An app a day … how m-health could revolutionise our engagement with the NHS

It seems like almost every day now we see in the news and read in newspapers about the increasing pressures on our NHS, strains on resources and the daily challenges facing already overworked GP staff.

Mobile health applications (m-health apps) are increasingly being integrated into practice and are now being used to perform some tasks which would have traditionally been performed by general practitioners (GPs), such as those involved in promoting health, preventing disease, diagnosis, treatment, monitoring, and signposting to other health and support services.

How m-health is transforming patient interactions with the NHS

In 2015 International Longevity Centre research found some distinct demographic divides on health information seeking behaviour. While 50% of those aged 25-34 preferred to receive health information online, only 15% of those aged 65 and over preferred the internet. The internet remained the favourite source of health information for all age groups younger than 55. And while not specifically referring to apps, the fact that many people in this research expressed a preference to seek health information online indicates that there is potential for wider use of effective, and NHS approved health apps.

A report published in 2019 by Reform highlighted the unique opportunity that m-health offered in the treatment and management of mental health conditions. The report found that in the short to medium-term, much of the potential of apps and m-health lies in relieving the pressure on frontline mental health services by giving practitioners more time to spend on direct patient care and providing new ways to deliver low-intensity, ongoing support. In the long-term, the report suggests, data-driven technologies could lead to more preventative and precise care by allowing for new types of data-collection and analysis to enhance understandings of mental health.

M-health, e-health and telecare are also potentially important tools in the delivery of rural care, particularly to those who are elderly or who live in remote parts of the UK. This enables them to submit relevant readings to a GP or hospital consultant without having to travel to see them in person and allowing them to receive updates, information and advice on their condition without having to travel to consult a doctor or nurse face-to-face. However, some have highlighted that this removal of personal contact could leave some patients feeling isolated, unable to ask questions and impact on the likelihood of carrying out treatment, particularly among older people, if they feel it has been prescribed by a “machine” and not a doctor.

Supporting people to take ownership of their own health

Research has suggested that wearable technologies, not just m-health apps, but across-the-board, including devices like “fitbits”, are acting as incentives to help people self-regulate and promote healthier activities such as more walking or drinking more water. One study found that different tracking and monitoring tools that collect and analyse health and wellness data over time can inform consumers of their baseline activity level, encourage personal engagement in health and wellbeing, and ultimately lead to positive behavioural change. Another report from the International Longevity Centre also highlights the potential impact of apps on preventative healthcare; promoting behaviour change and encouraging people to make healthier choices such as stopping smoking or reducing alcohol intake.

Home testing kits for conditions such as bowel cancer and remote sensors to monitor blood sugar levels in type 1 diabetics are also becoming more commonplace as methods to help people take control of monitoring their own health. Roll-outs of blood pressure and heart rhythm monitors enable doctors to see results through an integrated tablet, monitor a patient’s condition remotely, make suggestions on changes to medication or pass comments on to patients directly through an email or integrated chat system, without the patient having to attend a clinic in person.

Individual test kits from private sector firms, including “Monitor My Health” are now also increasingly available for people to purchase. People purchase and complete the kits, which usually include instructions on home blood testing for conditions like diabetes, high cholesterol and vitamin D deficiency. The collected samples are then returned via post, analysed in a laboratory and the results communicated to the patient via an app, with no information about the test stored on their personal medical records. While the app results will recommend if a trip to see a GP is necessary, there is no obligation on the part of the company involved or the patient to act on the results if they choose not to. The kits are aimed at “time-poor” people over the age of 16, who want to “take control of their own healthcare”, according to the kit’s creator, but some have suggested that instead of improving the patient journey by making testing more convenient, lack of regulation could dilute the quality of testing Removing the “human element”, they warn, particularly from initial diagnosis consultations, could lead to errors.

But what about privacy?

Patient-driven healthcare which is supported and facilitated by the use of e-health technologies and m-health apps is designed to support an increased level of information flow, transparency, customisation, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects for each user. However, it’s not all positive, and concerns are already being raised about the collection and storage of data, its use and the security of potentially very sensitive personal data.

Data theft or loss is one of the major security concerns when it comes to using m-health apps. However, another challenge is the unwitting sharing of data by users, which despite GDPR requirements can happen when people accept terms and conditions or cookie notices without fully reading or understanding the consequences for their data. Some apps, for example, collect and anonymise data to feed into further research or analytics about the use of the app or sell it on to third parties for use in advertising.

Final thoughts

The integration of mobile technologies and the internet into medical diagnosis and treatment has significant potential to improve the delivery of health and care across the UK, easing pressure on frontline staff and services and providing more efficient care, particularly for those people who are living with long-term conditions which require monitoring and management.

However, clinicians and researchers have been quick to emphasise that while there are significant benefits to both the doctor and the patient, care must be taken to ensure that the integrity and trust within the doctor-patient relationship is maintained, and that people are not forced into m-health approaches without feeling supported to use the technology properly and manage their conditions effectively. If training, support and confidence of users in the apps is not there, there is the potential for the roll-out of apps to have the opposite effect, and lead to more staff answering questions on using the technology than providing frontline care.


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Smart cities aim to make urban life more efficient – but for citizens’ sake they need to slow down

Sometimes you want to take it slow. Fabrizio Verrecchia/Unsplash. , FAL

Guest post by Lakshmi Priya Rajendran, Anglia Ruskin University

All over the world, governments, institutions and businesses are combining technologies for gathering data, enhancing communications and sharing information, with urban infrastructure, to create smart cities. One of the main goals of these efforts is to make city living more efficient and productive – in other words, to speed things up.

Yet for citizens, this growing addiction to speed can be confounding. Unlike businesses or services, citizens don’t always need to be fast to be productive. Several research initiatives show that cities have to be “liveable” to foster well-being and productivity. So, quality of life in smart cities should not be associated with speed and efficiency alone.

The pace of city life is determined by many factors, such as people’s emotions or memories, the built environment, the speed of movement and by the technologies that connect people to – or detach them from – any given place. As cities around the world become increasingly “smart”, I argue that – amid the optimised encounters and experiences – there also need to be slow moments, when people can mindfully engage with and enjoy the city.

Cities provide an environment for people to move, encounter, communicate and explore spaces. Research shows how these experiences can differ, depending on the pace of the activity and the urban environment: whether fast or slow, restless or calm, spontaneous or considered.

“Slow” approaches have been introduced as an antidote to many unhealthy or superficial aspects of modern life. For example, the slow reading movement encourages readers to take time to concentrate, contemplate and immerse themselves in what they’re reading – rather than skim reading and scrolling rapidly through short texts.

Similarly, the international slow food movement started in Italy as a protest against the opening of a McDonald’s restaurant on the Spanish Steps in Rome, back in 1986. Then, in 1999, came the “cittaslow movement” (translated as “slow city”) – inspired by the slow food movement – which emphasises the importance of maintaining local character while developing an economy which can sustain communities into the future.

Orvieto, Italy – home of the cittaslow movement. Shutterstock. 
Slow cities arise from grassroots efforts to improve quality of life for citizens, by reducing pollution, traffic and crowds and promoting better social interaction within communities. They must follow a detailed set of policy guidelines, which focus on providing green space, accessible infrastructure and internet connectivity, promoting renewable energy and sustainable transport, and being welcoming and friendly to all. Slow cities can create opportunities for healthier behavioural patterns – including pausing or slowing down – which allow for more meaningful engagement in cities.

These guidelines present a clear road map for city governments, but there are also ways that local people can promote a slow city ethos in fast-paced cities throughout the world. For example, in London, artists and activists have organised slow walks to encourage the general public to meaningfully engage with urban spaces, and show them how diverse their experiences of the city can be, depending on the speed of movement.

Slow and smart

Trying to put people’s concerns at the heart of smart city policies has always been challenging, due to the lack of creative grassroots approaches, which enable citizens to participate and engage with planning. And while technology has been able to give citizens instant access to a wide range of data about a place, it is rarely used to improve their actual experience of that place.

Getting smart cities to slow down could give citizens the means to explore the urban environment at a range of different paces, each offering a distinctive experience. To do this, architects, artists and urban planners need to look beyond the ways that technology can give instant access to information, services and entertainment – whether that’s video game lounges, or recharging and navigation pods in airports and stations.

Instead, they must recognise that technology can create platforms for citizens to immerse themselves and engage meaningfully in different experiences within the urban environment. For example, technology-based installations or projections can tell stories about people and places from other times, which enrich people’s experience of the city. Artificial Intelligence and machine learning can offer new ways to understand cities, and the way people function within them, which could help give human behaviour and experience a significant place in smart city planning.

Slow and smart cities could take the best of both approaches, helping citizens to connect with the history, present and future of a place, emphasising local character and building a sense of community, while also making use of the latest technology to give people greater choice about whether they want to speed up or slow down.

This would not only enhance efficiency and productivity, but also ensure that technology actively helps to improve people’s quality of life and make cities better places to live. It may sound idealistic, but with the range of advanced technology already being developed, ensuring cities are slow as well as smart could help people live better, more meaningful lives long into the future.The Conversation


Guest post by Lakshmi Priya Rajendran, Senior Research Fellow in Future Cities, Anglia Ruskin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Digital Leaders Week: Digital transformation in local government

Image: Digital Leaders

Today is the start of Digital Leaders Week, a celebration of the opportunities and challenges for the digital transformation of Britain’s businesses, public services and society.

Here at the Knowledge Exchange blog, we’ve been taking a keen interest in digital developments in both the public and private sector. To celebrate Digital Leaders Week, we’re revisiting some of our digital-themed blog posts from the past, and bringing you up to date on current developments.

Several articles on our blog have highlighted the potential of digital technologies as drivers of internal transformation and improved service delivery in local government.

In May 2016, we looked at the benefits of digital for local authorities, noting that research by Nesta and the Public Service Transformation Network had suggested local councils could save £14.7 billion by moving all transactional services online and digitising back office functions. This echoed the findings of Policy Exchange, which reported that £10 billion could be saved by councils making smarter use of data and technology.

But another article on our blog also pointed to some of the reasons why local government was struggling to develop digital strategies, including limited infrastructure, red tape and funding issues:

“In theory, providing technical solutions to local government services should provide long term efficiencies. Yet, in an era of constrained budgets, finding the initial capital for digital projects can be challenging. Leaders in councils trying to fund social care services and schools may not view digital as a priority.”

Further blog posts have indicated that some councils are overcoming the barriers to digital change:

“For example, Cambridge City Council have launched Cambridgeshire Insight, a shared research knowledge base which allows over 20 public and third sector organisations to publish their data and make it freely available. We have also seen 18 councils coming together to collaborate on a project which aims to keep electoral registers up-to-date, potentially saving £20 million a year.”

Today, more councils are embracing the challenges and opportunities of digital. A good example comes from Adur & Worthing Councils, which believes that digital inclusion can greatly improve the lives of local people. Among the digital services now offered by Adur & Worthing is an online payments facility. In addition, online access points enable residents to get up-to-date information on important issues such as council tax, recycling, public transport and cultural events.

Another example is Nottingham City Council’s workflow management app, introduced to replace an inefficient paper-based system:

“The new app allows staff from customer services, highway inspectors and response teams to enter faults, such as potholes or damaged street lights, directly into the system. It then automatically allocates the fault to the relevant inspector and, once the work is completed, digitally signs it off. The council has reported that the app has created £100,000 in savings in less than one year.”

However, we’ve also underlined that there’s more to digital transformation than getting the technical aspects right:

“With digital transformation, technology is less important than the vision and leadership provided by senior officials. Encouraging data sharing across organisations, empowering employees, and importantly, investing in digital services, are just some of the key ingredients.”

It’s clear that digital transformation is a journey, not a final destination, and we’ll continue to report on the ways in which local government is embracing digital technologies for the benefit of councils and citizens.

Our next Digital Leaders Week blog post, on Wednesday, looks at digital developments in Singapore and Estonia.


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Engaging the ‘silent majority’ in planning: is digital the answer?

It has long been a concern that traditional planning consultation methods do not adequately capture the views of the majority.

Instead, they tend to be dominated by individuals with certain characteristics – typically older people or retirees, with high disposable income and social capital, and the time and means to attend in person.

This is partially because traditional planning consultation methods, such as public exhibitions, mainly involve individuals physically attending events at pre-specified places and times.

Younger people, students, people with disabilities, and working families with or without children, may find it difficult to attend and engage with such consultation methods.

In addition to this – people are also more likely to engage with the planning system when they are opposed to something.  Research by Shelter found that people opposed to local housebuilding were three times more likely to actively oppose an application than supporters were to actively support it (21% compared to 7%).

However, the majority of people surveyed were actually supportive or neutral regarding local house building.  This means that in many cases, there is a ‘silent majority’ – people whose voices are not being heard by the planning system.

This ‘silent majority’ often includes young people and others who may have the most to gain from new housing, employment and other benefits created by local developments.

In the rest of this blog, we consider the potential of social media and digital apps to make the planning system more accessible, inclusive and representative.

The potential of social media

Social media is everywhere – and as such it has a huge potential to reach and engage people from all walks of life.

Through adverts or posts in relevant groups, information about developments can be shared, with likes and comments providing feedback.  Short questionnaires or polls can also be administered to help gauge public opinion on a range of matters, such as locations, layouts and designs.

At present, social media is not a widely used planning consultation method – however, there is support for it to become so.

In 2016, a YouGov survey explored local councillors’ attitudes towards the use of social media during public consultation.  It found that:

  • 75% of councillors felt that social media was an important or very important engagement tool
  • 74% believed that social media would add value when reviewing planning applications
  • 60% felt that developers should be doing more to engage with local communities through social media
  • 60% believed social media will increase in importance as a public engagement tool over the next three years

It has been argued that social media is a much more relevant way to share information and consult on development proposals, particularly for young people.

It also has the potential to help overcome many of the time and accessibility barriers that prevent people from attending traditional ‘time and place’ consultation events.  And it has an incredible potential reach too – with Facebook having a total of 44 million active users and Twitter 14 million.

There are, however, some concerns – particularly regarding the verification of an individuals’ locality and the public management of negative comments, particularly as users can remain anonymous.  The potential for cyberactivism against a development and the spread of ‘fake news’ are also concerns.  Social media training would no doubt be required for those using social media to consult on developments.

Innovative apps

In addition to social media, digital apps offer an exciting new way for people to engage with the planning system.

Hailed as ‘Tinder’ for urban planning, CitySwipe is a new digital tool being used in Santa Monica’s downtown area to learn citizens’ preferences and concerns about the city’s urban core.  It enables local residents to swipe left or right to indicate their preferences regarding various different urban development scenarios.  For example, users may be asked to choose between different types of outdoor seating.  The app also covers attitudes towards things such as walking, bike lanes, housing and other such areas of interest to urban planners.

If CitySwipe is Tinder, then TrueViewVisuals can be likened to the Augmented Reality (AR) mobile gaming app ‘Pokémon Go’.  AG is a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view of both.  TrueViewVisuals makes use of this to enable users to use their mobile device to view proposed developments in existing locations and is thus particularly useful in assessing their potential visual impact.

Bootlegger is a mobile app originally designed to film live music, which is now also being applied to the urban planning context.  It enables users to collaborate and share their footage with others, and edit them into a single video.   In Berwick-upon-Tweed, Bootlegger has been used to enable members of the public to make their own ­films regarding planning proposals and the neighbourhood area and share them with others.

ChangeExplorer uses location data to provide users with ‘push notifications’ when they enter a geographic location that is subject to redevelopment plans.  Users can then view and comment on the plans, making it much easier for local residents and visitors to have their say on planning decisions.  It has been used successfully by North Tyneside Council, where it was found to be “an effective tool in encouraging participants to think about what they would like to change and for them to feel empowered in raising relevant issues”.

Enhance and evolve

These are just a handful of the ways in which technology can be used to engage young people and others within the ‘silent majority’.  It is an area which is developing all of the time – as recent reports by the Scottish Government, Future City Catapult and the RTPI show.

It also comes at a time where there is wider discussion of the need to make planning more inclusive.  In order to do this, it is essential that the views captured by planning consultations truly represent the needs and preferences of all local residents.

Of course, online engagement cannot replace the need for traditional consultation approaches and techniques entirely.  Instead, they should complement one another, offering both an enhancement and an evolution of the current planning system.  And in doing so, the planning system can meet both the needs and expectations of an increasingly digital world.


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New year, new high street: it’s time to reshape our town centres (part one)

Wigtown town centre © Copyright Jim Barton

One thing is certain. The high street landscape has now irrevocably changed and there is no point clinging on to a sentimental vision of the past. We have to start planning for a bold new world.”

This was the conclusion of the Grimsey Review in 2013.  Five years on and the challenges facing the high street remain – now with the added economic complexities presented by Brexit.

Yet there remains optimism.  In the last year, a number of reviews have been published, illustrating how we can bring town centres and high streets back to life.

In summer last year, an update to the Grimsey Review was published. Its title – ‘It’s time to reshape our town centres’ – is something of a call to arms.

It sets out 25 recommendations to help support the high street to transform “into a complete community hub incorporating health, housing, arts, education, entertainment, leisure, business/office space, as well as some shops, while developing a unique selling proposition (USP)”.

In November, Lichfields also published a number of recommendations for high streets, based on their own research.  Their conclusions echo that of Grimsey: “Town centres and operators within them should embrace online, promote themselves better and develop their own unique selling point(s). They must broaden their offer and attract new anchors and other uses, which make them more family friendly, and improve the overall ‘experience’ for visitors”.  It also highlights a number of examples of innovative practice.

In addition to these, at the end of December, the Ministry of Housing, Communities and Local Government published the findings and recommendations of the High Streets Expert Panel, and a related report by the Institute of Place Management (IPM) – ‘High Streets 2030’.

The IPM report gathered the opinions of local people, including young people, about their town centre, what they would like to see developed, and the related challenges that they perceive.

Over the next two blog posts, we will look at some of these reports’ key recommendations, and highlight some innovative examples of good practice.

A diverse high street

A recent tweet by Fountain Bookstore in the U.S. highlighted the difficulties presented by ‘showrooming’ – where people visit high street stores to view items which they subsequently purchase online, often only for a marginally cheaper price.  The tweet went viral and sparked much debate.

However, realistically, online shopping is not going away – and in recognition of this, it has been widely recommended that high streets should diversify their offer, placing greater focus on services and experiences that cannot be replicated online – including food and drink uses, and leisure facilities, such as cinemas and gyms.

There does appear to be some evidence of this happening in practice – barbershops and beauty salons were ranked first and second respectively in terms of their number of net retail openings in 2017.  And Fountain Bookstore may be pleased to learn that there has been a small increase in the numbers of indepedent booksellers in towns across the UK.

A unique high street

Another key recommendation is for town centres to identify their own unique selling points (USPs).

Wigtown, in Dumfries and Galloway, is a fantastic example of a town that has developed a USP in order to regenerate the community.  In 1998, Wigtown was designated Scotland’s national book town, and it has since become home to a wide range of book-related businesses, including both new and used booksellers, and an annual book festival that attracts many people to the town.

Other towns have sought to capitalise on their heritage to bring people back to the town centre – such as through the relatively new Heritage Action Zones programme and the £55 million fund announced in the 2018 budgetfor heritage-based regeneration, restoring historic high streets to boost retail and bring properties back into use as homes, offices and cultural venues”.

A digital high street

While the ubiquitous growth of technology has presented high streets with some of its key challenges – in the form of online shopping and showrooming – it also presents a number of opportunities.

As well as making the most of click and collect services, many town centres may also be able to capitalise on the ‘clicks to bricks’ phenomenon – where online retailers open physical stores in order to provide their customers with an enhanced experience, such as being able to trial goods before purchasing.

Grimsey 2 also outlines a number of other ways in which high streets can capitalise on technology – from providing free wifi and spaces for freelancers to work/come together, to becoming involved in digital marketing campaigns and gathering/using local datasets.

In Scotland, a number of ‘Digital Town’ pilots have been set up with a view to improving the high street’s digital infrastructure and skills, and supporting high streets to take advantage of these in order to boost tourism and local economies. Related guidance on the development of ‘Digital Towns’ has also been produced.

A well-supported high street

There is also a range of innovative supports for high streets – some more traditional, like business improvement districts, and others more unconventional – such as the growth of popup shops and other supports for local entrepreneurs.  We have discussed the many benefits of markets for town centres in a previous blog post. There have also been various awards and awareness-raising campaigns, such as Love Your Local Market, and the Great British High Street.

Another approach is to use the planning system.  One particularly innovative example of is that of the Renfrew Town Centre SPZ – Scotland’s first Simplifed Planning Zone (SPZ) focusing on town centres.  It was set up in 2015 and built on the success of Glasgow’s award-winning Hillington Park SPZ.

The SPZ aims to support existing businesses, encourage new businesses, and increase the number of people living within the town centre by supporting the re-use of vacant property on upper floors.

The scheme has been hailed as an excellent example of the Town Centre First principle. According to Scottish Planner: “The scheme has been well received and offers simplicity to businesses who can invest in the town centre knowing that they can change the use of premises and upgrade the shop front without having to apply for planning permission”.

Renfrewshire Council have published a ‘how to’ guide detailing their experience.

To be continued…

These are but a few of the many innovative ideas and experiences that have helped town centres across the country.

In our next post, we will continue this theme and outline some additional ways that town centres can help to address their challenges and increase footfall – through community involvement, good quality, inclusive urban design, the promotion of healthy environments and the creation of homes on the high street.


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Do we really need a middle class? How the UK Government should respond to the challenge of job polarisation

Women sitting at her desk doing paperwork

By Steven McGinty

At the beginning of the year, former government advisor and HR expert Kevin Green gave a TEDx talk entitled “Why our jobs matter now more than ever before”.

In his talk, he explains that technologies such as artificial intelligence have transformed the labour market and, unlike previous industrial revolutions, old jobs are not necessarily being replaced by better forms of work.

Instead, he warns, the economy is experiencing ever-increasing ‘job polarisation’. In this labour market, highly skilled, in-demand workers benefit from higher wages and flexible working conditions, whilst middle-income earners are finding their jobs disappear, and competition grows for low skilled, often manual work.

What does the research say about this phenomenon?

In 2017, the OECD published the report ‘Future of Skills and Work’, which highlighted that labour markets are polarising within some G20 countries. In the EU, data shows that between 2002-2014 medium skilled routine jobs declined by 8.9%, whilst high skilled roles rose by 5.4%, and low skilled jobs grew marginally (0.1%).

As a consequence, wage inequalities have grown. In particular, the report found that countries experiencing skills shortages are paying higher rates for staff with desirable skills and that greater competition for low skilled jobs is holding down wages for the bottom half of earners.

Greater regional inequalities are also noted as a possibility, as employers are likely to locate in areas with a high concentration of high-skilled workers – which are often very different to the areas experiencing job losses.

However, the report does suggest that some groups may benefit. For example, it highlights that disadvantaged millennials, who have grown up with technology, may have an advantage over older, less tech-savvy workers.

Is technology the only factor leading to job polarisation?

Economist Andrea Salvatori has conducted extensive research and argues that job polarisation in the UK is far more complex. In a 2015 paper for the Institute of Labour Economics, he argued that although technology is a factor, the growth in high skilled jobs can be explained by the increase in the number of graduates since the 1990s.  Similarly, in a 2016 paper, he found that routine employment did not decline in organisations which had adopted technology and that workplaces which specialise in high skilled employment had grown dramatically, from 30% to almost 50% between 1998 and 2011.

One theory highlighted is that of MIT scholar David Autor, who suggests that while technology might be replacing workers in certain tasks, it’s also complementing them in other areas which are more cognitive and difficult to automate.

In addition, Professor Maarten Goos has suggested that offshoring and the global competition for labour has been a factor. In his view, companies have taken advantage of lower wages in foreign countries, particularly in middle earning jobs such as back-office administrative functions and in customer service positions. Highly skilled jobs have been less affected as the supply of skills is less readily available.

What are the social consequences of job polarisation?

Mr Green’s Tedx Talk is less about the economics of job polarisation, and more about the social issues which may stem from this divided economy. He recounts his own experience, describing himself as a ‘late bloomer,’ and recounting his journey from an administrative middle-class job in Wandsworth council to gaining promotion through further study.

For him, the real concern is that the chasm between low and high skilled jobs means that it will be increasingly difficult for some groups in society to progress in their careers. In particular, he highlights graduates looking for their first positions, as well as mothers returning to the labour market after a period out to raise children.

Research has also shown that increased job polarisation might be leading to discontent amongst low skilled workers, and that this could partially explain recent political divisions between those living in large metropolitan cities and those in left behind regions.

So, how should the UK Government respond?

Academics Dr David Hope and Dr Angelo Martelli recently investigated the role labour market institutions play in tackling wage inequality in modern economies. By analysing the economic data for 18 OECD countries from 1970 to 2007, they attempted to prove that national labour market systems could protect wages. They found that:

strong labour market institutions, in the form of coordinated wage setting, employment protection legislation, and high wage bargaining coverage, reduces the effect of the expansion of employment in knowledge-intensive services on income inequality.”

In addition, the Joseph Rowntree Foundation argues that there is a need to tackle inequality locally by focusing on the bottom of the labour market, particularly by improving working conditions for low-skilled workers.

Mr Green takes a similar viewpoint, and argues the solution is a ‘revolution in lifelong learning’. This means creating labour market institutions that help people trapped in low skilled work, so that they are aware of the opportunities available to them, and potentially providing funding to support them on their journey.


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Making the planning system more customer-friendly

By Donna Gardiner

Local authority planning departments are more often associated with bureaucracy than with delivering good quality customer service.

However, as the current reform of the planning system in Scotland puts the need to develop a modern, efficient service in the spotlight, thoughts have turned to how planning authorities can focus on the human side of delivering a good quality planning service.

Last month (August 2018), the Scottish Government published a report on customer service in the planning system.  It examined different approaches to customer service across a range of private and public sector organisations in Scotland, with a view to identifying the lessons from these that could be applied to the planning system. Although focused on Scotland, the lessons are transferable elsewhere.

A number of challenges

The research found that while planning authorities in Scotland viewed high quality customer service as highly important, they faced a number of challenges to delivering this in practice.

Limited staff and financial resources are a key constraint affecting planning authorities’ ability to deliver high quality customer service.  For example, customer expectations of the frequency and responsiveness of communication are often higher than what can reasonably be delivered.

There are also issues of inconsistency of service, both within and between local authorities in Scotland.  This is due in part to different interpretations of specific legislation, as well as different levels of investment in, and commitment to, customer service within individual planning authorities.

The risk of individuals confounding ‘customer service’ and ‘outcomes’ – where the planning decision reached affects the individual’s perception of the quality of service they have received – is another key challenge when measuring the customer experience.

Current approaches

Each year, planning authorities in Scotland must prepare an annual Planning Performance Framework (PPF) report, which details their performance over the previous year.

At present, the PPF has no specific measure of customer service delivery.  Instead, planning authorities must submit a ‘narrative commentary’ of their customer service performance, along with relevant case studies that demonstrate their actions.

This means that individual planning authorities decide how best to gather information about their own customer service performance.  Some of the key methods used include:

  • Customer charters – which communicate customer service commitments to customers and employees
  • Customer satisfaction surveys – mainly online, however, some were still postal
  • Forums – the use of customer forums or focus groups to engage with customers
  • Complaint handling procedures – published details of organisational systems, protocols and SLAs for registering and responding to complaints
  • Customer service standard accreditation – g. Customer Service Excellence (CSE), Investors in People (IiP), ISO9001, Customer Satisfaction Measurement Tool (CSMT) etc.

So what can be done? The benefits of e-planning

The report identified a number of ways in which customer service within the planning system could be improved.

First was the need to achieve a greater consistency of processes, enforcement and quality of service across Scotland.  Clearer national guidance on implementing legislation would go some way to achieve this. Establishing a national survey of customer service in the planning system is also a priority. Lessons could be learned from the building standards system, which currently incorporates a Key Performance Outcome relating to improving the customer experience.

Planning authorities also overwhelmingly believed that e-planning had improved customer service.  The benefits included:

  • more efficient information flows
  • better prioritisation of work
  • reduced printing costs
  • greater transparency
  • easier access to information by the public

What is clear is that the move to e-planning is bringing a ‘culture change’. By speeding up the planning process and making more efficient use of resources, e-planning frees up both time and money to be spent elsewhere in the planning process.  As one planning authority notes:

“It’s about how you work with the customer to bring them on the e-planning journey with you and change their mindset. In the long run the customer benefits because it speeds up the service.”

As technology and customer expectations evolve it will be important that e-planning solutions reflect this in the future.

Future directions

Good quality customer service helps to make the planning system easier to understand and processes more accessible and usable.  This in turn opens up the system to those who might otherwise feel that it is too complex or time consuming to participate.  This may be of particular importance when encouraging young people to become involved in consultations.

Improving customer service within the planning system is not something that is just ‘nice to have’. Planning has changed significantly over the years – and with change comes the need for reliable, cost-effective processes to drive end-to-end efficiency.


For 30 years, Idox has been supporting the work of local government planning departments. iApply, a planning application submission portal launched by the Idox Group in 2015, offers local authorities the opportunity to benefit from an out-of-the-box end-to-end digital solution that makes submitting planning, building and licence applications simple for customers and cost effective for the authority.

Public transport: lessons from our Nordic neighbours

Public transport is a vital element in the lives of many people. Commuters rely on bus, train, tram and metro services to get them to and from work. Public transport is also crucial for those without cars who need to access education, training, health and social care services.

The state of UK public transport

Recent research by the Urban Transport Group (UTG) has reported important trends in public transport England. Among the findings:

  • Buses remain the most used form of public transport, but service levels and usage have been in decline.
  • There has been rapid growth in rail passenger numbers over the last decade.
  • Patronage on Light Rail systems in England has seen an increase of 44% since 2007/08.

Elsewhere in the UK, there’s a mixed picture on the state of public transport:

  • New legislation introduced by the Scottish Government aims to halt the decline in bus use in Scotland, where passenger numbers fell by 10% over five years. Meanwhile, the rail regulator has demanded improvements to the punctuality of trains in Scotland.
  • Wales has seen a steady decline in bus usage in recent years, although over the same period passenger numbers on trains have increased.
  • Translink, which provides public transport in Northern Ireland has reported that trips by fare-paying passengers increased for the second year in a row, with rail passenger numbers reaching their highest level in 50 years.

Overall, rail passenger numbers in the UK are rising, although the recent disruption to services in the south east and the north of England following timetable changes underlined ongoing dissatisfaction with the standards of service from rail companies. Meanwhile, Britain’s bus network continues to shrink, especially on local routes.

Lessons from Scandinavia

When it comes to public transport, it’s often enlightening to look at how other countries manage. A recent UTG report explored how transport authorities in Sweden, Denmark and Norway are using devolved powers to transform public transport for the better. The report, written by Professor Tom Rye, from the Transport Research Institute at Edinburgh Napier University, considered various aspects of public transport, including service levels, fares, technological innovations, environmental impact and franchising.

Service levels

The report found that, in comparison with the equivalent city regions in the UK (outside of London), service levels in the Nordic countries are higher, particularly during off-peak times. In rural and low-density suburban areas, a higher level of service is provided since there is an element of cross-subsidy between revenue-generating and loss-making routes. By contrast, in the UK bus deregulation does not allow for comparable levels of cross-subsidy.

Fares

In Scandinavia, as in many other parts of continental Europe, fares are zonal and multi-modal. Passengers can travel on the same ticket by rail, bus, light rail, and in some cities on urban ferries. Journeys are paid for on a stored value or season ticket smartcard. The research found that, in comparison to incomes, fares for frequent users in Scandinavian cities are similar to those in the UK, but season tickets often cover wider geographical areas.

Technological innovations

The report provides examples of significant innovation on vehicle technologies, including smart ticketing. In Norway fares are increasingly supplied as mobile tickets.

Environmental impact

The research found that the Scandinavian countries have ambitious plans for public transport’s role in reducing carbon and toxic emissions. These include low or zero emission bus fleets and modal shifts from other transport modes. Copenhagen’s metro and suburban rail services are a key part of the city’s plan to be the first in the world to be CO2 free by 2025. There will be no diesel-powered buses in Oslo by 2020, and in Sweden Skåne’s bus fleet will run on fossil-free fuel by the same year.

Franchising

Public transport strategies in Norway, Sweden and Denmark are aligned with wider national and sub-national goals for economic development, land use planning and social cohesion. Levels of revenue support for bus services underpin a high quality of service, and levels of public transport use are high (although in Denmark, heavy investment in cycling infrastructure means public transport usage is relatively low).

One of the key features of public transport in Scandinavia is that virtually all bus services have been franchised. Metro and tram services are also provided either through franchising or by the incumbent municipal operator.The report notes that the main impact of franchising of bus services in all three countries has been to reduce costs and increase quality. The authors note that:

“…franchising in these countries and regions gives public sector Passenger Transport Authorities the direct ability to improve aspects of service because they specify and purchase that service from private sector operators. Thus, if they have the resources and are willing to pay for improvements, these can be delivered rapidly, to deliver on policy ambitions.” 

The Scandinavian way

Even as local, devolved and national governments are trying to encourage greater use of public transport, the evidence suggests that in a significant number of British cities – including Glasgow, Birmingham, Bristol, Leeds and Sheffield, the number of people travelling by public transport is falling.

The UTG report suggests that the Nordic model provides a road map for improvement in the way that UK transport service providers currently deliver urban public transport:

“Scandinavian countries have taken this approach because there is a political and public consensus that public transport is a public service. A public service that has a key role to play in tackling road congestion, reducing greenhouse gases and air pollution. A public service that also spreads the benefits of economic growth and promotes social cohesion through ensuring better connectivity within and between communities – including linking peripheral areas with the main towns and cities that are driving the wider economy.”


Read more of our public transport blog posts:

Disrupting cities: are tech firms to blame for rising inequalities?

By Steven McGinty

In cities across the world, there is growing unease at the impact of tech firms on local communities. In San Francisco’s Silicon Valley, “Google Buses” – the corporate commuter buses for Google staff – have been the subject of multiple protests by local activists, including the blockading of buses and displaying provocative banners.

The protesters’ main grievance? Housing. Researchers at the University of Berkley have found that rents close to bus stops used by Google employees are 20% higher than in other comparable areas.

It’s not just about Silicon Valley

In East London’s Tech City – home to both Google and Amazon – there have also been housing pressures, with property prices increasing by 13% in the two years to April 2017.

Further, The Economist has produced a map of London gentrification, showing that affluent young professionals are living in the inner-city, whilst poorer, often less educated ‘service workers’, are being pushed to the outskirts of the city. As Professor Richard Florida describes it “London is the archetypal example of a class-divided city”.

In Dublin, where Google and Facebook occupy 4% of all commercial office space, local activists have blamed tech firms for their housing crisis. Aisling Hedderman of the North Dublin Bay Housing Crisis Community, highlights that

“…we’re not going to see housing provided for families, but houses provided for single people and couples. And as long as people are willing to pay the high rents it’s going to keep driving up the rents

Tech firm Airbnb has also received a lot of attention for its impact on housing. Airbnb, who enable people to rent out their properties or spare rooms, has faced challenges in a number of cities. For instance, in November 2017, Vancouver introduced new regulations to stop businesses from offering short-term rentals through Airbnb and similar services. This means people can only rent out their principal property – which the city hopes will increase the availability of long-term rentals.

Technological change is nothing new

Edward Clarke, former analyst at the Centre for Cities, however, argues that the real problem for cities is not gentrification but poor city management.

In his view, urban neighbourhoods have always experienced periods of change, highlighting that Shoreditch’s status as a tech hub follows a long tradition of innovators moving to the area. And that research has shown that ‘new jobs’ (such as those in the digital and creative sectors) bring higher wages to an area, for the people working for these firms and in other sectors. Instead, Mr Clarke suggests there is a need to build more homes, and to consider developing on part of the Green Belt.

To alleviate these challenges, cities have started to recognise the need for closer collaboration. New York, Dublin, and London have all recruited tech leads to work with the tech sector. However, Joe Kilroy, policy officer at the Royal Town Planning Institute (RTPI), highlights that tech leads must have a remit that is wider than encouraging tech firms to move to the city. He explains:

Ideally the tech lead would liaise with city planners who can articulate the issues being faced by the city – such as housing affordability, infrastructure pressures, and skills shortages.”

Toronto and Kitchener, Ontario

In 2017, Toronto and its small town neighbour Kitchener announced plans to introduce a new transit line to ensure the city can cope with an expected influx of new tech workers.

It may be surprising to some that it’s not Toronto that’s the main tech player, but the region of Kitchener-Waterloo, home to the University of Waterloo and the birthplace of the Blackberry. It’s internationally recognised as a hub of innovation and prides itself on being different to Silicon Valley, viewing itself as more of a community than a series of business networks.

Local tech leaders acknowledge the importance of reaching out and working closely with local charities on issues such as affordable housing, as well as offering their skills to the community.

Final thoughts

Cities must ensure that the growth of the tech sector benefits everyone, and that sections of society aren’t left behind. However, big tech firms also have a role to play, and should become active participants in their communities, leading on areas such as education and skills and housing. Only then, will these tech firms truly prosper while having a lasting and positive impact on the surrounding communities.


The Knowledge Exchange provides information services to local authorities, public agencies, research consultancies and commercial organisations across the UK. Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

Joining the digital revolution: social workers’ use of digital media

In January 2018, NHS digital published a report, which highlighted the accessibility and availability of digital platforms to help social workers with their job role. The research, which was compiled from survey data, sought to understand not only how social work could be supported through the use of IT and digital platforms, but also to assess the current level of usage and understanding of digital technologies among the current workforce. While more than half of survey respondents said they had access to a smart phone as part of their role, far fewer were actually able to access case notes and other necessary documents digitally from outside the office.

The survey found there was an appetite for greater and better use of digital media in day-to-day work, which practitioners felt would not only improve their ability to work more flexibly but could also be used to forge better relationships with people who use services. In some instances, respondents to the survey felt improved use of digital media may provide a way to communicate more effectively with those who had previously been unwilling to engage, particularly in relation to social work with young people. The research found that digital technology was used in a range of ways to build and manage positive relationships, particularly with service users, including:

  • communicating with them to gather specific data (as part of assessment);
  • delivering interventions (such as self-guided therapy or telecare); and
  • supporting team work (peer support and online supervision)

Questions around the use of social media

Earlier research around the use of digital media in social care more generally found that it is used in a variety of capacities, such as storing and maintaining records, communications and day-to-day tasks such as booking appointments and scheduling in visits. However, the use of digital technologies by social workers can at times extend beyond simply maintaining records and scheduling visits. Many felt that while digital media in some ways makes their job easier, in other ways it can add to the stress of an already difficult job role.

A lot of the anxiety concerning digital technologies centres around social media. In the most positive of ways, it can be a core platform to allow service users to communicate, and make the social work team appear more accessible to people who may feel uneasy communicating in more formal ways. However, significant challenges around ethics and practice remain. Repeated instances of social workers being reprimanded have made some social workers wary of using social media platforms. In September 2017 HCPC published guidance which encourages practitioners to continue to use social media, but to seek advice and help if they are ever unsure. The guidance suggested that social media, if used responsibly, could support professionals to raise the profile of the profession and network with others nationally and internationally.

Supporting confidentiality and security

For many social workers and social work supervisors many of the challenges around using digital media centre on the necessity for confidentiality and security of information. While much of social work practice within offices is digitised with regard to record and case file keeping and report writing, security issues concerning remote access to files is one of the major challenges. In many cases until digital security can be assured, it will be difficult for social workers to work fully remotely and flexibly without some travel back to the office. GDPR also raises some interesting questions for the profession with regards to storing and accessing data.

An opportunity to improve information sharing and partnership working

It is well recognised that the use of digital media provides an opportunity to improve efficiency and partnership working within social work. If used effectively and supported well, it can allow information to be stored, shared and accessed across a range of different services, which can be particularly useful for increased health and social care integration. However, challenges in practice remain – including the ability of social workers to remotely access notes and information, the need to align working and IT systems, and the ability to access and read data in a number of formats across a number of devices. Research stresses the importance of risk management and appropriate training for staff so that they feel comfortable and confident using media platforms.

A welcome change in the profession?

For many within the profession, the rise of digital platforms as a way to engage with service users and provide increased support and flexibility for social workers themselves has been a positive development. It is a great leveller and can encourage service users who feel comfortable to engage in a much more transparent way with social workers. However, NHS Digital research shows that there are still significant challenges. Overcoming these to successfully integrate digital platforms and interfaces into social work practice has the potential to revolutionise not only how social workers engage with service users, but how they themselves conduct their work. Improved collaboration with other services, increased flexibility, and increased capacity for completing and recording continuing professional development and training to improve practice are just some of the potential fruits of social work’s digital revolution.


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