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

Shining a spotlight on Evaluations Online: Scotland’s essential economic development resource

Image: Marcus Winkler (via Unsplash CC)

The UK is currently at the beginning of what is expected to be the deepest recession in living memory. From a policy point of view, governments around the world are facing the daunting task of navigating a route through uncharted territory. As the recently launched cross-institutional Economics Observatory noted last month, “sound and non-partisan advice is needed to inform decision-makers across all parts of society, about the choices they face in dealing with the crisis and the recovery”.

Key role of economic development and sustainability in the Covid-19 recovery

As statistical analysis suggests that Scotland’s GDP fell 18.9% during the month of April, and that in May output remains 22.1% below the level in February, the need for a recovery approach that is based on empowering regions, cities and local communities is clear.

The independent Advisory Group established by the Scottish Government to advise on Scotland’s economic recovery in the wake of the COVID-19 pandemic, published its report at the end of June. This identified interventions to support Scotland’s economic recovery within the context of the strategic goal of shifting to a greener, fairer and more inclusive economy with wellbeing at its heart.

New economic development initiatives and programmes in response to the pandemic have already been launched in Scotland. Some are focusing on helping specific sectors such as tourism and the creative industries. There is also a recognition that it is important during the recovery to build on current strengths, such as inward investment and low-carbon technologies.

What works in economic development

Here at the Knowledge Exchange, we’re committed to supporting the use of evidence to inform policy development and practice. So in the light of the current importance of economic development, we thought we’d highlight a useful resource which makes available the results of evaluation work and research in order to enhance decision-making and investment in the future.

Evaluations Online is a public portal providing access to a collection of evaluation and economic development research reports commissioned by Scottish Enterprise, Scotland’s main economic development agency.

Ensuring that public investment generates economic and social benefits, and long-term inclusive growth for Scotland is core to Scottish Enterprise’s remit. Making evaluation and research reports publicly available supports this aim, as well as ensuring transparency.

Established for over a decade, the site now contains over 750 research and evaluation reports dealing with different aspects of economic development activity, such as business support, investment, sector growth and improving skills. All of the reports are publicly accessible and free to access.

Learning lessons from previous programmes

Developing the economic response to Covid-19 is happening at a much faster pace than usual policy-making cycles. It is important, though, that spending and investment is focused on areas that will have most impact, and will also contribute to the overall goals of supporting jobs, protecting and progressing education and skills, and tackling inequality. Considering lessons from previous interventions when commissioning new projects or allocating funding, is one way to address effectiveness.

It’s worth repeating that repositories of evidence can help bring about better policy in a number of ways:

  • improving accountability by making it easier for people to scrutinise the activities and spending of public sector organisations;
  • improving the visibility and therefore the impact of evidence;
  • helping identify gaps in evidence by making it easier to compare research findings; and
  • increasing our understanding of what works (‘good practice’), not only in the activities covered, but also in evaluation and research methods.

Evaluations Online offers resources in key areas such as entrepreneurship, regeneration, social enterprise, economic inclusion, skills development, financing, inward investment and commercialisation, as well as by sector. In recent years, questions about inclusive growth and generating social value have also become more important policy issues.

Some of the most popular recent reports added to the site have focused on:

It’s clear that there are huge sectoral and regional challenges within the economy which will need faced immediately and in the longer term, as a result of Covid-19. Business practices have changed, as have all our lives. But we believe that the use of evidence and research will be fundamental in successful recovery and the transition towards a greener, net-zero and wellbeing economy.


The Knowledge Exchange work with Scottish Enterprise to manage the Evaluations Online portal.

Evaluations Online is a publicly accessible collection of evaluation and research reports from Scottish Enterprise. The reports cover all aspects of Scottish Enterprise’s economic development activities and are available for download at no cost.

What works now: how can we use evidence more effectively in policymaking?

Evidence use in policymaking is nothing new. It has been talked about by policymakers, academics and professionals for the best part of ten years, and has been highlighted a lot, among other places, on this blog. Over the years various government initiatives have been set up to try to establish how best to use evidence and identify “what works” in relation to specific policy interventions, and “evidence-based” policymaking has become the catchphrase of policymakers across most sectors.

One of the newest books to be added to the Idox Information Service library reflects on the rise of “what works” as an approach to policy development. The book builds on discussions from the first edition of the book, and provides a sector-by-sector breakdown of how evidence is – and could be – used in policymaking across areas like health, the environment, education and criminal justice. It also offers some insight into appraising evidence and how to assess quality, as well as how evidence is used internationally, providing examples from the USA, Australia, New Zealand and Scandinavia.

As one of our key aims is to support and facilitate the sharing and use of evidence in the public sector, this book has been a welcome addition to our collection.

Making use of research across policy

In 2013, the UK government launched the What Works Network, which is now made up of 10 independent centres committed to “supporting the creation, supply and use of evidence” in specific policy areas including crime and policing, education and economic growth. The centres aim to improve the way government and other organisations create, share and use (or ‘generate, translate and adopt’) high-quality evidence for decision-making. According to the UK government, the initiative is the first time a government has taken a national approach to prioritising the use of evidence in decision making.

What Works Now? highlights research from Weiss (1979) which suggests that there are “7 types of research use”:

  • Knowledge Driven – research will be developed, applied and used once it has been produced
  • Problem Solving – research will be applied directly to a particular policy problem in order to solve it
  • Interactive – research forms part of a wider web of knowledge, policy and other research which all interact with each other
  • Political – research could (and probably will) be used to retrospectively provide support for a policy decision which has already been made
  • Tactical – research can be used as a tool to delay or deflect from decision making or action around a particular issue (i.e. “more research is needed in this area”)
  • Enlightenment – research informs policy through encouraging people to think and discuss particular ideas or concepts in a different way
  • Embedded research – research production is embedded in a wider contextual system which includes political priorities, the law and the media

Building a research base to support “what works”

Creating and disseminating research effectively have been cited as being key to creating a “what works” evidence base. A number of research institutes and think tanks contribute alongside real-life experiences of practitioners and other stakeholders to try and establish the conditions which support effective interventions and lead to positive policy outcomes.

One of the big discussions currently is around the creation of academic research to support what works programmes. Exploring what sort of research is useful to practitioners and policymakers and aligning this with the research agenda of academics and universities can help to create an effective supply chain of evidence to inform policymaking. However, often academics often do not engage with the policy process, or politicians politicise evidence, picking and choosing which findings to take notice of, which can distort the perception of what evidence is available in a particular area.

Encouraging fuller participation and a more robust appraisal of research from across the board is something which many institutions are trying to work towards. Research impact and knowledge exchange is now integrated into research funding and a growing number of people are working to feed research more effectively into the policy arena.

Evaluating research and evidence and judging which to take forward to inform policy decision making is also important. Along with discussions around assessing and labelling evidence the book considers how some of the main organisations in the UK concerned with promoting evidence-informed policy have gone about appraising evidence, weighing it up, assessing quality and “fitness for purpose” and taking account of non-research based forms of knowledge and evidence, such as the personal experience of practitioners.

Applying “what works” in practice

Applying “what works” in practice can be a challenge, especially in a setting that is perhaps very different from the conditions of a study that has been shown to produce successful outcomes from a particular intervention.

In the book, 10 guiding principles to support the use of evidence in practice are set out:

  • Translated – To be used research must be adapted and reconstructed to fit with local contexts. Simply providing findings is not enough
  • Ownership – Ownership of the research and allowing people to feel a sense of ownership over the development of research
  • Enthusiasts – Individual “champions” can be useful in ensuring that research actually gets used
  • Local context – Local context must be taken into account, particularly in relation to specific barriers and enablers which might help or hinder change
  • Credibility – Credibility of researchers and the people who support the research is key to ensuring that the research is taken seriously
  • Leadership – Strong leadership provides motivation, authority and integrity in the implementation of evidence
  • Support to implement change – Ongoing support to implement change is important, this could include financial, technical, organisational or emotional support
  • Develop Integration – Activities need to be able to be integrated with existing organisational systems and practices, changes do not happen within a bubble
  • Engage key stakeholders – To ensure effective uptake and buy-in key stakeholders should be involved as fully as possible form the earliest possible stage
  • Capture learning/ Effective evaluation – Don’t forget the importance of evaluation, identify what worked and what didn’t to help share learning and support future projects

Final thoughts

In theory, using evidence to inform policy sounds straightforward. The reality can be quite different. What Works Now? highlights that the “what works” agenda remains dominant across the policy landscape, even if the application or approach to it differs from policy area to policy area.

What counts as evidence is still disputed; getting evidence “out there” and encouraging academics to be involved in the policy process is still hard to achieve (although there is good work being done in this area to try and combat this); and context is still key to making evidence work in a particular environment.

Understanding evidence, and how to use it effectively has been a core aim of policymakers in the UK, and across the world for the many years. This book, and the supporting research outlined in it highlights that while evidence is still at the fore of policymaking, actually identifying what works and putting it into practice is a bit more of a challenge.

Members of the Idox Information Service can log into our website to request a loan of “What works Now?”

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A world of evidence … but can we trust that it is any good?

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Closing the race attainment gap: a new report aims to help universities move forward

Image: Universities UK

On the face of it, the UK’s university sector is an international success story. UK universities attract global talent, valuable income and investment, produce world-leading research, generate hundreds of thousands of jobs, and improve people’s everyday lives in countless ways. Britain’s universities are also more racially and culturally diverse than ever before.

But a recent report has shone a spotlight on fundamental barriers to racial equality at UK universities, indicating that a student’s race and ethnicity can significantly affect their degree outcomes. The Universities UK (UUK) / National Union of Students (NUS) report highlights significant gaps in attainment between white students and their black, Asian and minority ethnic (BAME) peers, finding that 81% of white students graduated with first and upper second class honours in 2017/18, compared to just 68% of BAME students. That’s an attainment gap of 13%.

The report echoes findings from the Office for Students (OfS), the independent regulator for higher education in England. Earlier this year, the OfS reported stark gaps in achievement for black students, and also found that higher numbers of BAME students were dropping out of university before completing their courses.

Why are BAME students not doing as well at university compared with their white counterparts?

The UUK/NUS research identified four factors that are contributing to the attainment gap:

  1. Varying degrees of satisfaction among different student groups with the higher education curricula, and with the user-friendliness of learning, teaching and assessment practices.
  2. Relationships between staff and students and among students: a sense of ‘belonging’ emerged as a key determinant of student outcomes.
  3. Recurring differences in how students experience higher education, how they network and how they draw on external support were noted. Students’ financial situations also affect their student experience and their engagement with learning.
  4. The extent to which students feel supported and encouraged in their daily interactions within their institutions and with staff members was found to be a key variable.

 How universities can improve outcomes

As part of its research, UUK and NUS engaged with students, the higher education sector and external organisations to identify the most significant steps needed for success in reducing attainment differentials:

  1. Strong leadership – university leaders and senior managers need to demonstrate a commitment to removing the BAME attainment gap and lead by example.
  2. Having conversations about race and changing the culture – universities and students need more opportunities to have open, meaningful and constructive conversations about race, racism and what is causing the attainment gap.
  3. Developing racially diverse and inclusive environments – A greater focus is needed from across the sector, working with their students, on ensuring that BAME students have a good sense of belonging at their university, and an understanding of how a poor sense of belonging might be contributing to low levels of engagement and progression to postgraduate study.
  4. Assess the existing mix of data and evidence used to understand the causes of the attainment gap – The sector needs to take a more scientific approach to tackling the attainment gap, gathering and scrutinising data in a far more comprehensive way than currently, in order to inform discussions among university leaders, academics, practitioners and students.

The report also provides a checklist to help university senior leaders to move forward with their own strategies. Among the actions on the checklist are:

  • consider whether coaching, development opportunities or programmes are needed to give leaders the confidence to talk about race and take a leading role in opening conversations.
  • consider mechanisms for recognising (and perhaps rewarding) staff and students who press for the removal of racial inequalities.
  • take responsibility for ensuring that appropriate resources are dedicated to removing the attainment gap, including for any appropriate tailored interventions, research and expertise in data analysis.

Learning from what works

Another important recommendation in the report is that universities should share and learn from evidence of what works and what does not. Case studies throughout the report demonstrate that higher education institutions across the country are trying to close the attainment gap:

The University of Manchester and the university’s students’ union have been working in partnership with Manchester Metropolitan University and the University of Birmingham to deliver a Diversity and Inclusion Student Ambassador Programme to tackle the causes of differential outcomes for BAME undergraduate students and those from low socio-economic groups. Key features include creation of safe spaces, where students and staff can engage in open dialogue on inclusive learning and teaching environments, academic support and well-being; and training student ambassadors to safely challenge racism, microaggressions and discrimination.

Intercultural awareness workshops have helped students at Glasgow Caledonian University to develop a better understanding of different cultural norms and values. The programme provides a baseline for first-year students to develop their understanding and recognise the unconscious bias that exists within global academic, social and working environments. It has already won a Student Engagement Award and been shortlisted for an NUS Scotland 2019 diversity award.

The University of Arts London has developed a data dashboard – the academic enhancement model (AEM) – which gives accessible information to course teams about all aspects of the student experience and differentials. The AEM is a cross-university approach to removing attainment differentials, based on agreed data thresholds for attainment and student satisfaction scores. Courses that fall below these thresholds work with AEM leads to create co-designed AEM support packages. The approach has contributed to UAL’s success in tackling attainment issues: in 2018, the university saw a 4.9% reduction in its BAME attainment gap.

Closing the gap, reaping the rewards

The report has united universities and students in highlighting the race attainment gap, understanding the reasons behind it and tackling the problem.

Baroness Amos, director of the School of Oriental and African Studies (SOAS), who co-led the report, said: “Our universities are racially and culturally diverse, compared to many other sectors, but we are failing a generation of students if we don’t act now to reduce the BAME attainment gap. Amatey Doku, NUS vice-president for higher education, added that for far too long universities had presided over significant gaps in attainment between BAME students and white students. “From decolonising the curriculum to more culturally competent support services, many students and students’ unions have been fighting and campaigning for action in this area for years.

Now that the issue has been raised, it’s up to universities to take action so that all students – whatever their background – are given every opportunity to reap the many rewards that higher education can bring.


If you’re interested in developments in higher education, take a look at our recent blog posts on the subject:

The unusual suspects: how to make sure Citizens’ Assemblies are representative

Citizens’ Assemblies have been in the news a lot recently. Among the ideas mooted have been a Citizens’ Assembly to sort Brexit, a Citizens’ Assembly to discuss the potential details of Scottish Independence and a Citizens’ Assembly to decide on steps to tackle climate change.

They have been heralded by some as a new democratic process which will put the public at the heart of policy development and decision making at a local and national level; one of a number of “deliberative democratic tools” to help engage people more in decision-making processes, allowing people to decide not only what outcome they want, but which issues should make up the agenda in the first place. However as experiences so far have shown, the theory and the execution do not always match up.

With some arguing that they are just another opportunity for those who already have a voice to make their voice even louder, advocates of Citizens’ Assemblies and similar projects have their work cut out to ensure they are both representative and effective.

What is a Citizens’ Assembly?

The basic principle of Citizens’ Assemblies is this: collect a representative group of people from a particular area, invite them to a discussion, and allow them to identify and discuss potential policy issues and options based on an initial question. They are then invited to come to an agreed consensus which is then reported to politicians/ government.

The members of a Citizens’ Assembly are typically selected at random from the general public – like a jury – and can, in theory, be any size, but the larger they are the more likely they will be to be representative of the electorate. The aim is to secure a group of people who are broadly representative of the electorate across different characteristics such as their gender, ethnicity, social class and the area where they live. Depending on the topic they will be discussing, information about party political affiliation or voting in referendums may also be taken into account.

Citizens’ Assemblies tend to rely on a few key values in order to function effectively, and participants should be made aware of these expectations and values (or any additional objectives) at the outset:

  • Debate should be informed and informative and should allow for discussion and deliberation based on sound argument and evidence;
  • Experts in a particular field and campaigners from all sides and all possible viewpoints should be invited to discuss their arguments with participants and be willing and able to be questioned;
  • Participants should be willing to talk and listen with civility and respect;
  • Participants should be representative of the general population as far as possible and should reflect a range of perspectives.

The sessions of the assemblies themselves vary but will usually include learning and evidence sessions introducing the assembly, the participants and the question to be discussed as well as background and contextual information and additional evidence from invited experts; sessions in which campaigners are able to present their arguments and be questioned; and sessions which focus on deliberation, discussion, consensus building and reporting. Facilitators will often be used to ensure a fair spread of opinions are heard – but facilitators cannot participate in the discussions themselves, and organisers will often pre-plan elements such as seating plans or evidence presented to assembly participants to ensure an even spread of opinions.

The fundamental idea is that if you randomly select a representative group and give them time, information and a safe space to discuss issues, you can create an illustration of what it would be like if everyone had the tools and time to discuss and debate the important issues. There is, however, no legal obligation for Government to take the recommendations forward.

What has happened elsewhere?

In the Republic of Ireland, they have held a number of “democratic experiments” and the Irish examples have been cited as examples of how Citizens’ Assemblies can effect change.

In 2012-13 the Irish Constitutional Convention led to the bringing forward of legislation and the eventual legalisation of gay marriage in the Republic of Ireland, and the 2016-17 Citizens’ Assembly paved the way for the 2018 referendum which legalised abortion. Ireland has been cited as a major inspiration for a Scottish Citizens’ Assembly to be established, something Nicola Sturgeon expressed support for in her speech at the 2019 SNP conference.

Ireland is, supporters of the concept argue, an example of how Citizens’ Assemblies can be effective at helping to reach consensus on contentious issues and allowing people to have a meaningful say in what legislation is put forward to parliament, not just having the choice of policies that are prescribed to them by politicians. Critics have argued however that the Irish experience has, to a degree, been oversold in Britain and shows how “the symbolic value of the ordinary citizen can be exploited for political purposes”.

And, for all the perceived successes of the Irish experience, the somewhat contrasting experience of Iceland also has some potentially useful lessons for anyone looking to implement Citizens’ Assemblies at a national level. The experience there shows that it doesn’t always go to plan. Citizens were invited to input into the new values of Iceland’s constitution following the 2008 economic crash. Consultations took place across the country and a series of recommendations were presented but these were not taken forward by parliament.

Other models of Citizens’ Assembly have been trialled in Belgium, the Netherlands and in Canada. The Canadian model invited public input into electoral reform proposals in British Columbia and Ontario, while the G1000s organised in Belgium saw 1000 participants randomly selected to deliberate for one day on major policy issues. Success in Belgium inspired the Netherlands to run a similar scheme.

How can we ensure everyone feels able to participate?

Deliberative models, like Citizens’ Assemblies, aim to encourage consensus building and finding common ground. They also aim to take opinions and make decisions based on a diverse spread of participants, however identifying and encouraging those on the fringes of democratic processes to participate can be a challenge. But it is a challenge that Citizens’ Assemblies and other local community engagement models need to address.

Research conducted around improving local community empowerment initiatives highlights a number of relevant questions and opportunities to improve engagement in deliberative democratic processes such as Citizens’ Assemblies.

  • Is it appropriate to pay participants to attend?
  • Should organisers actively invite participants from certain underrepresented groups or highlight to people that they are part of an underrepresented group to encourage participation (minimising self-selection bias)?
  • Will holding meetings at evenings or weekends enable or disable certain groups from attending and what impact might this have on the make-up of the assembly?
  • Have organisers considered holding meetings in facilities that are accessible via public transport?
  • Have organisers considered holding meetings in facilities which are accessible to disabled people and people with children (perhaps with creche facilities)?
  • Have organisers ensured that the information presented is robust but varied, so that everyone feels their views are represented in some way by the evidence?
  • Have organisers considered additional support for participants? (Organisers should provide effective and complete support throughout the process, making no assumptions on previous knowledge or understanding of how participation in activities like Citizens’ Assemblies work and understanding potential anxieties around participation, particularly of first-time participants).

Final thoughts

Citizens’ Assemblies and other similar mechanisms like Citizens Juries have the potential to revolutionise the democratic process in the UK. Although not intended to be a replacement of the traditional mechanisms of government, if done well, engaging citizens more meaningfully in not only the decision making process but in setting the options under discussion in the first place could transform how policy is made and how politicians interact with their public.

The emphasis on weighing available evidence and consensus building is also valuable, particularly in instances where politicians are unable to come together over contentious issues. However, to be truly transformational, the assemblies must have a level of self-awareness which recognises the difficulties some groups may have in participating in the process.

Finding ways of tackling this, and engaging the “unusual suspects”, giving them a voice and showing them that their opinion can have a direct impact on the choices taken by politicians could potentially repair some of the damage which appears to have been done to the relationship between those who govern and those who are governed, but it is clear we have a long way to go yet.


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This April get free access to the Social Policy and Practice database!

Social Policy and Practice is a database supporting the smarter use of evidence and research within the UK. The key strengths of the database lie in the area of health and social care – it’s not a medical database, but instead examines social issues such as health inequalities, care of the elderly, children and family social work, and community health.

Social Policy and Practice is exclusively available via Ovid – the internationally-recognised leader in information services – and this April they are offering librarians, academics and researchers the chance to trial it for free!

UK-focused evidence and research

Social Policy and Practice is produced by a consortium of key organisations within the UK:

  • Centre for Policy on Ageing – Originally established in 1947 by the Nuffield Foundation, the Centre has a long and distinguished record as an independent charity promoting the interests of older people through research, policy analysis and information sharing.
  • Idox Information Service – Set up 45 years ago to support the use of research within local government, it now works with government and the private sector to increase understanding of public policy issues.
  • National Society for the Prevention of Cruelty to Children – The UK’s leading children’s charity, campaigning and working in child protection in the United Kingdom and the Channel Islands.
  • Social Care Institute for Excellence – A leading improvement support agency and independent charity working with organisations that support adults, families and children across the UK, by supporting the use of the best available knowledge and evidence about what works in practice.

A valued resource

Social Policy and Practice has been identified by the National Institute for Health and Care Excellence (NICE) as a key resource for those involved in research into health and social care. And importantly, it supports a holistic approach to improving outcomes, by covering social issues such as poor housing, regeneration, active ageing, resilience and capacity building.

Social Policy and Practice was also identified by the Alliance for Useful Evidence in a major mapping exercise in 2015, as a key resource supporting evidence use in government and the public sector.

Unrivalled scope

Social Policy and Practice covers all aspects of public health and social care. It is a must-have resource for anyone interested in the following topic areas:

  • Social work and social care services
  • Children and young people
  • Adults and older people
  • Families and parenting
  • Safeguarding
  • Health promotion
  • Health inequalities
  • Community development
  • Physical and mental health
  • Education and special educational needs

It also offers a holistic view of wider policy areas that impact on health, such as homelessness and deprivation.

The database brings together research and evidence that is relevant to researchers and practitioners in the UK. A large proportion of material relates to delivery and policy within the UK and the devolved nations of Scotland, Wales and Northern Ireland, but the database also covers material that is transferable from Europe and across the world.

Social Policy and Practice boasts over 400,000 references to papers, books and reports and about 30% of the total content is hard-to-find grey literature.

The importance of geographical focus

Research studies have shown that people searching for social science evidence tend to neglect the question of geographical and coverage bias within research sources. And that the geographical focus of databases is a potential source of bias on the findings of a research review.

In the last ten years many UK-produced databases have ceased – funding has stopped, publishers have closed or databases have been taken over by international publishers (which reduces the balance of UK content and the use of UK-relevant keywords).

So as a UK-produced database, Social Policy and Practice is uniquely placed to provide relevant results for UK-based researchers.


To see for yourself why so many UK universities and NHS bodies rely on Social Policy and Practice as a resource, visit Ovid Resource of the Month for instant access.

To find out more about the history of the database and the consortium of publishers behind it, read this article from 2016 which we have been given permission to share.

Banning fast food outlets near schools: have takeaways had their chips?

A number of organisations – including the Academy of Medical Royal Colleges, Public Health England and the Royal College of Paediatrics and Child Health – have called for the creation of ‘fast food exclusion zones’ – banning fast food outlets from opening within 400m of schools and other places where children congregate.

In this blog post, we consider the arguments in favour of restricting the growth of such fast food outlets near to schools, and whether the evidence supports this.

More children becoming obese, earlier and for longer

The UK is now ranked among the worst in Western Europe for childhood obesity. Not only are more young people overweight or obese, they are also becoming obese at earlier ages and staying obese for longer.

Indeed, recent statistics show that nearly a quarter of children in England are obese or overweight by the time they start primary school aged five, rising to one third by the time they leave aged 11.

Increased risk of social, psychological and long-term health problems

In addition to the social and psychological problems associated with obesity, obese children are at a greater risk of developing serious diseases, including coronary artery disease, high blood pressure and type 2 diabetes.  They are also 20% more likely to develop cancer as adults than those of a healthy weight.

There is also a financial incentive for addressing obesity in both adults and children – recent estimates suggest that obesity-related conditions cost the NHS around £6.1 billion per year.  The total estimated cost to society is even greater – at least £27 billion per year.

Indeed, the annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined.

Deprived areas have greater levels of both obesity and fast food outlets

There are also strong reasons to address obesity from an equalities angle.

Recent data compiled by Public Health England shows that there is a strong association between area level deprivation and the density of fast food outlets.  Some areas, such as Blackpool, and parts of Manchester and Liverpool, have up to five times more fast food outlets than more affluent areas.

The evidence is generally clear that deprivation is associated with higher levels of overweight and obesity, and lower levels of vegetable consumption.

The evidence suggests that the food environment does influence food choice

During the past 10 years in the UK, there has been a significant increase in the number of fast food outlets, and the consumption of food away from the home has increased by 29%.

Researchers and policymakers have sought to understand whether unhealthy food environments – such as those with a high density of fast food takeaways – may encourage unhealthy food choices, and thus contribute to obesity.

Last year, the Scottish Government published a research paper on the link between the food environment and the planning system.

In relation to the link between the food environment and obesity in general, the report concludes that while the evidence is mixed, “overall the evidence would suggest that increased exposure to outlets selling unhealthy food increases a person’s likelihood of gaining weight”.

In relation to the effect of the food environment around schools on children and young people specifically, the evidence is less clear cut – with some research showing a link to obesity while other research does not.

Interestingly, there was evidence that access to outlets selling healthy food decreased the odds of being overweight or obese.

Research by Brent Council, involving seven secondary schools – four of which were within 400m of a fast food outlet – found that 27% of students said they would not bother going out at lunch if they had to walk more than 8 minutes.

It does seem like common sense – make fast food less readily obtainable and children will be less likely to consume it.

Prof Russell Viner, of the Royal College of Paediatrics and Child Health, has said “This food is tasty and cheap – it’s easy to blame the individual, but humans, particularly children, will find it hard to resist tempting food.”

England already making progress, Scotland likely to follow

In England, the National Planning Practice Guidance (PPG) outlines the role that planning can have in reducing obesity by limiting over-concentration of fast food takeaways, particularly around schools.  It also encourages planning authorities to limit takeaways in areas with high levels of obesity, deprivation and general poor health, and in areas with over-concentration and clustering of outlets within a specified area.

Similarly, the Child Obesity Strategy commits to developing resources to support local authorities who want to use their planning powers to restrict fast food takeaways, and providing up to date guidance and training for planning inspectors on the creation of healthy food environments.

A number of councils have already implemented 400m exclusion zones.  Some notable examples include St Helen’s Council, Sandwell Council, Dudley Council, and Milton Keynes.

Sadiq Khan has included proposals for a 400m exclusion zone around schools in the new Draft London Plan, and plans to limit the number of fast food takeaways near schools in Luton were approved in 2018.

At present, there are no powers to restrict fast food outlets on health grounds in Scotland – however, it is likely that this will change in the near future.

As well as the aforementioned research project, last year, the Scottish Government published the consultation, ‘A Healthier Future’, which commits to exploring the opportunity for the planning system to contribute to an improved food environment:

We will research precedent, evidence and good practice on the relationship between the planning system and food environment, including exploring how food outlets in the vicinity of schools can be better controlled, with a view to informing the review of Scottish Planning Policy”.

In the December 2018 issue of Scottish Planning and Environmental Law (SPEL), Neil Collar of Brodies LLP concludes that:

Taking account of Action 2.12 in ‘A Healthier Future’ and the research project, it seems likely that the draft National Planning Framework, expected to be published by the Scottish Government in 2019, will contain policies to control hot food takeaways and the food environment around schools. An evidence base to justify controls in local areas will be important”.

Creating a robust evidence base is crucial

Children have a right to grow up in an environment that supports them to attain the highest possible standard of health – and the planning system has a key role to play in facilitating this.

Of course, the planning system cannot address obesity on its own, and the causes of obesity are far wider and more complex than just the food environment.

Other approaches are also being put in place – including supporting food outlets to provide smaller portions and healthier options – some of which have been very successful already.

The creation of a robust evidence base upon which to make informed decisions regarding the location of fast food takeaways and the creation of healthy environments is essential.

There are already a number of useful datasets available for local authorities to use, including the Food environment assessment tool (Feat) and guidance on the creation of healthy food environments.

As more local authorities make use of their powers to restrict fast food outlets, it will be interesting to see whether more evidence emerges of the link between fast food and childhood obesity. We at the Information Service will, of course, be watching this with interest.


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Free access to Social Policy and Practice … only available this November!

Social Policy and Practice is the only UK-produced social science database focused on public health, social care, social services and public policy. It is exclusively available via Ovid – the internationally-recognised leader in medical information services – and this November they are offering librarians and researchers the chance to test drive it for free!

UK-focused evidence and research

Social Policy and Practice is produced by a consortium of key organisations within the UK. Currently these are:

  • Centre for Policy on Ageing
  • Idox Information Service
  • National Society for the Prevention of Cruelty to Children
  • Social Care Institute for Excellence

A valued resource

Social Policy and Practice has been identified by the National Institute for Health and Care Excellence (NICE) as a key resource for those involved in research into health and social care. And importantly, it supports the ability to take a holistic approach to improving outcomes, by covering social issues such as poor housing, regeneration, active ageing, resilience and capacity building.

Social Policy and Practice was also identified by the Alliance for Useful Evidence in a major mapping exercise in 2015, as a key resource supporting evidence use in government and the public sector.

Unrivalled scope

Social Policy and Practice covers all aspects of public health and social care. It is a must-have resource for anyone interested in the following topic areas:

  • Social work and social care services
  • Children and young people
  • Adults and older people
  • Families and parenting
  • Safeguarding
  • Health promotion
  • Health inequalities
  • Community development
  • Physical and mental health
  • Education and special educational needs

It also offers a holistic view of wider policy areas that impact on health, such as homelessness and deprivation.

The database brings together research and evidence that is relevant to researchers and practitioners in the UK. A large proportion of material relates to delivery and policy within the UK and the devolved nations of Scotland, Wales and Northern Ireland, but the database also covers material that is transferable from Europe and across the world.

Social Policy and Practice boasts over 400,000 references to papers, books and reports and about 30% of the total content is hard-to-find grey literature.

The importance of geographical focus

Research studies have shown that people searching for social science evidence tend to neglect the question of geographical and coverage bias within research sources. And that the geographical focus of databases is a potential source of bias on the findings of a research review.

In the last ten years many UK-produced databases have ceased – funding has stopped, publishers have closed or databases have been taken over by international publishers (which reduces the balance of UK content).

So as a UK-produced database, Social Policy and Practice is uniquely placed to provide relevant results for UK-based researchers.


To see for yourself why so many UK universities and NHS bodies rely on Social Policy and Practice as a resource, visit Ovid Resource of the Month for instant access.

To find out more about the history of the database and the consortium of publishers behind it, read this article from 2016 which we have been given permission to share.

Tackling health inequalities: what does the data tell us and how can it help?

Health inequalities in Scotland are significant. Every year we hear about how Scotland has some of the biggest gaps in the health and wellbeing of the poorest and richest in society. In some cases, Scotland has the largest gaps in equality in the whole of Europe. And in many instances, they are rising. Scotland also has the lowest life expectancy of all UK countries.

A number of studies and research projects have been commissioned to try to identify the key indicators and factors that are creating and reinforcing these inequalities, and what sorts of interventions would work best to try and reduce or eradicate them altogether. It is hoped that by conducting research, and compiling data, policymakers can use this to identify groups and geographic areas where health inequalities are significant, and to intervene to reduce them, with data to help back up and evaluate the effectiveness of these interventions. In Scotland, work is being done by a number of organisations including the Scottish Government, Glasgow Centre for Population Health (GCPH) and Public Health Innovation Network Scotland (PHINS).

What indicators and factors are being measured?

Income inequality has a related impact on health inequalities, and the scale of low pay is significant. The relationship between health inequalities, poverty and household income is one which has been explored at length and is often highlighted as one of the main factors which influences health inequalities. Studies which look at income, and also at relative levels of deprivation can provide useful comparison points, with comparable datasets on employment status and income readily available at a national and local level. Data also considers trends over time, comparing pre- and post-economic crash data, as well as relative earnings and expenditure relative to inflation and the rising cost of living. Other factors include age (those under 25 and earning a lower minimum wage for example) and by gender, with more women in lower paid, lower skilled and part time or insecure work.

How usable is the research being created?

The research which examines health inequalities explores a whole range of interrelated factors, and highlights just how complex the landscape of inequalities is. Creating a clear and holistic picture of all of the factors which contribute to health inequalities is not easy. Many studies, while detailed and effective, are niche, and focus on a very limited number of factors across a limited demographic source. As a result, questions have been raised about the utility of this research and its applicability and scalability at a national level. In an attempt to tackle this, combined data sets are being produced which provide opportunities for comparison across data from a range of studies.

The “Triple I” tool from NHS Health Scotland is designed to help policy designers to create effective interventions to reduce health inequalities. A second edition of the tool is due to be released in 2018/19. Triple I aims to provide national and local decision makers with practical tools and interpreted research findings about investing in interventions to reduce health inequalities in Scotland. It does this by modelling the potential impact of different interventions and policies on overall population health and health inequalities.

 

What can be done to act on the data?

While the research being produced is high quality, and thorough in relation to findings, the real question is what can actually be done with the research, and what steps can policymakers and practitioners take to use the findings to inform their own practice.

There are, researchers suggest, significant opportunities presented by the recent research which has been done on income inequality. In particular, they cite the public sector and public sector pay as a key way to reduce the income, and therefore the inequality gap, particularly among higher earners and those who would be considered “working poor” or “just about managing”. In Scotland, significantly more people are employed in the public sector than in any other part of the UK, and there is, researchers suggest, an opportunity to better align and increase low wages to help to reduce the gap.

The adoption of new initiatives, such as the “housing first model”, which is due to be rolled out in Glasgow to help homeless people break the cycle of homelessness, are also opportunities not only to address inequalities, but to ensure that long term help and support is in place to prevent any relapse into chaotic or risky behaviour. In relation to housing first, the savings on front line services such as emergency admissions to hospital, or contact with the police after committing a crime are significant, and while more in depth research is needed to create a full cost benefit analysis model of the scheme and its effectiveness, early studies show that the impact on health and wellbeing on those who had previously been homeless is huge in terms of reducing inequalities and improving wellbeing. However further data on homelessness in Scotland shows how far we have to go, and that housing first is only one mechanism which can be used to begin this process of reducing inequalities among the most and least deprived communities in Scotland.

Alternatively, some have suggested a more radical overhaul of how we distribute welfare and wealth within the country. Research has been coming thick and fast on the subject of a “citizens basic income”, particularly following the trial which was rolled out in Finland (the findings of which have not yet been published). Research on how this could impact on inequalities is not widespread yet, as pilots have been small scale, However, it is suggested that a total overhaul of welfare, replacing it instead with a citizen’s basic income would be a more effective way to reduce inequalities across the board, including in health.

Summing up

Health inequalities are significant in Scotland. Much of the research focuses on the impact of deprivation, poverty and low income on health inequalities and how, in order to tackle health inequalities in Scotland we must also tackle some of the other significant social problems within our communities, including low income and insecure work, and the impact of homelessness or chaotic lifestyles on health.

Data can be used in a number of ways to help inform policy decisions, some more radical than others. But creating a complete understanding of inequality in Scotland is challenging. It is up to researchers and policymakers to work together to create a better understanding of the conditions and factors which contribute to inequality, and what can be done to help tackle systemic and entrenched inequalities in our communities through policy levers and evidence based policy making.

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

Universal basic income: too good to be true?

A world of evidence … but can we trust that it is any good?

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Science in the city: applying neuroscience to urban design

Cities have long been considered primarily in terms of their buildings and infrastructure.  However, in recent years, a more ‘human-centric’ view has been adopted – focusing on the people who inhabit the city, and how they perceive and respond to the city that surrounds them.

Research from a variety of disciplines agree that buildings and cities have a significant impact upon the people – from their physical and mental health, cognitive development, and wellbeing to their levels of productivity.

Neuroscience offers a new way to further explore this impact – and by doing so, help urban design professionals to create places that promote human health and wellbeing, whilst mitigating the negative impacts of the city environment as far as possible.

 

What is neuroscience?

But what exactly is neuroscience?  And how does it relate to urban design?

A recent report by FutureCatapult looks at how neuroscience can be used to improve the design of urban places, and thus increase human wellbeing and productivity.

It defines neuroscience as “a multidisciplinary branch of biology and is the scientific study of the brain and nervous system, including its interaction with the other parts of the body”.

There are various ‘scales’ or ‘levels’ of neuroscience – from cognitive psychology, right down to the study of individual cells in the brain.  Each level of neuroscience studies different aspects of how the brain functions, and thus offers different ways to explore and understand how humans perceive, respond to and are affected by their surrounding environments.  It has many applications in real life – and one such application is informing city strategy, design and policy.

 

Applying neuroscience research to urban design

Take mental health, for example.  It is a prime example of an area in which neuroscience can be used by city planners and policymakers to help improve human wellbeing.

As FutureCatapult point out in their report, cities have a greater prevalence of mental health problems than rural areas.

They note that several factors associated with cities have been found to contribute to mental health problems. These include certain toxins (produced by traffic, industrial parks), environmental stressors (noise and light pollution), climate conditions (urban heat islands) and social conditions (isolation).  Neuroscience offers a greater understanding how these factors impact on human health and wellbeing, thus creating an evidence base for the design of healthy places.

There are many other ways in which neuroscience research can inform city design.  For example, it has been found that:

  • poor air quality has serious detrimental effects on the natural developments of children’s brains
  • social isolation can accelerate cognitive decline in older people
  • an increase in noise decreases worker productivity
  • light influences brain function during specific cognitive tasks, especially those requiring sustained attention

Such findings can help inform the decisions made by city planners and policymakers, and help create cities that maximise human health, wellbeing and productivity.

Research into the brain’s ‘wayfinding’ processes – that is, how the brain processes visual information and makes sense of unfamiliar environments – is also of interest.  For example, how do people choose which paths to follow?  Are they influenced by street size, shape, colours, noise, or the number of cars? Such information could be used to inform the design of streets and places that are easier to navigate. This is of growing importance given the drive towards the design of inclusive and dementia-friendly places.

Relatedly, neuroscience offers a way to gain a deeper understanding of how non-neurotypical brains process and respond to different environments – for example, people with dementia or autism.  Understanding these different perspectives and responses is key to the creation of spaces that are truly inclusive.

 

Neuroscience in action

But how exactly does one go about examining how brain cells respond to an urban environment?

There are a variety of neuroscience tools that may be used to gather information about human’s experience of the city.

A key tool is mobile electroencephalography (EEG).  Previously, EEG involved equipment that could only be used in a laboratory.  However, technological advances have seen the development of mobile EEG ‘headsets’ that can be worn as research participants navigate different streets and environments of the city.

Mobile EEG enables researchers to measure brain function and activity, as well as the responses of the autonomic nervous system (heart rate, skin conductivity, endocrinological levels).  This can be used to understand how individuals experience urban environments.

For example, mobile EEG has been used to help understand the urban experiences of people with visual impairments.  Other mobile EEG studies have looked at whether using quiet, low traffic streets has a different effect on pedestrians than using streets busy with shops, traffic and other pedestrians.

Eye tracking machines are another tool providing research findings of interest to urban designers.  They study gaze behaviours and cognition, which are in turn related to attention, memory, language, problem solving, and decision making.  Eye tracking can help researchers to understand which features catch and hold attention, visual preferences and experiences. For example, one eye-tracking study found (perhaps unsurprisingly) that humans prefer lush greenery in urban environments.

As these neurological research and related technologies advance, their application will undoubtedly become more sophisticated and widespread.

 

Building upon evidence

The urban population around the world is expanding rapidly and finding solutions to the mental and physical health challenges that cities present is crucial.

By understanding the insights that neuroscience can provide, city planners, policy makers and others involved in urban design can access a growing evidence base upon which to build future cities that are healthy, attractive and inclusive places to live.


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