‘Digital prescribing’ – could tech provide the solution to loneliness in older people?

Notruf und Hilfe für Rentner und Kranke

The number of over-50s experiencing loneliness could reach two million by 2026. This compares to around 1.4 million in 2016/7 – a 49% increase in 10 years.

It has also been estimated that around 1.5 million people aged 50 and over are ‘chronically lonely.’

With an ageing population and increasing life expectancy, it would seem likely that loneliness among older people is set to continue; unless something significant is done. According to Age UK, tackling loneliness requires more than social activities. A new report from Vodafone suggests technology could be the answer.

Impact

The impact of loneliness in older people can be immense, not only for the older people themselves but for those around them. It can also put strain on the NHS, employers and organisations providing support to people who are lonely; and have a negative impact on growth and living standards.

Research has suggested that those experiencing social isolation and loneliness are at increased risk of developing health conditions such as dementia and depression, as well as increased risk of mortality. The damaging health effect of loneliness has been shown to be comparable to smoking 15 cigarettes a day. Older people who are lonely are therefore more likely to use health services than those who are never lonely.

The economic impact is also significant. It has been estimated that increases in service usage create a cost to the public sector of an average £12,000 per person over the medium term (15 years). Vodafone’s report suggests that loneliness has a £1 billion a year impact on public services. It has also been found to cost employers £2.5 billion per year.

How tech can ease the burden

According to Vodafone, “new technologies are a key part of the solution” alongside more traditional public and community services. Two key routes through which technology can be used to reduce loneliness are highlighted:

  • by supporting older people to remain independent in their home and community; and
  • maintaining and building networks and contacts.

From wearable devices and touchscreens to personal robots that act as the eyes, ears and voice of people unable to present physically, these are all highlighted as viable and positive uses of tech to ease the burden of loneliness. And there are already a number of examples of innovative use of technology that can benefit older people.

1024px-AV1

No Isolation AV1 robot. Image by Mats Hartvig Abrahamsen, via CC BY-SA 4.0

Good practice examples

One such example is Vodafone’s smart wearable wristband, the V-SOS Band, which supports independent living while also increasing the wearer’s safety. It can directly alert family members via their phone if the wearer needs help. It also uses fall detection technology so that families can be alerted automatically if the wearer falls either in the home or when they are out.

Kraydel is another example. Its smart TV-top hub links elderly people to their carers or family members, through their TV screens, helping people be more independent and remain in their own homes for longer as well as helping them be more socially connected. It provides for user-friendly video calling via the TV and can help people return home from hospital earlier. Via connection to the cloud, the device interprets the data it receives to build up a picture of the user’s daily activities, health and wellbeing. It issues medicine and diary reminders, and alerts caregivers if it sees something amiss, or identifies potential risk.

Although aimed at children, No Isolation’s AV1 – a smart robot designed to reduce the risks of children and young adults with long-term illness becoming socially isolated – demonstrates the positive impact innovative technology can have on social isolation and loneliness. The robot avatar, with its 360 degree camera, acts as the child’s eyes, ears and voice in the classroom or at other events, keeping children closely involved with school and in touch with their friends.

Of course, loneliness is particularly prevalent among people who don’t use smart technology such as smart phones and tablets, one of the reasons cited by Kraydel for using the TV – probably the most familiar and widely used screen globally. This issue also led No Isolation to develop KOMP, a communication device for seniors that requires no prior digital skills. It enables users to receive photos, messages and video calls from their children and grandchildren, operated by one single button.

Another new project recently launched in Sweden – considered one of the world’s loneliest countries – uses a unique conversational artificial intelligence which enables older people to capture life stories for future generations while providing companionship. Memory Lane works with Google Voice Assistant and is able to hold meaningful conversations in as human a way as possible. A pilot test showed that the software “instantly sparked intimate conversations” and led to stories that hadn’t been told before.

Final thoughts

With a significant number of older people lacking confidence in their ability to use technology for essential online activities, support for digital skills is obviously still important. In response to this issue, Vodafone has launched free masterclasses across the UK, as part of a programme called TechConnect.

Many of the above innovative examples bypass the traditional barriers to realising the potential of technology in reducing loneliness as most:

  • don’t rely on older people engaging directly with the technology; and
  • are based on mobile technology that can be constantly connected, whether inside or outside the home.

However, there is still the issue of awareness of such technologies and their accessibility to older people. The Vodafone report suggests that access could be improved through social and digital prescribing and revitalising support for independent living, and calls for a challenge fund to support innovation. It is suggested that these innovative ideas are just the start and that combined action is needed from across all levels of government, business and community groups, amongst others.

Perhaps if such action is taken to address existing barriers, we will see a reverse in the loneliness trend over the next 10 years.


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Housing wealth matters

Houses-on-coins-by-Images-Money

With the widening gap between the richest and poorest across different measures of inequality, there is growing awareness that income is not the only factor that impacts living standards. This has led to increasing interest in the distribution of wealth. While wealth can take various forms, the most visible way households accrue and store substantial amounts of wealth is through property ownership.

Property wealth in Scotland has increased ten-fold over the last 50 years – driven primarily by rising house prices, but also by the increasing number of properties and transfer of public housing into the private sector. However, this wealth is not distributed equally. In its recent examination of the scale and distribution of housing wealth in Scotland over time, the Resolution Foundation highlighted the marked rise in housing wealth inequality over the last decade, which is now twice as high as income inequality.

Why?

The new report shows that the growing inequality in housing wealth is in large part due to the fact that while very few families in Scotland currently have no form of income, over one in three Scottish households hold no property wealth at all and those in the top income decile own around 30% of the country’s property wealth.

Additional property ownership has also increased in recent years, adding to the level of inequality. The biggest wealth gaps were found to be in Scotland’s largest cities – Aberdeen, Dundee, Edinburgh and Glasgow – where low rates of home ownership are coupled with ownership of multiple properties, concentrating housing wealth in fewer households’ hands.

In addition, the last decade has seen many people struggle to get a foot on the housing ladder and today’s young people hold less housing wealth than their predecessors. Location was also found to have an impact as house prices can differ greatly by local authority, although these variations have reduced in recent years.

As a result, levels of housing wealth inequality are now nearing the same levels as those in England and Wales, although rates of homeownership remain higher in Scotland than elsewhere in the UK.

With more people now having some form of income than ever before, it is perhaps reasonable to ask why housing wealth is so important.

The Foundation’s report highlights that owning property has value over and above general wealth effects in that it can also provide a secure home; a source of income; and greater financial security in later life. Indeed, the UK Collaborative Centre for Housing Evidence (CaCHE) and Policy Scotland’s evidence review, which complemented the Foundation’s analysis, also highlights why housing wealth matters, citing many economic, health and social impacts.

Why housing wealth matters

While it has been previously argued that housing wealth inequalities are of little significance in terms of macroeconomic impact and can therefore be disregarded, there is now a growing body of evidence suggesting that in fact these inequalities do matter. The evidence review notes that:

  • housing assets are of growing importance encouraging household spending and were implicated in the global financial crisis;
  • access to home ownership is increasingly reliant on parental property wealth with negative implications for social mobility;
  • housing wealth is cumulative: e.g. buy-to-let has increased dramatically in Scotland over the last 20 years, often facilitated by the re-mortgaging of existing property by owners;
  • rising house price and wealth effects reduces productivity growth; and
  • different rates of house price change create inequalities across UK regions.

This is not only the case in Scotland and across the UK; across Europe housing wealth inequality has been shown to exacerbate socio-economic differences by segregating households based on income levels.

In relation to health and wellbeing, housing wealth can be a double-edged sword. A rise in house prices can lead to increased physical health of owners but decreased physical and mental health of renters.

Of course, historically, housing wealth has been seen to contribute to reduced wealth inequalities due to increased home ownership, however, there is now also an emerging concern that high house prices and rents may impair labour supply and productivity.

HWI

Main elements of wealth inequality processes within the housing system (CaCHE, 2019)

It is clear that income is not the only important factor in inequalities. This is illustrated by recent figures on child poverty and in-work poverty, which show that despite recent record levels of employment, two thirds of children living in poverty come from working households and more than half the people living in relative poverty in 2017/18 (53%) lived in households where at least one adult was in paid employment.

The Resolution Foundation notes that while the scale and distribution of housing wealth has changed dramatically over the past 50 years, wealth taxation has not.

Indeed, it has been recently argued that policy is widening the housing wealth divide and that the local supply of housing needs to be realigned with local housing demand if this is to be rectified.

Way forward

The research suggests that a number of actions could be taken to address the growing housing wealth inequalities in Scotland:

  • Firstly, support for sustainable home ownership, especially for those on lower incomes or in the younger age bracket is highlighted as one obvious response, although it notes that policies such as Help to Buy risk stimulating demand to the point that house prices are driven up. As a result, it is suggested that policy action to lessen the demand for holding additional properties would be a more sensible strategy.
  • Second, it is argued that there is a strong case for substantial reform in the area of the property taxation to address the current mismatch between the value of housing wealth and taxation.
  • Third, it is suggested that the Scottish Government could give consideration as to how the benefits of holding housing wealth can be provided to those who are unlikely to ever be able to support home ownership, with more efficient taxing of housing wealth. In addition, the government could also build on their recent reforms which have provided tenants with greater security of tenure and more predictable rent increases, and look to provide more support to low-income families via further supplements to benefits.

With the current system of council tax described as “highly regressive”, “inequitable” and “inefficient”, the research calls for much needed reform.

Both reports acknowledge that radical change is a political challenge but while the Resolution Foundation’s report states the case for action is clear, the evidence review advises caution, suggesting that a more equal housing system is a long-term aspiration rather than something practical and realisable in the short to medium term.


If you enjoyed reading this, you may also be interested in some of our previous posts on housing topics.

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Supporting perinatal mental health: from peer-support to specialist services

There is a societal expectation that pregnancy and the arrival of a new baby are happy and exciting times.  However, it may come as a surprise to learn that up to 1 in 5 women develop a mental illness during pregnancy or within the first year after having a baby (also known as the ‘perinatal period’).

Up to 1 in 10 women may develop postnatal depression, however, there are actually a number of other mental illnesses that can affect women during pregnancy or following birth.  These include:

  • Antenatal depression
  • Perinatal anxiety
  • Perinatal obsessive compulsive disorder
  • Post-traumatic stress disorder (PTSD)
  • Post-partum psychosis

These illnesses can range from mild to severe.  Left untreated, perinatal mental illnesses can have a devastating effect on mental and physical health.  In fact, suicide is the leading cause of death for mothers during the first year after pregnancy.

The wider impact on children and families

Perinatal mental illnesses can also impact upon children, partners and significant others.  Research shows links to depression in partners, higher rates of divorces, lower levels of emotional and cognitive development and higher levels of behavioural problems and psychological disorders among children.

As well as the high human cost, there are also a number of economic costs associated with failing to address perinatal mental health needs. Research commissioned by the Maternal Mental Health Alliance found that perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK.

In comparison, it would cost only an extra £280 million a year to bring the whole pathway of perinatal mental health care up to the level and standards recommended in national guidance.

Access to specialist services is a ‘postcode lottery’

The good news is that most mothers who experience mental ill health can and do make a full recovery.

At present, mild to moderate cases of mental ill health in pregnancy and following birth are treated by the GP through anti-depressants, talking therapies and/or support from a community mental health team.  For more complex or serious illnesses, GPs can make a referral to specialist perinatal mental health services for expert advice and support.  This may involve staying in a specialist psychiatric Mother and Baby Unit (MBU) – where mothers and their baby can be admitted together.

However, despite the high prevalence of, and risks associated with, perinatal mental illness, access to specialist perinatal mental health services across the UK is a postcode lottery.

Maps by the Maternal Mental Health Alliance show that women in around half of the UK have no access to specialist perinatal mental health services.  There are currently no MBUs in Wales or Northern Ireland, meaning mothers with more serious or complex mental illnesses often face either being admitted to a MBU far from home, or being admitted to a general psychiatric ward without their babies, in order to receive treatment.

For those with mild to moderate mental illness, waiting times for NHS talking treatments can be many months.  Lack of awareness means that many cases of mild to moderate mental ill health go undiagnosed and untreated.  There is an urgent need for both greater awareness of mental illness and better access to mental health services across the country.

The role of peer-support

In recognition of and response to the need for better access to mental health support for pregnant and new mothers, a number of local ‘grassroots’ peer-support projects have been established by dedicated volunteers and campaigners.

One such project is Blank Canvas.  Blank Canvas is a creative journaling workshop in Lanarkshire, aimed at women during pregnancy or in the first two years since birth, who are experiencing mental health difficulties.

The project was set up earlier this year by midwife Elaine Connell, together with some of her midwife colleagues, who shared her dedication to improving mental health support for women in the perinatal period.

Elaine was keen to start her own peer support group following her own personal and professional experiences of perinatal mental ill health, and was inspired by the success of other projects focusing on art and creativity, such as Maternal Journal.

As Elaine explains:

It is free… …to access, and each attendee is given their own art kit to keep. We have a different theme each week and have guest speakers coming to do sessions also. During the group they can explore new art materials and create reflections in their journal, whilst chatting over some tea and cake. Each session they will take home a prompt card which can inspire their journalling during the week until the group meets next.”

Blank Canvas is free to access and works on a self-referral basis, with advertising mainly through Facebook.  A local shop and community space (Swaddle in Hamilton) donated a venue space, and all other costs (including materials) have been raised by volunteers committed to the project, through fundraisers such as coffee mornings and participation in the Kiltwalk.

Elaine has conducted an evaluation of the first 10-week block and feedback from participants has been extremely positive.  Word about the project has spread and the next block of Blank Canvas – which started on the 18th September – is fully subscribed (with a waiting list).  As Elaine notes, this is fantastic for the project, but highlights the high level of demand that exists for mental health support among new mothers.

The long term plan is to run 6-week blocks frequently throughout the year, moving to separate antenatal and postnatal sessions in 2020.  Elaine also hopes to start up a creative journaling group aimed at fathers too – noting that father’s mental health is often overlooked.

One of the key things Elaine has learned from the creation of Blank Canvas is that there is a lack of support available for people who want to establish their own peer-support groups:

What has been clear when forming the group, is that there is very little support to establish peer support. There are lots of people who want to help others but who won’t because they don’t know where to begin, or how to access funding, or lack of training opportunities.”

Grassroots peer-support groups are an important source of support for mothers in the perinatal period, particularly in cases of mild to moderate mental ill health, where NHS capacity is strained.

Attending peer-support groups such as Blank Canvas may also have a preventative effect for mums who attend during pregnancy. Statistically, women who experience antenatal anxiety are more likely to develop postnatal depression, and so early intervention could help to reduce that risk.

Urgent need for better access to specialist services

While these projects have been successful, they are aimed predominantly at women experiencing mild to moderate mental ill health.

For those experiencing more complex or serious mental ill health, there remains an urgent need for better access to specialist treatment and support.  The Maternal Mental Health Alliance ‘Everyone’s Business’ campaign calls for all women throughout the UK who experience perinatal mental ill health to receive the care that they and their families need.  Specifically, it demands that:

  • perinatal mental health care should be clearly set at a national level and complied with
  • specialist perinatal mental health teams meeting national quality standards should be available for women in every area of the UK
  • training in perinatal mental health care should be delivered to all professionals involved in the care of women during pregnancy and the first year after birth

Promising signs of progress

There have been some promising signs of progress.  NHS England recently announced their plans to rollout specialist perinatal community services across the whole of England, including the opening of four new Mother and Baby Units.

And in Scotland, the Scottish Government recently announced the rollout of an initial £1 million for perinatal mental health services, as part of a wider £50 million investment in mental health services.  This initial investment will support a range of areas, including supporting the third sector to provide counselling, befriending and peer support for women and their families.  It will also help provide more consistent access to psychological assessment and treatment, by increasing staffing levels and training at Mother and Baby Units, for women with the most serious illnesses.

The Scottish Government also established a Perinatal and Infant Mental Health Programme Board earlier this year.  The PIMH Programme Board aims to help implement the commitments to improving perinatal and infant mental health set out in the 2018/19 Programme for Government and Better Mental Health in Scotland.

Clare Thomson, Everyone’s Business Co-ordinator for Scotland, says “It’s fantastic to see the evidence-based approach to developing community perinatal mental health services and look forward to hearing about the first steps – particularly in the North of Scotland“.

Perinatal mental health is Everyone’s Business

However, there is still much to do, including ensuring that this funding translates into services on the ground.  Wales and Northern Ireland are still without MBUs and there is a pressing need to raise awareness of and address mental illness among fathers.

The cost to the public sector of perinatal mental health problems is 5 times the cost of improving services.  It clearly makes sense to invest in improving this care – not only from an economic perspective, but to help improve the lives of women, their children and families across the country. And while more funding is essential to achieve this, raising awareness of the importance of perinatal mental health really is ‘everyone’s business’.


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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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“The ‘frustrated’ housing aspirations of generation rent”

house prices

A key change in the UK’s housing market over the past twenty years has been the growth of the private rented sector (PRS), with more living in the sector than ever before. This growth has led to the view that there is now a ‘generation rent’ who are priced out of home ownership and stranded in insecure short-term lets for prolonged periods of their lives – fuelling concerns about intergenerational inequality.

At a recent seminar, hosted by the Public Services and Governance research group at the University of Stirling, Dr Kim McKee, a co-investigator for The UK Collaborative Centre for Housing Research (CaCHE), presented the key findings from her research on ‘generation rent’ and precarity in the contemporary housing market.

Who are ‘generation rent’?

The UK 2011 Census highlighted that 40% of private renters were young people under the age of 35. With a challenging labour market, rising student debt and welfare reforms, home ownership and social housing is increasingly out of reach for these young people, who end up stuck private renting for much longer than the previous generation.

It was noted by Dr McKee that there is a clear age dimension to the recent shifts in housing tenure, but that the ‘generation rent’ label is more complex than portrayed. Income and family support were emphasised as just as critical in the understanding of young people’s experiences and future plans, as was geography.

Indeed, other research has highlighted that income and family background have a huge impact on young people’s housing market experiences. The Resolution Foundation’s recent report highlights that young people from wealthier families are more likely to become homeowners, suggesting that there are also intra-generational inequalities.

Dr McKee’s study focused on the inequalities facing these young people through qualitative research with 16 young people aged 35 and under living in the PRS in Scotland or England. Those on low incomes were explicitly targeted with the aim of giving them a voice, which was considered to be largely absent in previous research.

Aspirations vs expectations

There was a long-term aspiration for home ownership among the majority of participants, with a smaller number aspiring to social housing. But private renting was seen as the only short-term option as a host of challenges thwart them from realising their ambitions:

  • mortgage finance
  • family support
  • labour markets
  • student debt
  • welfare reform

The fact that housing tenure was highlighted by respondents rather than housing type or location, as previous research has highlighted, suggests there is a general dissatisfaction with living in the PRS. Indeed, it was noted that the PRS was discussed largely negatively, perceived as the ‘tenure of last resort’.

Despite the continued aspirations for home ownership, there was a marked difference between aspirations and expectations. There was a levelling down of expectations to own and a gap emerging between what the young people aspired to as their ideal and what they expected to achieve. A small minority even remarked that a more realistic goal may in fact be improvements in the PRS. The study showed that such expectations were due, mainly, to low earnings and insecure employment, combined with a lack of family financial support.

While the short-term nature of private renting makes it a very flexible rental option, it also makes it insecure and precarious, creating barriers for tenants who want to settle into a home and community. This is particularly worrying for families with children, who can be greatly affected by the upheaval of having to regularly move.

Emotional impacts

The study was particularly interested in the more intangible and emotional impacts on ‘generation rent’ and how the frustrations in realising their aspirations impacted negatively on their wellbeing.

It was stressed that issues in the PRS are having serious negative impacts on the wellbeing of young people – insecure, expensive and poor quality housing are contributing to depression, stress and anxiety. Moreover, for those on the lowest incomes, such issues are even contributing to homelessness.

Not only is mental wellbeing affected but their physical health has also been impacted by poor quality housing. Problems with rodents, damp and mould, broken white goods and poor quality accommodation in general were all reported by participants.

The experiences of the young people in the study were described as a “sad reflection of housing in the UK today” and raises questions over whether the PRS can really meet the needs of low income groups in particular.

Geography matters 

Another key finding was that where people live really matters, not only because of the spatial nature of housing and labour markets, but also as tenancy rights and regulations vary across the UK.

Recent reforms in Scotland have provided tenants with greater security of tenure and more predictable rent increases. England was highlighted as lagging behind the rest of the UK in terms of regulation and tenants’ rights as it lacks any national landlord registration scheme. Letting agent fees in England were also highlighted as a real issue in relation to affordability.

It was suggested that the rest of the UK could learn much from the Scottish experience, although there is a need to go further, particularly in relation to affordability.

Way forward

A key message from the study was that security of tenure really matters for those living in the PRS but reform of the housing system can only go so far. Participants identified more affordable housing, more protection for renters and income inequalities as areas where the government could intervene to improve things.

Based on the findings, six key policy recommendations were made:

  • ensure security of tenure;
  • take action on rents;
  • provide better education for tenants on their rights, and indeed for landlords;
  • provide more affordable housing; and
  • ensure greater understanding of intra-generational inequalities.

If the wider inequalities within society are also addressed, perhaps the PRS could become an aspiration rather than the ‘tenure of last resort’.


If you enjoyed reading this, you may also be interested in our previous posts on build to rent and meeting demand and improving data in the private rented sector.

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“The great British sell-off” – losing community assets to balance budgets

Since 2016, local authorities have been allowed to invest the proceeds of assets sold by April 2019 (now extended to 2021-22) into transforming frontline services, something they were previously prohibited from doing.  Following years of austerity and the extent of recent government funding cuts, it is not surprising that councils have used such money in this way.

However, the rate at which such assets are being sold has raised concerns over the potential loss of publicly-owned buildings and spaces.  Earlier this year, coinciding with the launch of their Save our Spaces campaign, Locality highlighted that on average more than 4,000 publicly owned buildings and spaces in England are being sold off every year – “more than four times the number of Starbucks in the UK.”

‘Financial predicament’

This year’s National Audit Office (NAO) report on the financial sustainability of councils highlights the financial predicament facing councils across the country. While it notes that the sector has done well to manage substantial funding cuts since 2010-11, financial pressure has increased markedly since 2014. In real terms, there has been a reduction in government funding of 49.1% since 2010, representing a reduction in local government spending power of 28.6%.

These cuts are coupled with rising demand for services and other cost pressures. For example, demand has increased for homelessness services and adult and children’s social care. The NAO highlights that from 2010-11 to 2016-17:

  • the number of households assessed as homeless and entitled to temporary accommodation under the statutory homeless duty increased by 33.9%;
  • the number of looked-after children grew by 10.9%; and
  • the estimated number of people in need of care aged 65 and over increased by 14.3%.

Other cost pressures have included higher national insurance contributions, the apprenticeship levy and the National Living Wage.

It is perhaps no shock that Northamptonshire county council became the first local authority since 1998 to be issued with a section 114 notice earlier this year, indicating it was unable to balance its books and at risk of being unable to set a legal budget for 2018/19. Nor is it indeed a shock that the NAO have identified other councils that are in danger of following suit in the next three years.

Despite this dire financial situation, it seems worse is to come. It has been recently announced that local services are to face a further £1.3bn cut in government funding in 2019/20. The revenue support grant, the main source of government funding for local services, will be cut by 36% next year – the largest annual deduction in almost a decade.

While the 2018 Budget has made provision for extra funding for adult social care, recent analysis suggests this falls short of what is needed to plug the projected funding gap.

Plugging the gap

In a desperate bid to raise finances, councils have been trying to find alternative income streams. A growing reliance on the use of reserves to offset funding reductions is an approach highlighted as unsustainable by the NAO. Most councils plan to increase or introduce charges for various services and many have also been making use of the government’s flexibility offer of using capital receipts to make improvements to services.

According to the NAO, in the year to April 2017, £118.5m of such capital receipts were used in this way. Locality has reported that the rate of asset sales has been consistently high for the last five years, with an average of 4,131 publicly owned buildings and spaces being sold off each year. Many councils are hoping to sell off their historic town halls to save much needed money. But it’s not just buildings that are under threat; council-owned parks and other land are also at risk. A recent parks survey, published by the Association for Public Service Excellence (APSE), found that 85% of councils surveyed expect a cut in parks and green space funding in the next year. In January, Knowsley council voted to go ahead with proposals to sell 10% of its parkland to fund the running of its remaining parks, since funding for its green spaces is to end in March 2019.

Locality warns that selling such assets on the open market could result in them being lost to the community forever as they have no real influence over what they will be used for; and could potentially lead to social, economic and environmental decline.

Indeed, concerns have been raised over the programme of disposing of council assets by Norfolk County Council, which has recently been reported to be looking to save £10m by selling its assets.

Locality suggests that community ownership is the answer to saving such assets under threat. Community Asset Transfer, set up in 2003, enables councils to sell assets to community organisations at below market rates in return for demonstrable community benefit.

In a bid to increase affordable housing supply, for example, Leicester City Council has sold council land worth more than £5m for less than £10 as part of deals with housing associations. However, the Locality report shows that less than half of councils have a Community Asset Transfer policy. It also notes that while community ownership is a ‘powerful alternative’ to losing public buildings and spaces, it is not straight forward, and community organisations face a number of barriers, including:

  • funding;
  • lack of expertise;
  • limited time; and
  • a lack of clear process.

With 95% of councils surveyed expecting the sell-off of publicly owned buildings and spaces to play an increasingly important role in the next five years, it is surely paramount that something is done to protect important community assets from being lost.

Way forward

Locality has called for the government to create a Community Ownership Fund and for a change in legislation to make it easier for community organisations to gain control of such assets.

Or perhaps councils could follow the example of others who, instead of selling their assets, are using them to generate revenue. Lewisham Council for example, is planning to raise £500k through hosting large commercial events in its parks.

Whatever route local authorities take, it remains to be seen if others will follow in the  footsteps of Northamptonshire or succeed in counteracting continuing cuts to maintain services and balance budgets; and indeed protect important community assets.


If you enjoyed reading this you may also like our previous blogs on the civic use of heritage assets and the value of green spaces.

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Open access is rapidly rising but is it succeeding?

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Image by PLoS via Creative Commons

In an increasingly digital world where accessibility is a common goal, it is no surprise that open access (OA) publishing is increasing at a rapid pace. For UK research, there has been particularly notable growth in OA adoption. In 2016, 37% of UK outputs (25% globally) were freely available immediately on publication, up from 20% in 2014. This figure reached 54% within 12 months of publication – the first time the 50% OA barrier has been breached for UK articles in the Scopus database (Elsevier’s peer-reviewed abstract and citation database).

These are among the findings of a recent report from Universities UK (UUK), Monitoring the transition to open access, which illustrates the growth in OA and its implications. While the advancement of OA is generally seen as a positive outcome, this transition is not without its challenges.

What is open access?

OA is fundamentally about making research outputs freely accessible to all with limited restrictions with regard to reuse.

There are two main routes to OA, as highlighted in the UUK report:

  • Gold or immediate OA – this refers to articles published in an OA form in a journal, allowing immediate access to everyone electronically and free of charge. Publishers can recoup their costs in various ways, including through payments from authors called article processing charges (APCs), or through advertising, donations or other subsidies.
  • Green OA – this refers to the posting of a version of the published article so that it is accessible via a website, institutional or subject repository, scholarly collaboration network or other service. Access to the publication can either be granted immediately or after an agreed embargo period.

OA articles can also be published in hybrid journals which are subscription-based but provide some articles as OA, usually for a fee. According to the UUK report, more than half of UK articles in 2016 were published in hybrid journals, the proportion of which were published on immediate Gold OA terms was 28% – up from just 6% in 2012.

Growth

The numbers and proportions of both OA and hybrid journals have continued to rise, while the proportion of subscription-only journals has fallen. The number of articles published on immediate Gold OA terms is also rising, with a high level of take-up in the UK of hybrid OA options. Particularly notable findings from the report include:

  • the proportion of titles published globally offering immediate OA rose from under 50% in 2012 to just over 60% in 2016; and to nearly 70% for journals in which UK authors have published;
  • the proportion of UK-authored articles published on immediate Gold OA terms rose from 12% in 2012 to 30% in 2016, an annual growth rate of over 30% sustained throughout the period;
  • the global proportion of subscription-based articles accessible in some version, on Green OA terms, within 24 months of publication via a non-publisher website, repository or elsewhere, rose from 19% in 2014 to 38% in 2016, while the UK proportion rose from 23% to 48%;
  • OA articles are downloaded on average between twice and four times as much as non-OA articles; and in the UK, where the numbers of full-text articles in UK repositories increased by more than 60% between 2014 and 2016, the number of article downloads more than doubled from 6 to 12 million.

The rapid rate of growth in the UK appears to demonstrate the effects of policies to promote and support OA. The government has long been committed to the transition to OA, particularly since the Finch Report, and these figures show that the UK is world leading in “a significant global movement which is fundamentally changing the way that research is conceived, conducted, disseminated and rewarded.” (UUK)

Rising costs

Most would argue such growth is a positive outcome but the rise in OA has also contributed to other issues, such as the transitional costs to universities and research funders. The findings show that costs are also rising, and at a rate significantly above inflation. The mean average APC payment rose by 16% between 2013 and 2016, compared with a rise of 5% in the Consumer Price Index (CPI).

And the number of APCs paid has grown rapidly, with the ratio between subscription and hybrid APC expenditure falling from roughly 19:1 in 2013 to 6:1 by 2016. There is evidence of various offsetting deals, although these vary significantly and can be complex. The majority of known funding for APCs has however been provided by UK funders. Therefore tools that help universities identify and manage funding, such as RESEARCHconnect, could become even more important.

Concerns have also been raised around the financial implications for learned societies that publish academic journals. Although the findings show that publishing revenues have risen steadily over the period (18%), publishing expenditure has risen by 27%, resulting in falling margins.

A mixed picture is highlighted in terms of societies’ overall financial health, with a sharp rise in the number reporting a loss, although some of the most recent losses arose from strategic decisions or exceptional items. Of course, OA is not the only factor and the wider economic and political uncertainties are recognised as particular risks.

To mitigate the financial risks, societies are diversifying their income streams which could strengthen their role. But despite publishing margins being under increasing pressure, the report identified no evidence of systemic risk to UK learned societies or their broader financial sustainability from OA.

Final thoughts

In terms of the aim of policy in the UK to achieve a shift towards OA, the fast-paced growth can be considered a success. However, as the UUK report shows, there are still a number of challenges that need to be addressed.

According to the Chair of the UUK Open Access Coordination Group, the continued engagement of all stakeholders will be important “to ensure that the transition to open access is maintained, is financially sustainable, and that the benefits to research and to society are maximised.”


RESEARCHconnect is Idox’s latest funding service which provides information on thousands of funding opportunities dedicated to the UK research community. It supports universities, research institutions and research-intensive companies across Europe in identifying and disseminating R&D funding. In the current economic climate, there is increasing pressure to exploit alternative funding sources and RESEARCHconnect ensures that global funding opportunities will not be missed. Find out more.

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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.


The Knowledge Exchange provides information services to local authorities, public agencies, research consultancies and commercial organisations across the UK. 

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It’s National Writing Day! But writing enjoyment is in decline, finds new survey

Today is National Writing Day, an annual celebration to inspire people across the UK to get writing. But this year’s annual literacy survey from the National Literacy Trust has found that children and young people’s enjoyment of writing and how often they write is in decline, suggesting that more action is needed to inspire this section of society.

Worryingly, the survey highlights that daily writing levels have been falling since 2014, and this year the Trust recorded the lowest levels of daily writing since they began asking this question in 2010 (27.0%).

What do the figures show?

Based on a survey of 47,786 children and young people aged 8 to 18 between November 2017 and end of January 2018, key findings include:

  • only half of children and young people enjoy writing very much or quite a lot (49.2%);
  • less than 1 child in 5 writes something that isn’t for school on a daily basis (17.3%);
  • more girls than boys enjoy writing (57.4% vs 40.9%) and write daily (19.9% vs 14.3%); and
  • younger children enjoy writing almost twice as much as their older peers (68.5% of 8 to 11-year-olds, 46.5% of 11 to 14-year-olds, 36% of 14 to 16-year-olds).

The percentage of children and young people who enjoy writing either very much or quite a lot decreased by 1.5 percentage points between 2016 and 2017/18, following the highest levels of writing enjoyment recorded in 2016.

Most children and young people do, however, write things on a regular basis with the use of digital technology. Most respondents said they write text messages (88.1%) and instant messages (77.8%) in their free time at least once a month, followed by short stories/fiction (44.1%) and song lyrics (35.8%). One in six children also engages in online fiction writing (such as Movellas, Wattpad) at least once a month.

This is perhaps no surprise, given the digital age we live in. However, concerns have been raised over the impact increasing use of digital technology is having on children’s ability to write. Could this be attributable, at least in part, to the declining enjoyment of writing?

Initiatives to inspire – can the World Cup help?

In an attempt to stem the decline and help inspire children and young people once again in the run up to National Writing Day, the Trust has launched a series of programmes. Drawing on the excitement surrounding the 2018 FIFA World Cup in Russia, a range of football-themed activities, competitions, teaching resources and lesson ideas have been created to boost literacy this summer. These include:

The hope is these activities will inspire more children and young people to get writing, both within the classroom and outside it.

Previous years’ activities that have drawn on the influence of football and major sporting events suggest that these activities may well achieve their aim. Following a writing competition around the Women’s FA Cup last year, teachers said their students’ enthusiasm for writing (80%), motivation to write (76%) and confidence in writing (68%) had improved.

Similarly, the Premier League Reading Stars (PLRS) programme has had a significant impact on pupils’ reading attainment. In Christ’s School in Richmond upon Thames, 80% of pupils made more than expected progress after taking part. Commenting on the success of the programme in Girlington Primary School in Bradford, Assistant Headteacher, Daniel Walker, noted:

 “Two boys made two sub levels of progress, which is the equivalent of more than a year’s expected progress in one term. One boy made dramatic progress of a whole level (3 sub-levels) in a term.”

Final thoughts

There is universal agreement that writing is important, particularly for young people, in terms of engagement and development. Even the respondents to the Trust’s survey agreed with statements highlighting the functional aspect of writing – 77.6% of children and young people agreed that writing will help them learn more and 74.7% agreed that the more they write, the better their writing becomes. Over half also agreed that they will get a better job if they are good at writing.

The fun aspect of writing, on the other hand, fared less well. Only 41.6% agreed that writing is fun, and only 34.0% agreed that writing is cool. Indeed, it has been argued that there is a need for greater emphasis on writing for pleasure. With their focus on the more fun aspects of writing, perhaps the recent programmes from the Literacy Trust and other similar programmes can help turn these statistics around.

And when next year’s National Writing Day comes around, hopefully we will be highlighting a rise in writing enjoyment.


If you enjoyed reading this, you may be interested in our previous post on writing and mental health.

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‘The great training robbery’ – one year on, is the apprenticeship levy having the desired effect?

It’s now been a full year in operation, but will the apprenticeship levy “incentivise more employers to provide quality apprenticeships” and “transform the lives of young people who secure them”, as the government hopes?

A new report from Reform, which has reviewed the available evidence, suggests that “significant reforms are needed”.

Purpose of the levy

Unveiled in 2015 as part of the government’s commitment to deliver three million apprenticeship starts by 2020, the apprenticeship levy aims to encourage employers to invest in apprenticeship programmes and raise additional funds to improve the quality and quantity of apprenticeships.

The levy mandates that employers in England with annual wage bills of over £3 million pay a tax of 0.5%, which can then be spent on apprenticeship training. Employers pay their levy contributions via the PAYE system into a digital account held by HM Revenue and Customs (HMRC). Smaller employers can also access the funds generated through the levy, but they must pay a ‘co-investment’ of 10% towards the cost of the training.

According to the 2015 Spending review and Autumn statement, the levy was expected to raise £3 billion per annum by 2019/20. However, the evidence reviewed by Reform suggests the levy is instead leading to unintended consequences.

Lower quality apprenticeships and bureaucratic burden?

The number of apprenticeship starts following the introduction of the levy has continued to fall. Reform highlights that the number of people starting an apprenticeship in the six months after it was introduced was over 40% lower than the same period the previous year. The most recent figures are little improved – in December 2017 there were 16,700 apprenticeship starts compared to 21,600 in December 2016.

Reform also found that younger and less experienced people have been particularly badly affected with the focus now being towards Higher and Degree level apprenticeships. And many apprenticeships are now for low-skilled, low-wage jobs or for re-labelled management programmes and do not meet the original definition of an apprenticeship, thus diminishing the quality.

The OCED recently highlighted the importance of maintaining skilled roles in apprenticeships, noting that:

“In the long run, even just a small proportion of low-quality apprenticeships can damage the overall reputation and “brand” of apprenticeships.”

Skills, Knowledge, Abilities

The use of the levy to re-badge existing training courses as a way to shift the costs onto government is a particular concern. A CIPD survey of more than 1000 organisations in January 2018 found that:

  • 46% of levy-paying employers think the it will encourage their organisation to rebadge current training in order to claim back their allowance
  • 40% of levy-paying employers said it will make little or no difference to the amount of training they offer
  • 35% of employers will be more likely to offer apprenticeships to existing employees instead of new recruits

Commenting on the findings, skills adviser at the CIPD, Lizzie Crowley, said “this is not adding any additional value and is creating a lot of additional bureaucracy and cost.

Reform argues that the impact on the public finances of allowing employers to re-label courses in this way should not be underestimated. It is estimated that inappropriately labelled ‘apprenticeships’ represent 37% of the people training towards any apprenticeship standard – a figure that could become even higher if employers are allowed to continue to rebadge training as they see fit.

If current trends continue, the government could be spending almost £600 million per annum by 2019-20 on training courses that have been incorrectly labelled ‘apprenticeships’.

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Concerns have also consistently been raised over the complexity of the levy for employers. It has been claimed that the slump in apprenticeship starts could be blamed on “a combination of confusion surrounding the Apprenticeship Levy and the ‘increased administrative burden’ it placed on employers”. The Reform report highlights that the substantial increase in bureaucracy, among other issues, has led business groups to brand the levy ‘disastrous’, ‘confusing’ and ‘broken’.

Despite this, however, there is still support for the levy. A recent survey by the Chartered Management Institute (CMI) of over 1,500 managers found that two-thirds (63%) agree that it is needed to increase employer investment in skills. It has been suggested that employers have ‘fundamentally failed’ to prepare for the levy as the scale of the challenge was not recognised. And a lack of clarity from the government has also been attributed some blame.

Way forward

The evidence would suggest there is potential for the levy but not in its current form.

The Reform report recommends six significant changes if the objectives for funding apprenticeships are to be realised:

  • there should be a renewed focus on quality over quantity
  • a new internationally-benchmarked definition of an ‘apprenticeship’ should be introduced
  • the 10% employer co-investment requirement should be removed
  • a simpler ‘apprenticeship voucher’ model should replace the existing HMRC digital payment system
  • all apprenticeship standards and end-point assessments should be assigned a fixed cost
  • Ofqual should be made the only option for quality assuring the end-point assessments to maintain standards

If the necessary changes are made, the Reform report concludes that “apprentices, taxpayers and employers across the country stand to benefit for many years to come.”


If you enjoyed reading this, you may be interested in our other posts on diversity in apprenticeships and higher apprenticeships.

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