Tag Archives: integration

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

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

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

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

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

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

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

Mental health

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

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

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

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Structural reform

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

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

Digital transformation

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

Final thoughts

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

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

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

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

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

Virtual reality: a game changer for mental health treatment?

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

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

The ‘Netflix of transportation’ – could MaaS be the future of urban mobility?

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Congestion, air pollution, inadequate public transport services – these are just some of the issues cities around the world are having to try and mitigate.  Could Mobility as a Service (MaaS) be the solution?

A recent webinar presented on Intelligent Transport looked at the different approaches currently being proposed, discussing the various benefits they offer and the challenges they face.

What is MaaS?

Although MaaS is enabled by technology, it was made clear from the get go that it is fundamentally about the user perspective.

Keynote speaker, Jonathan Donavan, CPO of Masabi, highlighted one definition provided by University College London’s MaaS Lab:

“Mobility as a Service (MaaS) is a user-centric, intelligent mobility management and distribution system, in which an integrator brings together offerings of multiple mobility service providers, and provides end-users access to them through a digital interface, allowing them to seamlessly plan and pay for mobility.”

Essentially, MaaS aims to provide the convenience of a private vehicle without the need for ownership, making users’ lives easier.

From the user perspective, it has to make it easier to plan and pay for travel, match the right mode of transport for the journey, be cost-effective and provide complete journey coverage. From a city perspective, it has to move people away from private cars, keep the city moving, provide equitable service to riders and optimise transport resources.

Real world examples

In an attempt to address these needs, a number of pilots have emerged. These include: the Whim app in Finland, which has now expanded to projects in the UK and Europe; Transport for Greater Manchester; UbiGo in Gothenburg, which has expanded to Stockholm; and NaviGoGo, Scotland’s first MaaS web application, similar to UbiGo, which was piloted in Dundee – to name but a few.

Other examples of MaaS in practice, include: Uber, which is expanding its market by bringing different forms of transport onto the platform; Citymapper, a journey planning app bringing in different ways of paying for and commissioning your own travel; Transit App, a navigational app based in Montreal, Canada; and Kisio’s PlanBookTicket, a mobile ticketing solution.

Stephen Miller, the Communications Lead at Transit outlined the work they are doing. Transit provides navigational services getting people from A-B without their own car, shows nearby transport and other mode options, and can track buses and trains approaching in real time. It also includes bike share, car share, your own bike, walking and now scooters, showing how multiple modes can integrate. It is the number three navigation app in the US and Canada, after Google Maps and Waze.

With PlanBookTicket, Kisio has moved towards a one platform MaaS, as described by their Chief Product Officer, Laurent Leca. It covers the data platform, trip planner, booking and ticketing, and analytics. Providing a seamless user experience, it offers a full ticket range which can be purchased with or without an account and it enables flexible integration with the existing infrastructure, making it affordable for medium-sized cities.

These real world examples show that MaaS is about enabling a simple and combined experience. Such initiatives are a good example of how the public and private sector are working together by combining various transport options. Nevertheless, there are still issues that need to be addressed for MaaS to be a true success.

Subscription or account based MaaS

MaaS has been referred to as the ‘Netflix of transportation’. However, a digital platform is very different to providing physical services and there are a lot of different services available for providing transport. In consideration of what might be the best model for MaaS, two were discussed: subscription based and account based.

Subscription based benefits:

  • Commitment to package means usage of car may be reduced, therefore shifting behaviour
  • Potential to support initial pilots
  • Under-utilised subscriptions may have roll-over model to ensure passengers don’t miss out

However, various issues were also highlighted. For example, subscription based models could favour those who can afford to pre-pay for their transport; there are potential barriers in relation to which package is most suitable and the geography of services; and there are national constraints of supply and demand.

It was also noted that the subscription demographic is a very niche one that is already well served by a mix of mobility options, but it doesn’t cover everybody. It was therefore argued that there is a need to look at different options to make it more universal.

Unlike Netflix, there is finite capacity within the transportation system and a lot of transport systems are physically constrained by something.

It was therefore suggested that perhaps more of an ‘Amazon for transportation model’ is more appropriate, where users can pay as they go for the services they need when they need them. This paves the way for an account based model.

Account based benefits:

  • Puts the city at the centre of MaaS
  • Customer does not need to pre-select their package – lower barrier to entry, more flexibility for customer and city
  • Greater equity – pay for travel once consumed
  • Greater ability to link together transit, tolling, parking and other mobility solutions

It was suggested that this provides a much more holistic option.

Future of public transit

With the success of numerous pilots across the globe, and with 85% of transport professionals in the UK who responded to the Landor Links 2018 annual survey of Mobility as a Service perceiving MaaS as an opportunity and something that would improve matters, both socially and environmentally, MaaS may well be the future of urban mobility.

Perhaps one concern, as highlighted by the author of the survey, Beate Kubitz, is resistance among public transport operators, the very people that are expected to provide the services. They only made up 4% of responses to the survey. The reason cited was because they are concerned about the costs and don’t see the business case. The automotive industry on the other hand is moving towards cooperation and collaboration with MaaS. Clearly more work is needed to increase cooperation and collaboration among the public sector.

Nevertheless, as highlighted throughout the webinar, the fundamentals are there for MaaS to be a success.

If you enjoyed reading this, you may also be interested in our other posts on the potential of smart cities and lessons from public transport in Nordic countries.

Follow us on Twitter to discover which topics are interesting our research team.

 

World Social Work Day: promoting community and environmental sustainability

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Tomorrow is World Social Work Day (WSWD), and this year the focus is on community sustainability. The theme is inspired by the third pillar of the Global Agenda for Social Work, which was created in 2010 to integrate the aims and aspirations of social workers across the world. It stresses the important role of social workers in prompting sustainable communities and environmentally sensitive development.

This includes:

  • working closely with other partner agencies – including those beyond social work – to create communities of practice, particularly in relation to environmental sustainability;
  • promoting community capacity building, through environmentally friendly and sustainable projects, where possible; and
  • responding to environmental challenges, including helping communities to be resilient to and recover from environmental and natural disasters, as well as in relation to “human disasters” which includes refugee families fleeing persecution or war.

But how does this play out in everyday practice?

Supporting integration

Across the world, social workers are being asked to address ‘human disasters’ as they seek to support and integrate refugee families fleeing persecution and war in conflict zones. Some of the biggest challenges for social workers today relate to refugee and displaced communities. As well as dealing with the effects of trauma, they also help integrate refugees successfully into existing communities and build bridges with others to promote cohesion, reduce tensions and help them make positive contributions to society. Social workers also have a responsibility to encourage all members of the community to help with this support and integration process.

However, in a UK context, supporting people to make positive contributions to their community is not limited to refugee families. It also relates to intergenerational work, valuing the experience of older people, developing the skills of vulnerable adults, or encouraging children to feel connected to a place and community so that they might better take care of it as they grow up.

Supporting sustainability

The role of social workers in supporting the sustainability agenda may not be so obvious. The ability of social workers to adapt and respond to the needs of communities which are experiencing environmental sustainability issues is of growing importance in developing countries. However, social workers in the UK can still contribute to this element of the global social work agenda.

This includes behaving in a way that recognises the need to protect and enhance the natural environment. In practice, this may mean social work departments having policies on going paperless where possible, recycling in offices, and reducing the use of cars, or car sharing (for frontline social workers, however, this is often impractical).

Social work practice can also consider how it supports sustainable social development outcomes within a community, and maintaining personal CPD, education and training levels to reflect this. There should also, as always, be an attempt to share best practice and learn from others.

Final thoughts

This World Social Work Day, let’s take a moment to reflect on the positive contributions that social work professionals are making to their communities as well as to the lives of individuals. It’s also a chance to consider what the future might hold for the profession and how it can continue to promote and support the growth and development of sustainable communities.

If you would like to follow the events going on to mark World Social Work Day or, share any of your own stories you can do so on twitter using the hashtag #WSWD17.

We regularly write on social work topics. Check out some of our previous articles:

And follow us on Twitter to see what developments in public and social policy are interesting our research team.

Housing matters: our recent publications cover issues from homelessness to housing and health

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tiny houses 4

By Heather Cameron

The Chartered Institute of Housing (CIH) annual conference and exhibition, the largest housing-focused event in Europe, takes place this week. Over the next three days the conference will examine and explore the political and policy environment, the economic outlook and the latest thinking across the sector.

A variety of topics will be addressed, including housing supply, housing policy, social housing, welfare reform, regeneration and homelessness. These topic areas feature extensively on our database, some of which we have also written about. So this is a good opportunity to highlight some of our recent publications in this area.

What we’ve published

Our most recent ‘In focus’ briefing looks at housing retrofitting, something that has been highlighted as essential for improving the energy efficiency of our housing stock. It considers the benefits of renovating domestic properties to improve energy efficiency and environmental performance and describes the features and technologies of retrofit, such as heat pumps, combined heat and power and various types of insulation. The environmental, economic and social benefits as well as the barriers are summarised. Recent developments concerning retrofit schemes introduced by the UK government and the devolved administrations are also described, and there are examples of good practice from the Netherlands, Sweden and the UK.

Last month we published Delivering solutions to tackle homelessness (Ideas in practice), which looks at the scale of homelessness across the UK and its causes, and provides innovative examples of projects and initiatives that are tackling the problem.

The examples of innovative approaches highlighted include:

We have also written a series of blogs on the topic of homelessness. These include a look at the Christmas Dinner campaign for the homeless run by Scotland’s not-for-profit sandwich shop, Social Bite, while also highlighting the recent increase in homelessness in Scotland and the UK, and the shocking number of homeless children at Christmas.

Another blog post looks at the problem of the hidden homeless and its financial and human costs.

Digital inclusion and the social housing sector is the topic of another ‘In focus’ briefing. This looks at the benefits of digital inclusion, the barriers to digital inclusion for social housing tenants, and how these might be overcome. It refers to a 2012 report which found that almost half of the UK’s adult population who do not use the internet live in social housing, suggesting digital exclusion is a particular problem in the sector. It includes examples of good practice and highlights the importance of digital inclusion in the context of welfare reform.

We also recently blogged on this topic, highlighting one of the examples of best practice featured in our briefing: a case study of a collaboration between Reading Room – a digital consultancy which joined the Idox Group in 2015 – and Catalyst, one of the leading housing associations in London and the South East. This collaboration highlights the potential of technology for improving communications between social housing providers and their tenants, and for encouraging more people to reap the benefits of going online.

Another topic we have looked at is the integration between housing and health. Housing conditions can affect the physical and mental health of people, and can contribute to many preventable diseases and injuries. The ageing population is also putting pressure on the NHS, and growing numbers of older people have to stay in hospital longer because their homes are unsuitable for their recovery. Our briefing notes that housing associations, local authorities and healthcare providers have been working on solutions to tackle these challenges, and provides case studies from London, Tyneside and Bristol as examples of greater collaboration between housing and health services.

The challenges of an ageing population for the housing sector has also been highlighted in our briefing on meeting the housing needs of older people. It indicates that there will be a need for: adaptations to existing housing stock; mainstream rented accommodation built to accommodate wheelchair users; and newly built specialist accommodation. Examples of good practice – including case studies of extra care housing from Calderdale Council, and adapting homes for older and disabled residents in Knowsley, Merseyside – are highlighted.

This is just a flavour of what we’ve recently covered on housing-related topics, and we will inevitably produce more as the sector responds to a time of change and uncertainty.

Some of our briefings are only available to members of the Idox Information Service.

Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

‘High quality and equitable outcomes for all’ – highlights from the Scottish Learning Festival 2015

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By Rebecca Jackson

“High quality and equitable outcomes for all”  – that was the theme of this year’s Scottish Learning Festival held last week at the SECC in Glasgow. A mix of academic and policy based seminars, converged with practitioner based learning during the session on Wednesday.

Out of a packed schedule we chose to attend the launch of a new initiative to encourage more STEM teachers; information on the Scottish Attainment Challenge, delivered by Education Scotland and the Scottish Government; and a promotion of employment partnership learning, showing how schools and colleges can engage more with local business to provide opportunities for students.

A fundamental commitment of the Scottish Government

The keynote speech on Wednesday was delivered by Angela Constance MSP, Minister for Education at the Scottish Government. In her address, she stressed the importance of the key themes of the conference, which were collaboration, best practice and ensuring that no child in Scotland should be unable to fulfil their potential at school because of their background or their ability to pay.

Scottish education she said, would be “driven by evidence of ‘what works’ “ and “education in Scotland must be about ability to learn, not ability to pay, at all levels” and that this was a fundamental commitment on the part of the Scottish Government.

She also launched a new initiative aimed at getting more STEM teachers into the teaching system in Scotland. Teachers, she said, were key not only to teaching but to inspiring students to pursue subjects to a higher level.

She awarded the Robert Owen Award for an Inspiring Educator to Professor Graham Donaldson, the man behind Teaching Scotland’s future report on the education of Scotland’s teachers.

Angela Constance MSP addresses the conference. Rebecca Jackson, 2015

Angela Constance MSP addresses the conference. Rebecca Jackson, 2015

Tackling the attainment gap: the Scottish Attainment Challenge           

The Scottish Attainment Challenge was promoted as an accelerator of change, building on what has already been done in Scotland and using core values and agreed outcomes to create a system which takes a uniquely Scottish approach. The focus is on 4 key areas, and is delivered by a three way framework which uses a national hub, inter authority collaboration and support and the Scottish Attainment Fund.

The four key areas are:

  • Collaboration for improvement
  • High quality teaching and learning
  • Linking with family and community
  • Supporting nurture and well-being.

Speakers in this seminar emphasised that in Scotland, policy needs to be driven by what works. The challenge, they said, could not be delivered in isolation. Kevin Helman from Stirling and Clackmannan provided a local authority perspective. He highlighted the role of head teachers sharing best practice among schools.

The Scottish Attaniment Challenge outlined in Stirling and Clackmannan. Rebecca Jackson, 2015

The Scottish Attaniment Challenge outlined in Stirling and Clackmannan. Rebecca Jackson, 2015

The Girls in Energy Programme

Employment partnerships between schools and businesses could be a key way to promote vocational learning and encourage STEM subjects in schools. We’ve written before on this blog about the need to build STEM skills in the UK and especialy the importance of providing girls with STEM role models.

It was encouraging therefore to hear in another seminar session about the Girls in Energy programme, an Aberdeenshire based project between Mintlaw Academy and Shell.

The project provides a useful blueprint which could be recreated across Scotland. The programme combines:

  • blended learning, of academic and vocational qualifications (2 HNC’s and 1SVQ level 2);
  • industrial visits;
  • a 2 week placement.

Girls in Energy programme. Rebecca Jackson, 2015

Girls in Energy programme. Rebecca Jackson, 2015

There was an emphasis on how the scheme boosted employability skills, including interview technique, presentation skills and communicating with others, equipping the girls involved with practical skills valued by employers.

Practitioners and students who have been through the scheme were keen to stress that the scheme could easily be recreated if strong relationships between education and industry/business are forged. They highlighted the potential in engineering, construction and other industries which could follow the same outline as their model.

All that is good about Scottish education

The conference highlighted all that is good about the Scottish education sector. The stalls and exhibition space were filled with people who are passionate about providing a better, more equal and well-rounded education for children in Scotland.

However the conference also emphasised the core values of what academics and practitioners feel  is needed to drive education forward in the future – an understanding and sharing of best practice and resources, and the ability to integrate multiple aspects of learning to create a better experience for teachers, local authorities and children alike.

Enjoy this article? Read some of our other popular blogs on education:

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

How is health and social care integration being achieved in England?

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By Steven McGinty

Since coming to power in 2010, the coalition government has introduced a series of major reforms to health and social care. They argue that these reforms are necessary for meeting the future needs of patients, as well as providing a more efficient public health service.  Central to these changes is the idea of integration, where services are delivered in a way that limits duplication, delivers more preventative care and targets resources more effectively. However, what has the government done to facilitate integration between health and social care?

In 2012, the Health and Social Care Bill was given royal assent and became an Act. The Act introduced a number of key changes to the way that healthcare is delivered, including:

  • the merging of a numbers of quangos, such as the Health Protection Agency and the National Treatment Agency for Substance Misuse, into one national body, Public Health England (PHE);
  • the abolition of Primary Care Trusts (PCTs), and the introduction of Clinical Commissioning Groups (CCGs), which are GP led bodies responsible for the commissioning of local health services, as well as a greater responsibility for local authorities;
  • the extension of the remit of bodies, such as Health and Wellbeing Boards, giving them extra responsibilities, including the development of strategies across health and social care to meet local public health issues;
  • the introduction of a new organisation, Healthwatch England, an independent body set up to promote the interests of patients in health and social care services.

In 2013, the government introduced a new funding mechanism known as the ‘Better Care Fund (BCF)’. This was a £3.8 billion pool of money to support health and social care bodies through the process of integration. Health and Wellbeing Boards (HWBs) are expected to provide plans to access the funding. These plans are assessed using criteria that includes:

  • how well data is shared between health and social care bodies;
  • how well plans protects social care services;
  • how it protects seven day a week services;
  • how well it reduces admissions to hospitals at weekends.

According to the County Councils Network, plans will have to show how services will be delivered in an innovative way that meets the local needs of people over the long term, in order to ensure funding.

In 2014, the government introduced the Care Act, a piece of legislation based on the 2011 Dilnot report into the funding of adult social care. The Act has been described as the biggest transformation in the care system since 1948, and introduces a number of significant changes, including:

  • that those who receive care from a regulated care provider or local council will be covered by the Human Rights Act, although those paying for care are not covered;
  • introducing a new cap of £72,000 on the cost of care for those eligible under the Act;
  • introducing duties for local authorities to offer prevention services, including the right to receive accessible information and advice, to try and reduce the numbers of people needing to go into hospitals.

The current Minister of State for Care and Support, Norman Lamb MP, has stated that the government is committed to integrating health and social care by 2018. However, it will be very interesting to see if the health care system can be fully integrated by that deadline and whether it can deliver the sort of outcomes expected.

Idox are involved in an innovative partnership with Calderdale Council. The council has developed an innovative case management tool to support their day-to-day work, in areas such as child protection, looked after children, and fostering and adopting.

Calderdale have teamed up with Idox, a specialist in providing technology, content and funding solutions to government, and are now offering their system to other local authorities. The partnership has already proven to be successful, with Calderdale and Idox providing their solution to councils in the Isles of Scilly and Leeds.

We blogged recently about the benefits of the system for integrated working. We have also looked at the barriers to the uptake of digital technologies in health and social care.

Further reading:

Putting the “Smarts” into Smart Cities

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Liverpool Albert Dock

by Rebecca Riley

Last week I attended a workshop organised by Red Ninja Studios, bringing together a wide range of place based organisations, to explore what a technologically integrated future for Liverpool would look like. We spent the day exploring the three main domains of economy, health and transport, what the issues were in the city, what data was available and what innovative ideas we had to solve the issues through technology.

The discussion was interesting and lively but throughout the sessions I kept coming back to ‘why?’. Technology seemed to be the answer but what was the question, what were we trying to achieve?

Smart Cities is the latest policy buzzword – our briefing earlier in the week highlighted the wealth of research and development which is going on in this area and how great leaps in technology are changing the way we live and work in cities. The danger with looking at developing Smart Cities is that the opportunities and options are boundless, and this came through in the workshop. Smart travel systems, integrated health care, environmental measurement, technology development, graduate retention, high quality jobs, access to learning –  all could be tackled through integrated next generation technology. So how do we prioritise and get the highest impact we can in a city such as Liverpool?

One of the participants asked “what connects all these ideas, what integrates them?” the simple answer is people, not technology.

So on returning to my desk (or rather my kitchen as I am one of the nation’s 4.2m home workers) I started to think about what ‘people’ would want from a technology driven environment, rather than what the technology will deliver to the people.

A guide on service design in smart cities highlights that we have to start with the ‘business proposition’; people have to be willing to ‘buy’ the service on offer. It highlights two reasons for improvement:

Improving customer service

  • Increasing the take up of services among key groups to achieve targets
  • Making it easier to access services
  • Giving a better service
  • Giving a service targeted to individual needs
  • Giving access to a broader range of services

Improving efficiency

  • Increasing take up among key groups to increase income
  • Increasing early take up and reducing more expensive interventions later
  • Improving processes to streamline services and reduce costs
  • Switching customers to more cost efficient channels

These business imperatives should be at the heart of any technology implementation and technology can impact across all these goals but, form should follow function.

When people were asked by Steer Davies Gleave what words describe a ‘Smart’ city their response was surprising. Although there were a wide range of answers (reflecting the diversity of the term), ‘clean’ and ‘technology’ came out top, followed by ‘transport’, ‘friendly’, ‘connect’, ‘internet’ and ‘eco’. Overall people said smart cities should aim to be ‘a pleasant place to live, work and socialise’ with a ‘healthy, vibrant economy’, and sustainability was at the bottom of the list. When answers were normalised for population, Oxford, York, Bath and Cambridge were seen as the most ‘smart’ cities – all areas with higher ‘smart’ populations as well as ‘nice’ places to live. The priorities for making cities smarter were seen as availability of facilities and services (shops, places to eat and drink, sports and entertainment), modern public transport and safe, secure travel. People want good quality of life experiences.

Future Everything presented a series of essays aimed at shifting the debate on future cities towards the central place of citizens and open urban infrastructures. The essays focus on how cities can create the policies, structures and tools to engender a more innovative and participatory society. Dan Hill discusses the idea that “smart citizens make smart cities” and a city cannot be ‘managed’– it’s a living organic response to people’s lives, where people are often invisible in the management of transport or infrastructure systems. As Hill says, smart cities do not exist, but smart citizens do. The city is its people and technology should enable people to come together.

Can we harness the power of the citizen as an ‘organic sensor’ to improve services, drawing them in to actively engage with improving society? Can a ‘smart city’ be one where active, participatory, citizenship becomes central to the development of infrastructure? If a cities’ smart citizens applied their Instagram, TripAdvisor and Twitter engagement to the transport network or the health centre they use would it drive more responsive services? The answer is yes, but only if those services are listening or care. How can technology help citizens reclaim their space; would we all share information if it improves our quality of life?

The challenge for technology is to respond to the smart citizen, the millennials and generation Alpha will have very different demands, ones we cannot conceive of now. The challenge for government and large technology firms is not to emphasise top-down solutions but to respond to the issues, aspirations and abilities of individuals and make personal and civic responsibility core to a Smart City Vision.

Further reading

Smart cities – the who’s, what’s, where’s?

Accenture Survey 2013: What Travellers Want from Public Transport Providers

Smart Cities and Smart Citizens

Understanding Smart Cities: An integrative Framework

Smart Citizens

The Smart City Market: Opportunities for the UK

The way forward for mental health services for children and young people

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Black and white photo of young girl.

Image courtesy of Flickr user darcyadelaide using a Creative Commons license

By Steven McGinty

“Not fit for purpose” and “stuck in the dark ages”

These are two of the phrases used by the Care Minister, Norman Lamb, to describe mental health services for children and young people in England. The minister admitted that young people are being let down by the current system and has announced that a new taskforce will look into how the system should be improved.  To coincide with this review, I decided to look at the current situation for children and young people with mental illness, as well as highlight some of the main themes from the latest evidence.

The Office for National Statistics (ONS) reports that one in ten children and young people (aged 5-16) have a clinically diagnosed mental health disorder. This covers a broad range of disorders, including emotional disorders, such as anxiety and depression, as well as less common disorders such as autism spectrum disorders (ASD) and eating disorders. Approximately 2% of these young people will have more than one mental disorder. The most common combinations of disorders are conduct and emotional disorders and conduct and hyperkinetic disorders.

The likelihood of a young person developing a mental disorder is increased depending on a number of individual and family/ social factors. There are a whole range of risk factors, but some of these include:

  • having a parent in prison
  • experiencing abuse or neglect
  • having a parent with a mental health condition
  • having an autistic spectrum disorder (ASD)

It’s important to note that mental illness is complex, and that not everyone in these risk groups will struggle with it. This is particularly true when a young person is in receipt of consistent long-term support from at least one adult.

The impact of mental illness can be particularly difficult for young people. For instance, the National Child and Adolescent Mental Health Service (CAMHS) Support Service reported that young people who suffer from anxiety in childhood are 3.5 times more likely to suffer from depression or anxiety in adulthood. There is also an increased chance of young people coming into contact with the criminal justice system, with Young et al highlighting that 43% of young people in prison have attention deficit hyperactivity disorder (ADHD). The Centre for Mental Health also suggests that young people with mental health problems struggle to achieve academically, as well as in the employment market.

When a government minister condemns his own department, it’s evident that there are severe problems.  However, this does not have to be the case.

Below I’ve outlined some of the key lessons to come from evidence on what makes a good mental health service for children and young people.

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The Public Bodies (Joint Working) Scotland Act 2014 – should it have gone further?

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Health Cubes_iStock_000022075266Largeby Steven McGinty

Last month, on April 1st, the Public Bodies (Joint Working) Scotland Act 2014 was given its royal assent. According to Alex Neil, Cabinet Secretary for Health and Wellbeing, this new addition to the statute book signifies a ‘landmark’ change for the provision of healthcare in Scotland. The Act will be introduced in stages, with the full integration of health and social care expected by April 2016. The principal aim is to provide better patient outcomes through the integration of health and social care services. There has been broad support for the new legislation, but some say the Act has not gone far enough. Continue reading →