Zero suicide cities: learning from Detroit in the UK

Suicide is the biggest killer of men under the age of 45. Yet people still experience stigma when seeking help for mental illness, despite high-profile discussions of mental health issues such as those by members of the royal family and sportspeople. And a report into the Government’s suicide prevention strategy in March 2017, suggested that although 95% of local authorities now have a suicide prevention plan, there is little or no information about the quality of those plans, or whether adequate funding is available to implement them.

The lack of progress made on improving suicide and general mental health provision has led to a growing frustration among professionals and resulted in attempts to create new approaches to tackle mental health issues, and in particular to improve access to support for people in crisis or at risk of suicide.

The idea of a “zero suicide city” was first adopted in Detroit in the late 2000’s, with others following its lead in subsequent years. With reports finding that around 14 Londoners a week took their own life in 2015 (735 in total), an increase of a third from the 2014 statistics, a report in February 2017 by the London Assembly Health Committee suggested that London too should take this approach.

So what can London, and other areas of the UK, learn from Detroit’s approach? And how can services act to reduce the number of people taking their own lives?

Zero-suicide cities

Poverty and high unemployment in Detroit are contributing factors to high levels of depression among city residents. As a result of these high rates of depression and very high suicide statistics, Detroit-based mental health professionals adopted a new approach to tackle the stigma around mental illness and use identifiers to highlight cases of crisis, or potential crisis. The focus is on preventative care, encouraging professionals to act upon signs of mental illness before a suicide or attempted suicide takes place.

Patients attending health clinics for other illnesses, including diabetes or heart failure, are also now screened for depression and other mental health issues before they are released. This allows people deemed to be ‘at risk’ to be identified as soon as they come into contact with medical professionals, who can then refer the patient to a mental health specialist if needed, rather than reacting to mental illness once it reaches crisis point.

In order to support this approach, a centralised IT system was created which means results are traceable, and surveys and information are standardised so they can be used and accessed across clinics throughout Detroit. Coordination with non-medical practitioners, including social workers, employers and family members, has also been key in identifying people at risk and signposting them to help at every possible opportunity. There has also been additional training for staff to improve recognition of identifying factors. Patients can email their clinicians or liaising staff directly and attend regular drop-in appointments. Up to 12,000 patients using mental health facilities are tracked each year in the city and some statistics suggest that the clinics reduced suicides by over 80%.

There have been some criticisms of the system however, despite the reduction in the number of suicides in the city. Critics highlight the fact that many of the poorest and most severely in need of help are not reached as they do not have health insurance and so do not attend those clinics involved in the scheme.

Ultimately, however, the scheme seeks to provide better preventative, coordinated and targeted care to those who are at risk or show some signs of mental health crisis. And some in the UK have suggested there are lessons that could be learned from this approach.

Whole system approach to suicide prevention in the East of England

Four local areas in the East of England (Bedfordshire, Cambridgeshire & Peterborough, Essex and Hertfordshire) were selected in 2013 as pathfinder sites to develop new approaches to suicide prevention based in part on the Detroit model.

Since then, Mersey Care, Cambridge and Peterborough Clinical Commissioning Group and Teesside councils have also become aligned with the programme and are continuing with their approach towards improved suicide prevention. The Centre for Mental Health evaluated the work of some of the sites during 2015.

The evaluation found there were a range of activities that had taken suicide prevention activities out into local communities. They included:

  • training key public service staff such as GPs, police officers, teachers and housing officers
  • training others who may encounter someone at risk of taking their own life, such as pub landlords, coroners, private security staff, faith groups and gym workers
  • creating ‘community champions’ to put local people in control of activities relating to promoting positive mental health and signposting to help services
  • putting in place practical suicide prevention measures in ‘hot spots’ such as bridges and railways
  • working with local newspapers, radio and social media to raise awareness in the wider community
  • supporting safety planning for people at risk of suicide, involving families and carers throughout the process
  • linking with local crisis services to ensure people get speedy access to evidence-based treatments.

However, subsequent research also highlighted some of the challenges. The marketing of the pilots was seen to be damaging and misleading with regards to creating “zero suicide areas”, rather than suicide prevention areas. It has also been suggested that although the campaigns serve to raise publicity and awareness, there is little evidence that the schemes actually reduce the number of suicides in an area any more than “traditional campaigns” to better signpost people to available support.

In addition, many of the projects struggled past the initial implementation stage to have long-term impact, as the buy-in from local GPs and other service professionals was not as high as was expected.

Final thoughts

Widening and improving access to support and services for people at risk of mental ill health or suicide is a big challenge for health and social care professionals. Identifying those people at risk is one of the key barriers and taking inspiration from schemes like those trialled in Detroit is one way for professionals in the UK to adapt their approaches in order to overcome these barriers.

Providing more opportunities for people to get help, and better training for professionals who may come into contact with people with mental illness are some of the ways that current schemes are trying to address mental health and suicide in particular.

However, as many of the evaluative studies from test sites in the UK have found, going beyond that to take mental health into the community, in order to create whole system pathways of care across multiple settings and professions, remains a challenge.

As the London Assembly report pointed out, another key aspect is creating an open environment for people to talk about how they are feeling. This week is Mental Health Awareness Week 2017 and the theme is ‘surviving to thriving’ – and emphasising that good mental health is more than the absence of a mental health problem. Whether in the workplace or in the home; with friends, family or colleagues; it’s important that everyone feels that they have a space where they can talk, and to cultivate resilience and good mental health.


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Driving diesel out of town: how cities are tackling the deadly problem of air pollution

2017 was less than a week old when, on a single day, London used up its entire annual air pollution limit.  European Union air quality standards permit the maximum safe levels of toxic nitrogen oxide (NO2) to be exceeded no more than 18 times a year. But on 6 January just one site – Brixton Road in Lambeth – generated levels of NO2 high enough to burn through the capital’s annual limit.

Experience underlined that the first breach of the year was always unlikely to be the last. In 2016, another part of London (Putney High Street) exceeded the limit 1,200 times. Other UK cities are also badly affected by air pollution. Government figures show that 38 out of the country’s 43 air quality zones breached legal limits for air pollution in 2015.

The deadly effects of air pollution

Since 2012, evidence on the effects of air pollution on the environment and public health has been mounting. Health issues such as cardiac and respiratory conditions can be aggravated by poor quality air, which can also cause lung cancer. In the UK, pollution is estimated to cause the early deaths of 40-50,000 people each year, while in London 9,500 are believed to have died prematurely in 2010 due to air pollution. Beyond the human costs, poor air quality also has economic costs (around £15-20 billion a year), as well as damaging biodiversity, wildlife and crops.

Action on air pollution

“Nearly 40 per cent of all NOx emissions within London come from diesel vehicles, and unless this is explicitly tackled it will be impossible to cleanse London’s air.”
Lethal and illegal: solving London’s air pollution crisis – IPPR

The most significant cause of poor air quality in the UK is road traffic pollution, and in particular nitrogen oxides (NOx) from diesel engines. In recent years, scientists have been highlighting the dangers of diesel, but the Volkswagen emissions scandal underscored just how bad diesel vehicles are for urban environments.

In 2015, the UK government announced plans to discourage diesel vehicles from entering clean air zones in Birmingham, Leeds, Southampton, Nottingham and Derby. Further measures are expected to be unveiled in the coming weeks. Meanwhile, the Mayor of London,  Sadiq Khan, announced yesterday that from April 2019 the most polluting vehicles will have to pay a daily charge to drive within central London. He is also proposing to expand this charge, the Ultra Low Emission Zone (ULEZ), across Greater London for heavy diesel vehicles, including buses, coaches and lorries. In the meantime, from October this year, cars, vans, minibuses, buses, coaches and heavy goods vehicles (HGVs) in central London will need to meet minimum exhaust emission standards, or pay a daily £10 Emissions Surcharge (also known as the Toxicity Charge, or T-Charge). In addition, London has been considering more innovative approaches to cleaner transport.

Last month, four House of Commons committees announced an unprecedented joint enquiry into the health and environmental effects of toxic air. Louise Ellman of the Transport Committee acknowledged the need for an efficient and flexible transport system, but added:

Emissions from vehicles are a significant problem and the standards that governments have relied on have not delivered the expected reductions. We will be asking what more can be done to increase the use of cleaner vehicles as well as to encourage the use of sustainable modes of transport.”

Cracking down on diesel vehicles

But many believe tougher action is needed, and that the time has come to drive diesel vehicles out of towns and cities.

This month, Westminster City Council becomes the first in the UK to impose additional charges for parking diesel-powered vehicles. For a trial period, drivers of diesel cars and vans will have to pay an additional 50% to park in one of the borough’s most heavily polluted streets.  Westminster’s Councillor David Harvey believes the charge will cause drivers to make more environmentally-friendly choices:

“Additional charges for diesel vehicles will mean people think twice about using highly polluting cars and invest in cleaner transport that will make a real difference in the quality of air we breathe and our environment.”

Another London council – Hackney – has gone further, announcing plans to ban any non-electric cars from parking on several streets bordering the City of London’s financial district.

International action

Beyond the UK, national and local governments are also taking the problem of air pollution caused by diesel emissions more seriously.

In December 2016, the longest and most intense pollution spike for a decade jolted the authorities in Paris into restricting traffic coming into the city. On alternate days, drivers of vehicles with odd-number and even-number licence plates were told to leave their cars at home. At the same time, public transport in the city and the suburbs was free of charge. The following month, a mandatory scheme was introduced in Paris and Lyon obliging drivers to display anti-pollution stickers indicating the age and cleanliness of their vehicles. Paris had already announced that cars registered before 1997 would be banned from the city between 8am and 8pm on weekdays.

Paris has also forged a joint agreement with Athens, Madrid and Mexico City to completely remove diesel vehicles from their city centres by 2025. The Netherlands is also believed to be considering a diesel ban, although reports of a similar move in Norway proved premature.

Meanwhile, Barcelona’s ambitions for car-free “superblocks” to improve the city’s air quality have received international attention, but have also encountered some local resistance.

The death of diesel?

Some are concerned that a total ban on diesel vehicles is being put forward too easily as a solution to the problem:

Transport for London recently sought public consultation on what they should do to improve air quality, and their website notes that people are twice as likely to die from lung diseases if they live in “deprived vs. affluent areas of London”, both signs that this problem is too complex to be solved by a blanket ban on diesel cars.”

But as the case mounts against diesel, drivers are taking note. In February 2017, registration of diesel cars in the UK fell by 9.2%, while demand for alternative fuel vehicles saw a dramatic increase of 48.9%. London and other UK cities may not yet have completely banned diesel vehicles from their centres, but increasingly the question is not if, but when.


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Graduate ‘brain drain’ – is regional economic growth the solution?

college graduates groupBy Heather Cameron

With the economic performance of cities and regions increasingly reliant on the skills of their workforce, the longstanding issue of graduate ‘brain drain’ to London and the south is something that needs to be addressed.

Although students attend many of the universities spread across the country, a significant number of graduates flock towards the capital at the end of their studies. According to a recent report from Centre for Cities, this deprives other cities of skilled workers and essentially damages the overall economy.

The evidence

A quarter of all new graduates in 2014 and 2015 were found to have moved to work in London within the six months of finishing their degree. And the highest achievers make up a significant proportion. While London accounts for around 19% of all jobs, of the graduates that moved city six months after graduation London employed 22% of all working new graduates, and 38% of those with a first or upper second class degree from a Russell Group university.

Although most cities experience an overall graduate gain, cities outside London don’t retain the majority of students that move to their city to study – the ‘bouncers’ that drive the brain drain overall, overshadowing any gain:

  • Manchester lost 67% of these students upon graduation;
  • Birmingham lost 76%; and
  • Southampton lost 86%.

Other figures show that 310,000 graduates have left the north in the past decade, contributing to a net average deficit of 7,500 highly qualified workers leaving annually, or 75,500 over a decade.

Northern regions have to some extent offset the effect of local brain drain by attracting enough highly qualified foreign workers to fill the gap. But with reductions in immigration, these regions could be left lacking.

Given the UK’s current position regarding the EU, concerns have also been raised over whether Britain faces a further brain drain of academics to Europe, following Brexit. A recent survey highlighted that 42% of academics said they are more likely to consider leaving Britain after the vote to leave.

Why?

While it may seem plausible to assume that higher salaries are the reason for this brain drain, it appears that the main pull for graduates is the availability of jobs and career progression, which London’s vast labour market offers.

However, as recent research from Homes for the North has identified, these are not the only reasons. It highlights the importance of additional non-work drivers of graduate location decisions, including the cost and quality of housing, quality of local amenities and the prospect of home ownership.

Of the graduates polled, 80% said the quality of housing was important, while more than 60% said the cost of housing was important. The quality of green spaces and local amenities was also deemed important by over 60% of graduates.

What can be done to redress the balance?

There have been numerous graduate retention initiatives at the local and regional level aimed at tackling the uneven distribution of graduates, such as graduate wage subsidies and local graduate job matching.  But it seems little has improved. The Centre for Cities research argues that these alone will not tackle the root cause of the graduate brain drain.

It suggests that cities themselves have a vital role to play in ensuring the local job market offers an appropriate number of graduate job opportunities that will allow them to both retain graduates and attract graduates from elsewhere. Policy should therefore broaden its focus to improve local economies by investing in transport, housing and enterprise, rather than focusing solely on graduate retention and attraction policies.

The chief executive of the Centre for Cities commented that the government’s new economic and industrial strategy should be used to strengthen existing devolution deals for city-regions such as Greater Manchester, extending their scope to grow.

Indeed, the industrial strategy green paper, published in January, clearly places emphasis on addressing the economic imbalances across the UK through a number of measures, such as working with local areas to close the skills gap, including new schemes to support the retention and attraction of graduates. However, the strategy has been criticised for providing little clarity on how regional rebalancing and sectoral deals will work in practice.

Final thoughts

While it appears clear that cities outside London need to improve their graduate offer with better job prospects, the evidence on graduate migration suggests it is more complex than this.

As has been argued, the provision of good quality affordable housing could play a role alongside high-skilled job creation and opportunities. With the cost of living in London so expensive, this would make sense, particularly as the average graduate salary in London is not that much higher than the average across other UK cities.


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Night mayors: building bridges between businesses and communities

We’ve previously written about the importance of the night-time economy as a driver of tourism, leisure and business growth in towns and cities. And we’ve also blogged about the challenges facing night-time industries, notably the number of nightclubs forced to close due to economic factors and security concerns.

A growing number of city authorities are responding to these developments, and exploring new ways of meeting the distinctive economic development, public safety and quality of life demands presented by cities after dark.

The pros and cons of the after-hours economy

The UK night-time economy is substantial. One estimate has put its value at £66bn, employing 1.3m people. In London, an already thriving after-hours economy is set to grow by a further £77m a year following this year’s launch of the 24-hour Tube on the Victoria, Central and Piccadilly lines.

But a city’s nightlife is about more than commerce. Noise, violence and other forms of anti-social behaviour can upset nearby residents, and put people off living in or visiting a city.

Some authorities have taken a hard line towards areas with a reputation for trouble at night. The New South Wales government has introduced laws to crack down on drug and alcohol-fuelled violence in parts of Sydney. But, while the new rules – including 1.30am lockouts and 3am last drinks at nightclubs – have reduced street crime, their impact on Sydney’s night-time economy has been devastating. More than 100 venues have closed, and the once booming entertainment district of King’s Cross is now being described as a ghost town.

Night mayors: bridging the divide

There’s a balance to be struck between protecting communities from anti-social behaviour and enabling a dynamic night-time economy to flourish. One idea for bridging these competing interests is the appointment of an individual dedicated to the needs of the city after dark.

Shortly after the Night Tube started operations, the Mayor of London, Sadiq Khan, announced plans to appoint a “Night Czar”. The role of this new figure will be to engage with night-time businesses, residents and public authorities, and to create a “vision for London as a 24-hour city”. And on 4 November it was confirmed that the new Night Czar would be the writer, broadcaster, DJ, performer and campaigner Amy Lamé.

London is following a trend set by other cities that have recognised the need for a distinct approach to their after-hours economies. In 2014, Marik Milan was elected Amsterdam’s first night mayor. Previously a nightclub promoter, Milan leads a non-profit foundation funded jointly by the city council and the business community.

One of his early successes has been helping to establish 24-hour licences for selected nightclubs on the outskirts of Amsterdam. It’s hoped that the relaxation of licensing laws will help to relieve the pressure on the city centre, while regenerating pockets of the city lacking both daytime and night-time offerings. And, given that most problems happen when clubs are opening or closing, the 24-hour approach may also lower the chances of disturbances.

Marik Milan also wants to bring some of the positive lessons from music festivals into the centre of Amsterdam. He’s suggested that the presence of stewards, trained in how to de-escalate situations and report incidents, could make for a safer city, especially at weekends.

Milan believes his approach, in contrast to that adopted in Sydney, is more likely to bring positive results:

“Cities are always interested in solutions, but if they keep treating night life as a problem, they’ll keep having the same outcome.”

An idea whose time has come?

The successful deployment of night mayors in Amsterdam and other Dutch cities has prompted municipalities around the world to consider, and in some cases, to copy their example. In France, night mayors have been elected in Paris, Toulouse and Nantes, and they are also to be seen in Zurich and most recently in the Colombian city of Cali. Similar posts have been proposed for cities such as Berlin, Dublin, Toronto and New York.

Earlier this year, Amsterdam hosted the first Night Mayors Summit, at which city representatives could combine knowledge and share experiences on their night-time economies. This short film, from Monocle magazine, reports on the summit, and explains how the cities of Amsterdam, Berlin, Tokyo and Sao Paulo are exploring creative approaches to managing the night-time economy.

It remains to be seen whether London’s new night czar can win the support of local communities while championing the capital’s night time culture. But the experience of Amsterdam suggests that it’s an idea worth exploring.


If you’ve enjoyed his blog post, you might also like our other posts on the night-time economy

 

Mobilising healthy communities: Bromley by Bow Health Partnership

Ian Jackson of the Bromley by Bow Health Partnership was the guest speaker at the first Glasgow Centre for Population Health (GCPH) seminar series of the year.

The Bromley by Bow Health Partnership (BBBHP) is a collaboration between three health centres and other non-primary care partners in the Tower Hamlets area of London. The aim of the partnership and the new primary care delivery model which comes with it is to transform the relationship between the public and primary health care. This means considering the wider determinants of health when the partners plan and deliver care, rather than treating healthcare in a purely biomedical way.

Edited image by Rebecca Jackson. Map via Google Earth

Edited image by Rebecca Jackson map via Google Earth

Effect of social determinants on health

In the 1890s Charles Booth created a map of London which categorized areas of the city of London depending on their levels of deprivation. The most recent Indices of Multiple Deprivation Report showed that those same areas considered deprived in the1890s are still facing the highest levels of multiple social deprivation and health inequality today. It is no secret that disadvantage has a negative impact on people’s ability to make the best choices when it comes to health. And disadvantage at a social level can have a significant influence on poor physical and mental health across a range of conditions.

More recent research conducted by Michael Marmot looked more closely at what determines health outcomes in populations, and the extent to which other factors influence people’s health, or rather their ability to be well.

He produced what is known as the 30/70 model: 30% of what determines your health is your genetics and improvements in pharmacology, the other 70% is related to other “external factors” including poverty, environment, culture, employment and housing. BBBHP has used this as the foundation for their primary care model, arguing that primary care providers are not just dispensers of medical products, but have a responsibility to contribute to people living healthier lives in their community.homeless

Social prescribing

One issue highlighted by the BBBHP was the significant number of people presenting at GP surgeries with “non-medical” ailments, or medical ailments triggered by “non-medical stimulus”. People were arriving at the practices and booking appointments because they were lonely and it gave them somewhere to go. Others were presenting with symptoms of depression, which on further investigation were found to have stemmed from issues around debt or domestic violence. A social prescribing service was set up by the partnership to try to tackle some of these non-medical conditions and improve the health of the general population by non-pharmacological means.

The social prescribing service, where GPs refer people to other local services for help, can be used as a replacement for pharmaceutical interventions, or be supplementary to them. GPs, or other primary care staff, may refer any adults over the age of 18 to one of over 40 partnership organisations. These range from walking groups to formal sessions with advisors in debt or domestic violence agencies, as well as art classes, community gardens and companionship services to combat loneliness. The organisations can provide help and advice on issues such as employment and training, emotional well being and mental health.Ölfarbe

The challenges of quality and funding

Maintaining quality in the provision of social prescribing is a particular challenge for BBBHP. They work regularly with trusted partners, particularly the Bromley by Bow Centre. However, there is no consistent quality check for many of the services from the health partners themselves. Evaluative studies and feedback sessions are used to assess quality and impact, and consider the scale of demand. And while it is acknowledged that more formal frameworks for assessing quality and impact of social prescribing services are preferred in formal assessments, in reality, word of mouth, participant feedback and uptake rates are used as a standard for quality as much as official feedback in a localised community setting.

A second issue is funding. BBBHP identified that finding long term funding was their main issue in providing security for providers and service users, as well as for GPs referring to services. Funding is vital not only to ensure the survival of the community groups who provide some of the referred services, but also to allow them to develop longer term partnerships and build capacity within the social prescribing service. The BBBHP works closely with the Bromley by Bow Centre, a key provider of support services for the local community, but like many services which rely on funding, they increasingly have to plan for tighter budgets.

blue toned, focus point on metal part of stethoscope

A final challenge for the staff at BBBHP was changing people’s expectations of primary care, and what it means to live well. Some patients were suspicious and reluctant to be recipients of “social prescription”, as this did not fit with the traditional expectation of what GPs should do to make people well. This can be a big change in mindset for some people, according to Ian Jackson, when people come expecting to be prescribed antidepressants but are instead “prescribed” a walking club or a debt advice service. He noted that the reaction from patients can sometimes be confused or hostile, and some patients do not even turn up for referrals.

Improving patients’ understanding of the benefits of social prescription, ensuring people attend referral appointments, and that social prescriptions have a long term impact is something which BBBHP are hoping to research further. They feel that looking at the long term impact of non-pharmaceutical interventions and how these feed back into the wider agenda of tackling inequalities is important to allow the partnership to continue to build healthy communities and save on primary care costs in the long term.

category-picture-community-development

Creating positive social connections to improve community health

Social prescribing and other associated projects have sparked new social connections. Members of the community have come together to form their own support groups. The Children’s Eczema support group run by local GPs and the DIY health scheme, which sought to educate and support parents who were anxious about minor ailments in children, have helped parents in the area to set up WhatsApp groups, organise coffee mornings and go to one another for support. Such initiatives are regarded by BBBHP as important in tackling wider, systemic social inequality in the area.

Currently, primary health care in communities is focused on illness. This needs to change, according to BBBHP, with local community-based health delivery based as much around social health as biomedical issues. Through its social prescribing and other services BBBHP has aimed to focus on supporting people in a holistic way, tackling health inequalities as well as biomedical illness, to allow them to make good choices to improve their health.


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Controlling the urban landscape: the pros and cons of putting public spaces in private hands

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A 2007 report from the Royal Institution of Chartered Surveyors (RICS) described the growing private ownership and management of the public realm as a “quiet revolution in land ownership”.

The study included a handful of early examples, such as the Excel Centre and Canary Wharf in London, and Liverpool’s Paradise Street development (later rebranded Liverpool One). Since then, more of these privately owned public spaces (POPS) have been appearing across the UK, including Granary Square and the Queen Elizabeth Olympic Park in London, Gunwharf Quays in Portsmouth, and Brindleyplace in Birmingham.

The evolution of public space

Until relatively recently, local government owned, managed and maintained streets and squares in the UK’s towns and cities. But over the past two decades, budgetary constraints have diminished local authorities’ ability to maintain the public realm. Increasingly, the gap has been filled by the private sector, which has created new POPS.

On the face of it, the redevelopment of previously run-down areas with no cost to the public purse would appear to be a good thing. But there are concerns about the private landlords of these spaces who have the power to restrict and control activities of the public using these spaces.  Alongside these new private-public developments, the rise of Business Improvement Districts (BIDs) has increased private sector influence over town and city centres.

A bridge too far?

The issue of privatised public spaces was given renewed prominence with the proposals for a new “Garden Bridge” across the River Thames. Designed by Thomas Heatherwick  the project envisions a pedestrian bridge with its own elevated garden.

Supporters say the Garden Bridge will enrich London, providing economic, environmental and aesthetic benefits. But opponents have expressed concerns about a list of rules prohibiting activities on the bridge, such as busking and cycling. Restrictions of this kind have been applied to other POPS, sometimes resulting in awkward encounters between members of the public and security guards representing the property managers.

As things stand, the fate of the Garden Bridge remains uncertain, following the decision by the Mayor of London to set up an inquiry into the project’s use of public money, and a warning from the National Audit Office that the money may have been wasted.

The pros and cons of POPS

But does it really matter if urban spaces that appear to be public are actually privately-owned?

No, say POPS supporters. Without private funding, spaces such as Brindleyplace and LiverpoolOne might not have been developed at all. Furthermore, the cost of maintaining these privately owned public spaces can be borne by the private sector, instead of local authorities (and the taxpayer). They also point to Liverpool One as a successful example of town centre regeneration, and suggest that private ownership of public space can be a catalyst for renewal of neglected spaces.

But others are unhappy with the creeping privatisation of public spaces, arguing that they sacrifice community spirit and historical identity for the sake of a sterile, monotonous, corporatised spaces. Opponents of POPS are also concerned about the restrictions land owners place on such spaces.

The view from Aberdeen

One city which has recently bucked the trend towards private control over public spaces is Aberdeen. In 2010, the city council planned to hand over the historic Union Terrace Gardens in the city centre to a consortium of business interests – Aberdeen City Garden Trust – under a long lease. The trust released its plans to redesign the Victorian park, raising the sunken gardens to street level. Campaign groups mounted opposition to the scheme, but it was narrowly approved in a city-wide referendum in 2012. However, a new Labour administration came to power shortly after the referendum, and the scheme was finally scrapped. During the summer of 2016, the council announced new plans to redevelop the site, which will remain in public hands.

Final thoughts

The Aberdeen example shows that moves to put public spaces in private hands are not universally popular, or inevitable. Even so, many local authorities are struggling to maintain public spaces, leaving the way open for private developers. The Queen Elizabeth Olympic Park, in the borough of Newham, is one of the most recent POPS to appear in London. Sir Robin Wales, the elected mayor of Newham would have preferred the park to be maintained using public funds, but has accepted that his borough could not afford to manage it: “We know we don’t have an income stream.”


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Going through the roof: could building upwards address London’s housing problem?

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The Ter Meulen Building, Rotterdam: 21st century residential apartments built on top of a post-war shopping centre

The housing challenges facing London are well documented::

  • London needs around 50,000 new homes a year, but housebuilding is running at around half that.
  • Between 2005 and 2015, private rents in London rose by an average of 35%.
  • Future projections suggest there will be 9m people in London by 2020, 10m by 2030 and 11m by 2050.

There are now serious concerns that the lack of affordable housing and rising rents risk driving key workers out of London, and may cause businesses to think twice about locating in the capital. But as well as triggering dire warnings about the future of London and the UK economy, the housing crisis has also prompted increasingly creative ideas on how to solve it.

Going up

Last year, Darren Johnson, who represented the Green Party on the Greater London Assembly, proposed five ideas to secure land for affordable homes. One of his proposals was to build additional storeys on top of existing buildings.

Johnson suggested that this approach has many advantages over demolishing existing properties and building new homes, including:

  • a shorter period of disruption for residents;
  • more environmentally friendly than demolition and rebuilding
  • an opportunity to refurbish the existing homes

He offered the example of the Ducane Housing Association in Hammersmith, which built 44 new homes on top of two 1970s buildings. Based on data from London’s Borough Councils, Johnson estimated that almost 50,000 new homes could be built using Ducane’s example.

One potential stumbling block is the difficulty of getting planning permission for intensive construction projects in the heart of active communities. However, in July 2015, the Treasury signalled the government’s intent to end the need to obtain planning permission for upwards extensions in London.

Building on public buildings

Another approach, on similar lines, is the idea of building new homes on top of publically owned buildings. In 2015, WSP professional services consultants conducted a survey to gauge interest in the idea. Among their findings:

  • 61% of respondents supported the idea of allowing private developers to refurbish government buildings, allowing them to make their money back by building additional housing on top of the refurbished building, which they could sell for profit.
  • Over 60% of Londoners would happily live above a library, while 44% would be willing to live above a government administration building, and around a quarter of Londoners would be willing to live above a school or hospital.

The WSP report went on to suggest that developing all available sites by building apartments above all available public buildings in London could provide over 630,000 residential units.

“Of course we acknowledge that not every building will be able to be redeveloped in this way, but even targeting one in every two municipal buildings could go a long way in solving the housing crisis, providing 315,000 homes.”

These homes, the report argued, would be most suitable for key workers employed by these facilities, or by students, older people and young professionals. Some may even house those working in the facilities below.

One landlord is already exploring the idea with several London councils. Apex Housing Group has experience of converting airspace above properties into luxury penthouse apartments. Managing director Arshad Bhatti believes the principle could be applied to affordable homes:

“We are working with a number of local authorities across London and expect airspace development projects will help bridge the gap between demand and supply of new homes in London – crucially with minimum lead times, and offering maximum value for property owners.”

The view from overseas

The idea of building up may be relatively new to London, but other densely populated cities have already been exploring its possibilities.

  • In Rotterdam, developers have been combining ultra-lightweight materials to build apartments on top of a 1940s shopping centre.
  • In New York, a developer is planning to construct a nine-storey condominium on top of apartments dating from the 1950s.
  • In Paris, three prefab dwellings attached to the rooftops of existing buildings were completed in January 2016.

The architects of the Paris project believe it has multiple benefits:

“Building on top of the roofs is not only an ecological and economical solution, it’s working against the urban sprawl that kills the social link. It’s also a contemporary way to discover new perspectives of the city, a new Paris above the horizon.”

But not everyone is happy with the idea. Residents in the existing apartments beneath the proposed New York condominium are concerned that the wear and tear of construction could damage their properties. And they’re also worried about the stability of the columns supporting the new building.

The only way is up?

Clearly, building on existing properties is not without its problems. But as the housing crisis in London intensifies, and spreads to other parts of the UK, it’s an idea that may no longer be regarded as pie in the sky.


If you liked this post, you may also be interested in other blog posts on suggestions for tackling the UK housing crisis:

Supporting regeneration and creative start-ups … what can we learn from Hackney?

View of Amazon HQBy Morwen Johnson

A traditional pub, standing alone in the midst of a massive development site in East London. The photo above, taken at the end of June, seems to sum up dramatic changes that are being replicated all across London as regeneration transforms many Boroughs. Social and community regeneration, however, does not inevitably follow from investment in commercial property development. And ensuring that local communities benefit, and are not displaced or excluded by processes of gentrification, can be a tough balancing act.

I recently went on a study tour within Hackney, organised as part of the RTPI Convention in June, to understand how the council’s planning and regeneration team have been working to attract investment into the area and tying this in to employment support and small business growth.

Rapid economic growth but continuing deprivation

A number of high profile major site developments are underway in Hackney, including multiple hotels and the new Amazon HQ. This has gone hand-in-hand with its emergence in the last few years as an attractive location for start-ups and entrepreneurs.

Hackney experienced a business growth rate of 40% between 2004 and 2012, 17% higher than London as a whole. The population of the Borough has also grown from approximately 265,000 in 2006 to an estimated 310,000 in 2015. A report from Tech City published last month also highlighted the importance of the key sectors of creative, technology and business services in the local economy – they make up 37% of all employment in Hackney and 54% of its 11,000 businesses.

It’s worth noting, however, that this economic success has come at a time when Hackney still has some of the highest levels of deprivation and poverty in London. For example, in 2016, 30% of nursery and primary school pupils are eligible for and claiming free school meals, rising to 33% at secondary level (London Datastore).

Vibrancy of the area at risk?

The improved perception of the area, while welcome, is pushing up property and rental prices. And now, as start-ups and small businesses risk being priced out of Hackney, it is important for the area to retain the ability to host start-ups. One solution is ‘meanwhile use’ – the temporary use of vacant buildings or sites, especially for community projects.

Hackney council has engaged with local developers and property partners to create innovative and cost-effective spaces on a temporary basis to promote local business, employment and culture.  Hackney House on Curtain Road is just one example – the building provides a café and bar area, as well as exhibition and meeting space for hire. Wi-fi and desk space is available for not-for-profit organisations and start-ups to use, and regular events encourage business networking. The project won the Best Town Centre project at the London Planning Awards in February 2016.

The council suggests that while it’s important to keep businesses in the area, the core aim should “be to keep projects innovative and exciting”. Some churn is inevitable and councils should “extend both a platform and an open mind to its current local business communities”.

Ways into work

Another example of collaboration which has delivered cost effective assets to support the local community is The Opportunity Hub on Pitfield Street. The council has been working to develop its role as a broker between the private sector and community sector to create jobs and training for local people. The Opportunity Hub sits next to a large housing estate and research showed that nearly a quarter of residents local to the Hub had never used the internet.

Previously a community centre that was only being used for two hours a week, the building has been redesigned to offer an antithesis to job centres. As well as having space for training or employer recruitment sessions, there is free hot-desking space. A team of information and guidance advisors are available and focus on getting local people ‘job-ready’. They also engage with local businesses to promote apprenticeships. Touchingly, the local group of women who used the previous centre for afternoon bingo now use the Hub space instead.

Hackney collateral

Looking to the future

It’s clear that the council in Hackney aren’t resting on their laurels. As well as continuing to use Section 106 as a tool to ensure larger businesses moving into the area will offer jobs to local unemployed people, they are planning another Opportunity Hub in the foyer of a local library. They are also looking at new ideas to provide space for temporary uses, such as the untapped potential of over 2000 empty garages in the area.

Close relationships between planning professionals, town centre managers and the business development teams appear to have helped the council to use regeneration to benefit the local community.


Read more about Hackney’s three year framework to promote enterprise and regeneration in the Tech City Best Practice report.

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Read some of our other blogs on regeneration:

Rent controls: lessons from Berlin?

 

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Image: James Carson

In March 2016, a study by the Centre for Economics and Business Research highlighted the growing problem of rising rents in the UK. The Cost of Renting found that the average private rent in England is growing at an annual rate of 2.5%, and forecast that rents were set to rise by 28% on average by 2026. The findings support recent studies suggesting that the UK is now the most expensive place in Europe to rent.

In contrast to the UK, renting in Germany is less expensive. For historical as well as economic reasons, only 43% of Germans are home owners (compared to over 70% in the UK). The rest rent their homes, making rent rises a highly sensitive political issue in Germany.

In recent years, Germany has been experiencing a housing shortage. Last year, the Cologne Institute for Economic Research reported that in 2014 the number of new flats and houses built in the biggest cities was 50% fewer than needed to cope with rising population numbers. As a result, rents in Germany have been rising more steeply.

Introducing rent caps

Last year, concerns about keeping homes affordable for tenants on average incomes prompted the German government to introduce legislation on rent control. The new law means that private landlords taking on new tenants can only raise rents by up to 10% above the local average for similar properties.

Even before the law was passed the state government of Berlin had announced that it would be the first city in Germany to introduce rent controls. In recent years, the German capital has been growing by around 50,000 people a year, putting greater strains on the city’s housing market. Rents in Berlin have risen on average by almost 53% in the past five years, and in some districts, by 79%.

The trend has raised concerns among Berliners that their city could be on the way to emulating London, where growing numbers of people are struggling with the cost of living in their private rented homes. The Cost of Renting report found that Londoners on average spend nearly a third of their disposable income on rent payments, and suggested that worsening rent affordability may push residents on lower incomes out of the capital. Rent control is one measure intended to prevent Berlin going the same way as London.

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Image: James Carson

The impact of rent controls

Within weeks of Berlin introducing its rent cap, there were signs that the move was having an immediate effect, with the average rents per square metre falling by 3.1%. But in February 2016, a survey of Berlin rents by CBRE found that the year-on-year rise across the city for 2015 was 5% (compared to the 2014 rise of 6.5%).

On the face of it, this looks like the new controls are not working. But the rent cap was always intended to slow down Berlin’s spiralling rents, rather than bring them to a halt, and on those terms the law has been effective. Moreover, while new rents for Berlin’s most expensive apartments rose by 5.7%, rent rises for the cheapest 10% of flats rose by just 2%.

And, as if to underline how serious Berlin is about tackling rising rents, in addition to the rent controls on private landlords, the Berlin state government has also introduced new rules for over 500,000 social and state-owned housing tenants, guaranteeing that rent rises will not price them out of their homes.

Lessons for the UK?

Since Berlin introduced rent controls, other German states, including Hamburg and Bavaria, have followed suit. This has prompted some commentators to wonder if the idea could help to tackle the UK’s housing crisis.

A recent report from Shelter highlighted the serious impact of rising rents in London:

“Those who find it difficult to pay their rent are likely to cut back on food for themselves or clothes for their children. Others get deep into debt to avoid going into rent arrears or to cover the high costs of frequently moving home. At worst, a growing number of London renters lose their home and become homeless.”

Although London has seen the steepest rises, other parts of the UK have also been affected. In April 2016, figures showed that rents on new tenancies in Greater London were, on average, 7.7% higher than a year ago. But in Scotland the increase was 7.3%, just ahead of the East Midlands with 6.8%.

Writing in the Financial Times, columnist Jonathan Eley acknowledged the differences between the UK and German housing markets, including the high numbers of renters in Germany and the larger number of properties owned by institutions (in contrast to the UK, where most private rented sector properties are owned by individual buy-to-let landlords). However, he concluded that the UK had something to learn from the introduction of rent controls in Germany:

“It is not perfect, but it does a much better job of balancing the interests of tenants and owners than the policies of successive UK governments, who have basically ramped up house prices without much thought for the long-term consequences.”

It’s still too early to say whether Germany’s attempt to tackle rising rents will have a long-lasting impact. But if the measures succeed in putting a brake on spiralling rents, there may be growing calls here to follow Berlin’s example.


Further reading
If you’ve enjoyed this blog post, you might also be interested in these previous posts:

Generation rent: are there lessons from Germany?
To regulate or not to regulate? Housing standards in the private rented sector
Support for the squeezed middle: could public subsidies tackle London’s housing crisis?

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