minute database covers all of the key research disciplines and is updated by an expert team who monitor and report on a wide range of funding sources including charitable trusts, government, research councils, foundations and corporate sponsors. The ResearchConnect team maintains regular contact with funding administrators and policy managers across a wide range of sources, providing advance notice of new funding opportunities and policy changes.

For more information, visit the ResearchConnect website.

Keeping our finger on the pulse: recent additions to our collection across health

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The health and care landscape has been changed in unprecedented ways over the past year. The coronavirus pandemic has not only highlighted strains within the system and required a response to a public health emergency unlike anything else that has been seen for decades, it has also provided an opportunity to push innovation in areas like digital infrastructure and partnership working, and encouraged decision makers to look at public health as an essential part of policy making in all areas.

The Knowledge Exchange database is full of reports, articles and documents which offer insight into these themes, published by organisations from across the heath and social care landscape. In this blog post, we’re highlighting some recent additions to our collection and some of the big themes being discussed within the sector.

Covid-19, “building back better” and a “health in all policies” approach

In March 2021 think tank IPPR published their report State of health and care: the NHS Long Term Plan after Covid-19. The recommendations form a £12 billion blueprint to ‘build back better’ in health and care and the report calls for an adaptation of the NHS Long Term Plan published in 2019 focusing on cancer, mental health, cardiovascular disease and multimorbidity. The authors believe the Long Term Plan needs to change to ‘build back better’ health and care post-pandemic, in relation to: ensuring a sustainable workforce; resourcing the NHS to deliver transformation; empowering integration; upgrading the digital NHS; funding and reforming social care; and levelling up the nation’s health.

Another report, from the Local Government Association (LGA), published in September 2020, provides specific guidance to local authority councillors on ways to improve the approach to population health and use of public health resources in dealing with the pandemic, highlighting the Health in All Policies (HiAP) approach to addressing health inequalities and improving wellbeing. There are a number of other resources which look at public health approaches to tackling other areas of policy such as youth violence and urban regeneration.

Build back fairer: the Covid-19 Marmot Review: the pandemic, socioeconomic and health inequalities in England, published by the Health Foundation and the Institute of Health Equity examines inequalities in coronavirus mortality, looks at the effects that the pandemic, and the societal response, have had on social and economic inequalities, the effects on mental and physical health, and the likely effects on health inequalities in the future. The report assesses the inequalities in the risk of COVID-19 and mortality and explores the impact of containment on inequalities in the social determinants of health, in terms of: early life; education; children and young people; employment and working conditions; a healthy standard of living; healthy and sustainable places and communities; and healthy behaviours.

Mental health

Mental health services have been under significant pressure in the UK for a number of years now, with children’s services (CAMHS) particularly stretched as the number of specialist practitioners is limited. The coronavirus pandemic has, according to many specialists, exacerbated existing pressures and placed even more demand on services. In April 2021 the All-Party Parliamentary Group on a Fit and Healthy Childhood published a report: The COVID generation: a mental health pandemic in the making – the impact on the mental health of children and young people during and after the COVID-19 pandemic  which explores a range of themes in relation to the impact of the pandemic on the mental health of children and young people. The report presents evidence from a range of sources on the potential implications of the pandemic on young people’s mental health and discusses the impact of school closures on children’s future health and well-being.

The Children’s Commissioner for England recently published a report  which looks at the progress made in improving children’s mental health services in England, and  the impact of the pandemic on the mental health of children. The report also examines the provision and accessibility of children’s mental health services in 2019/20, finding that access is still not adequate and not improving as quickly as expected.          

The other pandemic: the impact of Covid-19 on Britain’s mental health  explores how the mental health of people in the UK has been affected by the pandemic, drawing on a survey of over 4000 people. It describes the different experiences of groups across society and the highlights the disproportionate mental health impact on people who are exposed to higher levels of social deprivation, as well as on women, younger people and those who live alone.

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Structural reform

In August 2020 the Health Devolution Commission launched its final report, Building back health and prosperity. Among other themes, such as taking a “health in all policies approach”, the report found that devolving accountability and power to a more local level creates the potential to understand communities and places better, and to meet their needs.

One of the main focuses of the health and social care white paper published in February 2021 is around developing an integrated health and social care system and taking a ‘population health’ preventative approach to healthcare, while a report from the NHS confederation recommends a reformation of the framework for elective care and increased healthcare funding.

Digital transformation

Even before the pandemic, The King’s Fund was publishing widely on digital transformation. But their recent report Understanding factors that enabled digital service change in general practice during the Covid-19 pandemic  looks specifically at the impact of the pandemic on accelerating the transformation of the delivery of some services by GPs to focus more on digital delivery and whether this change can (or should) be sustained once the pandemic is over. It explores the challenges around trust, staff and patient digital literacy and the evaluation of digital tools in practice. Parliamentary Office of Science and Technology (POST) published their own review of AI and healthcare , providing an overview of AI in the healthcare system and its potential impacts on the cost and quality of healthcare, and on the workforce.

Final thoughts

The landscape of health and care is changing. The Covid-19 pandemic has placed unprecedented demands on a system which was already facing significant challenges. While in some instances this has led to innovation and accelerated the pace of change, it has also exposed some of the significant weaknesses of the system.

This blog highlights some of the big topics the sector is currently grappling with, but there is more available for TKE members on our database. Members can also sign up to receive our health Topic Update, which will provide fortnightly email updates of items recently added to the collection in health, easily allowing you to stay up to date.

If your organisation is not a member of the Knowledge Exchange and you would like more information, please contact us.


If you liked this article you may also be interested in reading:

A nudge in the right direction? Using behavioural insights in health

Virtual reality: a game changer for mental health treatment?

Devolving health and social care in England: an opportunity to transform how we approach health and care?

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

Living and working in an ‘age of ambiguity’

The pandemic is having a wide ranging impact on all aspects of people’s lives. From the massive shift to home working for many to the furlough scheme for others, employees have experienced a fundamental shift in the way they work and live.

According to a recent survey of workers, employee happiness has declined and there has been an increase in presenteeism during the pandemic, as the boundaries between home and work, which were once certain, have become blurred.

Blurred lines and a culture of presenteeism

The survey by Aviva, polled 2,000 employees in February 2020 and again in August 2020, finding that most people were happier before the pandemic and that a culture of presenteeism had emerged. Key findings included:

  • More than half (52%) agree the boundaries between their work and home life are becoming increasingly blurred – up from 40% in February.
  • The number of employees who are completely happy almost halved: 20% in February vs. 13% in August.
  • 43% of employees ranked their mental health between ‘very bad’ and ‘fair’, compared with 38% in February.
  • 84% say that they would carry on working even if they felt unwell.

A significant trend of presenteeism and the ‘always on’ culture was highlighted by the survey. The increased uncertainty and heightened anxiety has led to many employees working longer hours and taking fewer sick days. In February 2020, 67% of employees took zero sick days over a three month period; this increased to 84% in August.

Employees may feel the need to prove their productivity while working from home, particularly if they feel their jobs are at risk. But such e-presenteeism is likely to have a negative impact on productivity and inevitably mental wellbeing. According to the report “the ambiguity experienced is compounding behaviour that is detrimental to long-term employee wellbeing.”

Young people (18-25) were found to be particularly affected, with 53% reporting feeling anxious compared to the national average of 34% and 17% ranking their mental health as bad compared to an average of 11% across all age groups.

There have been changes in employee self-determination across the board and the main priorities for employees have shifted as they are increasingly looking for a greater work-life balance over salary – a trend which has increased since the pandemic struck.

Employer considerations

Most employers have implemented new ways of supporting employees, which has been welcomed, but the survey highlights that more needs to be done. Despite a majority of employees believing employers have made some effort to adapt, there is still a loss of motivation among employees. Just 15% of employees agree that their employer is trying really hard to understand what motivates them and only a quarter (26%) agree their employer is genuinely concerned about their wellbeing.

With research confirming a conclusive link between wellbeing and productivity – employees are 13% more productive when happy – no organisation can afford to ignore the issue of employee wellbeing.

Indeed, employee wellbeing was already rising up the corporate agenda pre-Covid-19 but the pandemic has propelled it further into focus for many organisations.

It is argued that a new partnership is required between employees and employers. Personal control surpasses employer control when it comes to what employees want and there is clear evidence that more tailored support, rather than a one size fits all approach, is required.

Aviva’s report argues that “now more than ever there is a case for employers to embrace the ‘Age of Ambiguity’ to support their workforce with their mental health, physical and financial wellbeing.” To this end, Aviva recommends five ‘employer considerations’:

  • Understand how they can deliver on emerging flexibility needs.
  • Personalise mental health and wellbeing support.
  • Create sense of purpose, clarity and autonomy in the workplace.
  • Prepare workers for fuller working lives and the transition from work to retirement.
  • Create more targeted interventions by understanding personality types.

Towards a happier future

As all personality types were found to desire flexibility, it is suggested that prioritising employee wellbeing as a ‘need to have’ rather than a ‘nice to have’ and incorporating flexibility into working life could be a way forward for businesses when it comes to recruiting and retaining the best workers.

The ‘age of ambiguity’ could be the perfect opportunity for businesses to make the necessary changes to support their employees, helping them to improve their physical, mental and financial wellbeing – for mutual benefit.

The pandemic has thrust the world of work into a period of intense change and uncertainty, but many of the trends were already underway, particularly the shift in employee outlook. Employees’ desire for flexibility continues to grow as they seek a better work-life balance and there is no sign of this abating. The Aviva survey has shone a spotlight on this trend and suggests that “employers who embrace their employees’ desire for long term flexibility will see the benefit of a healthier and happier workforce” – leading to a happier future for all.


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Britain’s town centres: down, but not out

Image: Mayfield development, Manchester (U+I plc)

Town centres have taken a battering in the past year, with many shops and services forced to close during lockdowns and growing numbers of stores going out of business.

But even before Covid-19, UK high streets were already under pressure. Economic recessions, rising business rates, higher rents, the growth of online shopping and development out-of-town retail parks have left Britain’s town centres struggling to survive.

Last month, Planning magazine brought together a panel of experts to discuss the future of town centres. Among the issues considered were trends affecting town centres, how demand for town centre property is changing post-pandemic and how developers are responding to changes in market demand and planning laws.

The bigger picture: online shopping and working from home

Jennet Siebrits, head of CBRE UK’s research team, gave a helpful overview of two key trends affecting town centres.

In the past decade, e-commerce has seen a dramatic increase in activity. Since 2011, the value of online shopping has mushroomed from £23 billion to £58 billion –a 158% increase. But in 2020, even that figure was eclipsed, with the value of e-commerce rising to £84 billion – a 44% increase in just one year. The evidence from the first national lockdown suggests that this step change is here to stay.

The impact of this, along with the Covid-19 restrictions, has been grim for town centre stores. Over 11,000 shops closed in 2020, and while not all of those closures were due to online shopping, it’s clear that e-commerce has been a real driver of this.

Jennet suggested that, as the restrictions ease, it’s likely that supermarkets, along with in-store health and beauty and DIY stores will continue to attract customers. But other sectors will have to come up with innovative ways to lure consumers off their iPads.

Jennet also highlighted the increased move towards home working. Once people return to their workplaces, it’s likely that many will ask to continue working from home, at least for part of the working week.

The rise in home working may also affect demand for residential property, with more people moving further away from city centres. This could have a knock-on effect for ancillary services like coffee kiosks and sandwich bars, with local town centres capitalising on the losses experienced by city centres.

The legal perspective: changes to planning laws

David Mathias, a specialist planning solicitor at Shoosmiths law firm described some recent planning law changes that have particular relevance to town centres.

Since the demise of Woolworths in 2008, more and more UK department stores have been closing down, leaving big gaps on the high street. In future, it’s likely that many property developers will want to convert from retail to residential.

Until recently, permitted development rights for conversion to residential only applied in a limited set of commercial uses. But the UK government has announced new permitted development rights in England enabling greater flexibility on conversions without the need for planning permission. These will go ahead in August, subject to certain conditions.

In addition, further legislation on expansion of permitted development rights introduced last summer allows the construction of an additional storey on freestanding blocks and buildings on a terrace to create additional housing, and the demolition of buildings built before 1990 and construction of new dwellings in their place.

The government has argued that these changes will help to revive town centres, although others believe easing planning rules for developers will have the opposite effect. 

The developer’s perspective: re-imagining Manchester

Martyn Evans from the U+I Group offered his view of how developers are responding to changes in market demand and planning. He did so using U+I’s development at Mayfield in Manchester.

Located next to Piccadilly railway station, in the centre of the city, this 24 acre-site is being redeveloped from derelict railway land. A consortium of Manchester City Council, Transport for Greater Manchester and London & Continental Railways (LCR), along with U+I, has been working to regenerate the area, with the first buildings due for completion next year.

Right from the start, the consortium focused on the importance of creating a place where people want to live, work, rest and relax. One important feature of the development is a seven-acre park. Although it was planned into the scheme years ago, this green space has become all the more significant in the past year.

Image: Mayfield development, Manchester (U+I plc)

The pandemic has demonstrated the importance of green space as a vital part of city living, both for physical health and mental wellbeing. Such spaces not only attract workers, residents and visitors, they also increase the value of developments. And because decisions about commercial property are increasingly being taken by HR teams rather than finance departments, the wellbeing benefits of workers’ surroundings are being taken more seriously. In short, understanding quality of place gives developers more of a competitive edge. 

The local authority perspective: managing change

To conclude, Michael Kiely from the Planning Officers Society looked at what local planning authorities can do to help sustain town centres.

Michael described some of the planning tools local authorities can use, including strategic planning, masterplanning and local plans. But with recent changes in planning laws, including the use classes order, Michael argued that policies such as Town Centre First may be ineffective.

However, local authorities can still make a difference, through partnerships with other stakeholders, such as land owners and Business Improvement Districts (BIDS), and the use of intervention and compulsory purchase powers.

In closing, Michael suggested the need for a licensing or permitting regime to manage and curate activities so that they do not cause harm and town centres can thrive.

Future perspectives: rethinking town centres

A £150m project to revamp London’s Oxford Street signals that high streets are already re-imagining themselves as leisure-focused and “experiential shopping” centres. And the Mayfield site in Manchester has the potential to transform a part of the city centre that has been underused for decades.

These are just two examples of the planning community working together to help sustain town centres. Britain’s high streets face substantial challenges, but this interesting discussion suggested there are good reasons to optimistic about the future.

A recording of The Future of Our Town Centres discussion is available to watch on-demand at the Planning magazine website.


Further reading: more on town centres from The Knowledge Exchange blog

Glasgow Green photo essay: a park for all seasons

For generations, urban public parks have been places for communities to meet, to connect with nature and to enjoy recreational activities. Parks have multiple benefits for biodiversity, human health and the environment. They can help with flood prevention and during the summer can help control temperatures and humidity.

One of the oldest public parks in the UK is Glasgow Green, a short walk from the centre of Scotland’s biggest city. In 1450, the Bishop of Glasgow gifted the common lands of Glasgow Green to the people, and for centuries it was the city’s only green public space. The park has witnessed some important moments in the city’s history, including demonstrations, sporting and cultural events.

During the early years of the industrial revolution, the park became an oasis for residents from unhealthy housing and working conditions. Similarly, in our own times, Glasgow Green has been an important refuge during the restrictions imposed as a result of the coronavirus pandemic.

Today, Glasgow Green remains open 24 hours a day, with its 136 acres of lawns, flowerbeds, fountains and architectural monuments maintained by workers from Glasgow City Council’s Parks Department. This photo essay reflects on some of the sights and stories associated with Glasgow’s oldest public park.

Flora, fauna and the Glasgow Green geese

Glasgow Green is home to a variety of plants, flowers and trees, as well as a wide range of wildlife species, including birds, butterflies and red foxes. One of the more unexpected sights in the park is a flock of geese.

For more than 50 years, geese were deployed to guard the stocks of Ballantines whisky maturing in Dunbartonshire warehouses. Geese are famously territorial, and act as a vocal alarm against intruders. With the advent of CCTV in the 1990s, the “Ballantines Bodyguards” were retired to Glasgow Green, and placed in the care of the Glasgow Humane Society. Coincidentally, their new home looks onto a grain distillery, perhaps serving as a reminder of their past life.

A gathering place for sport and culture

In all weathers, Glasgow Green attracts walkers, cyclists and joggers, as well as offering open spaces for team sports. Rowers from both Glasgow and Strathclyde University boat clubs train on the River Clyde beside Glasgow Green.  The park also has strong historical sporting connections. Golf was played here as early as the 16th century, and Glasgow’s two famous football teams – Celtic and Rangers – were both established on Glasgow Green. In 2014, the Glasgow Green Hockey Centre was opened in time to host matches for the Commonwealth Games.

Glasgow Green has also played host to some of the biggest names in music, from Radiohead and Iggy Pop to Coldplay and Lewis Capaldi. In 1990, the park hosted a summer concert celebrating Glasgow’s year as European City of Culture, headlined by local heroes Deacon Blue. In the summer months, Glasgow Green also hosts the World Pipe Band Championships and Proms in the Park.  

Glasgow’s Arc de Triomphe

The McLennan Arch started life in 1796 as part of Robert and James Adams’ Assembly Rooms in the city centre. When these buildings were demolished, the arch was reconstructed at the northern edge of Glasgow Green. Since then it has been moved three more times, reaching its final resting place in 1991, a gateway to Glasgow Green’s western perimeter.

History matters: demonstrations, rallies and the birthplace of the industrial revolution

Glasgow Green has always been a focal point for popular demonstrations. In the 19th century, trade unionists and Chartists gathered in the park to campaign for workers’ civil rights. During the 1930s, at the height of the Spanish Civil War, thousands gathered in Glasgow Green to support the Spanish Republic against General Franco and his fascist allies. More recently, the park has seen rallies against war in Iraq and in support of Scottish independence.  

Close to the centre of the park, a statue of James Watt commemorates one of the driving forces of the industrial revolution. It’s believed that Watt came up with the idea for fixing the inefficiencies of the steam engine while taking a stroll on Glasgow Green. The moment of inspiration was the vital spark that would revolutionise Britain’s mining, iron, transport and manufacturing industries.

In the summer of 2020, a Black Lives Matter demonstration took place on Glasgow Green, and a notice was placed on the James Watt statue highlighting his role in the trafficking of enslaved people. History is being reassessed in Glasgow, a city that richly benefitted from the proceeds of the Virginia tobacco plantations and the slave trade.

A river runs through it

The River Clyde flows alongside Glasgow Green. In recent years, environmental protection regulations have cleaned up the river, and there are plans to make the Clyde a focal point of economic regeneration. However, the legacy of Glasgow’s industrial past continues to affect the river. A 2019 report by the Clyde Gateway regeneration agency revealed that toxic waste from a former chemicals factory was leaking into the river, posing risks to human health and the environment. Clyde Gateway and Glasgow City Council have been taking remedial action until a permanent solution can be found.

From carpets to cocktails

One of the most impressive architectural features of Glasgow Green is the Templeton Building. It was opened in 1892, and designed by William Leiper who modelled the building on the Doge’s Palace in Venice. The façade of the building reflects the exotic designs of the carpets that were made there for almost 100 years. The building has also been touched by tragedy. During construction, a gust of wind brought one of the walls down on a shed, where a large number of young women were weaving carpets. 29 of them died in the east end’s worst peacetime disaster.

Today, the Templeton building contains apartments, offices and a microbrewery. During the summer months of 2020, the bar extended its beer garden to create an open-air restaurant for visitors to meet together when the lockdown restrictions were relaxed.

A clean sheet

Almost from the start of its history in the 15th century, Glasgow Green was used for household washing and drying. The drying green, opposite the Templeton Building, was in regular use until 1977. The women of Glasgow washed their clothes in the nearby wash-houses (or “steamies”) and then chatted together while their weekly wash dried in the open air. Today, while the iron poles have been retained, they are rarely used for drying clothes.

On International Women’s Day in 2019, the drying green enjoyed a comeback when 30 bed sheets were hung to celebrate the work of women past and present. Local businesses sponsored each of the sheets, women gathered to celebrate their mothers and grandmothers, and the proceeds from the day went to charity.

The never-ending story

Glasgow Green is unique, but like so many other public parks around the UK, it is an important community resource, a gathering place and a link between the past and the present.

A study by the Social Market Foundation reported on research that estimated the wellbeing value of UK parks and green spaces at £32.4bn. A further 2020 report by NESTA highlighted the threat to parks as a result of budget cutbacks imposed on local authorities, noting that some councils have reduced spending on parks by as much as 87%.

But during the pandemic, the value of parks has suddenly become clearer, as individuals, families and communities have rediscovered the benefits of spending time in green open spaces. As visitor numbers have soared, councils have acknowledged the importance of parks. In March 2021, Liverpool City Council became the first UK local authority to legally protect the future of its parks and green spaces. As the council’s acting mayor observed:

“…the benefits aren’t just health related. Access to green spaces improves our neighbourhoods, tackles climate change, supports education and economic growth and they frequently become the stage on which we host many of our hugely popular cultural celebrations.”

That’s certainly true of Glasgow Green. More than 500 years after its establishment, the park continues to generate joy and jobs, stories and memories. Glasgow Green truly is a park for all seasons.


Further reading: more on parks from The Knowledge Exchange blog:

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