Digital infrastructure supporting health care during the COVID-19 pandemic

Healthcare is a key frontline service in the response to the COVID-19 outbreak. The NHS has had to react at pace to plan and deliver services in new and innovative ways.

Digital healthcare solutions are at the fore of ensuring not only the delivery of acute care for those patients suffering from COVID-19 but are also supporting the successful continuity of care and the day to day running of a health service which still needs to maintain “normal service” as well as its pandemic response. Digital infrastructure is helping the NHS and other partners to adapt and to meet the demand for health and care in a number of ways.

Supporting the delivery of care

In many ways, the NHS and frontline care in particular were already making inroads towards transitioning to digital and online platforms before the pandemic emerged. Many GP surgeries allow online appointment booking, and where appropriate, monitoring of those with long term conditions can be done remotely through at-home testing facilities, such as home heart monitors or monitors to help people monitor their diabetes.

Many care providers also already offer telehealth solutions for clients, and patient records are now stored online. However, in many ways the COVID-19 pandemic has catalysed uptake of digital solutions to healthcare diagnosis and delivery, with an increase in online consultations, greater use of the NHS Digital and NHS24 online and app platforms and a rise in the development of digital solutions to better support care in the community.

Support and training for frontline staff

In addition to supporting the direct delivery of care to patients, digital health infrastructure is also being adapted and used to deliver training and support to staff on the frontline. Blogs and online forums, including social media groups are enabling people to share experiences and best practice, and to create a sense of community among healthcare workers. In addition, virtual and e-learning opportunities are being developed to enable staff to access educational activities remotely. These include supporting the rapid education of the healthcare workforce in how best to manage the respiratory conditions encountered, as well as providing education to staff who may have been redeployed to other departments or settings as a result of the pandemic response. Online learning has also been used to help train volunteers and help the public to keep up to date with the latest developments across the health service.

Beyond healthcare to support the response to the pandemic

Artificial intelligence and data analytics also have a vital role to play in helping prevent the spread of coronavirus and other infectious diseases as digital solutions look to be developed to help beyond acute healthcare responses.

Predictive analytics and scenario modelling can be used to help identify those populations who are at risk of spreading the virus and of falling most severely ill to help support shielding campaigns and protect vulnerable groups as lockdown measures ease.

A project run by UK firm Biobank is looking to use samples collected by volunteers to map genetic sequencing in order to identify whether certain genetic characteristics make people more predisposed to become seriously ill, or more likely to contract the virus in the first place. This may help in the development of a vaccine and can also help identify those groups who will be most vulnerable when lockdown conditions are lifted so that they can be monitored more effectively.

Modelling and analytics can also be used to try and project any potential “second waves”. It is hoped that AI, analytics and machine learning will be able to help organisations learn from events such as the SARS epidemic, as well as quickly creating new knowledge from the millions of data points being generated in this outbreak.

Final thoughts

The significant humanitarian response to this global pandemic is being underpinned by a digital infrastructure, the extent of which we have never had at our disposal before. This digital support, of care delivery, communication, analytics, and modelling is being used in conjunction with insight from health and scientific specialists to try and help us find a path through this pandemic, deliver care, aid recovery and prevent re-emergence.

Making best use of the data and digital capacity we have throughout our health and care infrastructure will be a key part in preparing and meeting the needs and challenges that communities are facing.


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Further reading: articles on COVID-19 from The Knowledge Exchange blog

“Talent without Limits”: the impact of apprenticeships in Scotland

by Scott Faulds

Over the past six years, Skills Development Scotland has been working to increase the number of people starting apprenticeships across Scotland. Recent statistics have revealed that they are on track to meet their target of 30,000 new apprenticeship starts by the end of the financial year 2020. The provision of apprenticeships has been a key element of the Scottish Government’s youth employment strategy , which highlights the government’s belief that apprenticeships are an excellent opportunity for young people to gains skills, experience and a qualification while in employment.

This week (2nd March to 6th March) Skills Development Scotland has launched Scottish Apprenticeship Week 2020, with the theme “Talent without limits”, designed to celebrate the benefits apprenticeships bring to businesses, individuals and the economy. This blog will explore the impact of apprenticeships on business, education providers and young people in Scotland. It will also consider the benefits of work-based learning, graduate apprenticeships and workplace diversity.

Work-based learning

The availability of good-quality apprenticeships allows those who may not be interested in pursuing further education an alternative route in which to gain a formal qualification whilst gaining experience in the world of work. This is known as work-based learning, which is widely considered to be beneficial to the apprentice, education provider, employer and the wider economy.

According to research conducted by the European Training Foundation, workplaces where employees are constantly learning new skills tend to be more productive, more profitable and have lower staff turnover. A recent survey conducted by Skills Development Scotland found that 83% of modern apprentice employers agree that apprenticeships have improved productivity, whilst 79% said that employing apprentices improved staff morale.

Additionally, work-based learning has been found to improve the job prospects of learners, allowing them to build relationships with employers who may offer them full-time positions on completion of their apprenticeship.

The development of apprenticeship programmes allows employers and education providers to develop a close working relationship, which enables a better understanding of the skills required by the labour market. This allows for the creation of educational programmes that are more relevant to the demands of all employers, not just those who operate apprenticeship schemes. As a result, the skills developed by apprentices will be directly relevant to the skills required by the labour market. This could potentially improve the likelihood of securing a job following the completion of an apprenticeship. Thus, it can be said that work-based learning features benefits for apprentices, education providers, business and the wider economy.

Skills, growth sectors and graduate apprenticeships

Apprenticeship schemes provide the government with an opportunity to improve the collective skill base of Scotland by encouraging the development of apprenticeship opportunities in key sectors and areas which have the potential to generate economic growth. For example, analysis conducted by Oxford Economics has found that there will be a 4% growth in science, technology, engineering and mathematics (STEM) related roles in Scotland from 2015 to 2027. This equates to the creation of approximately 42,600 skilled jobs.

Therefore, it is of no surprise that the Scottish Government has been focused on trying to increase the number of apprenticeship opportunities available in STEM roles. In the past year alone, four out of ten modern apprenticeship starts, and the vast majority of all graduate apprenticeship starts, have been in STEM occupations.

Traditionally, securing a STEM role would require a formal qualification secured via an academic route, which can often be costly and take up to four years. Research conducted by Ekosgen has revealed that there has been a decline in the number of pupils studying and passing STEM-related subjects at schools and a decline in STEM enrolments in Scottish colleges. As a result, the traditional academic route in which to secure a STEM role may not be able to produce enough STEM-qualified individuals to meet the demands of industry.

In order to meet the demand for skilled workers, Skills Development Scotland has worked with industry and education partners to develop graduate apprenticeship schemes. These apprenticeships offer people the opportunity to gain up to a Master’s degree qualification in subjects such as civil engineering, data science and software development. The development of this model of apprenticeship has been praised by organisations such as PwC, Aegon and Universities Scotland, as a vital way in which to develop a highly-skilled workforce that will meet the demands of the growing STEM sector.

Diversity and equality

A key theme identified by the Scottish Government within their youth employment strategy is the need to develop clearer routes into apprenticeships for those from previously under-represented groups. The strategy explicitly discusses the need to increase the number of apprenticeship starts from minority ethnic communities, young disabled people, looked after children and a desire to improve the gender balance of apprenticeships (particularly those in male-dominated sectors).

According to Skills Development Scotland’s recent Apprenticeship Equality Action Plan, efforts to improve under-represented groups’ access to apprenticeships have had mixed results. Over the past four years, the number of disabled and BME (Black and minority ethnic) individuals starting modern apprenticeships has risen year on year. However, 72% of modern apprenticeship frameworks continue to have a gender imbalance of 75:25 or worse. This is particularly prevalent within the construction sector where only 2% of participants are female. Additionally, there has been a slight decrease in the number of care experienced people starting modern apprenticeships. Therefore, it is evident that whilst some progress has been made at improving the diversity of individuals starting an apprenticeship, there is still work to be done, particularly when it comes to improving gender balance.

Recent research has highlighted that diversity is essential for organisations who are looking to foster a culture of sustainable innovation. As previously discussed, future jobs are likely to be created in innovative STEM-related sectors, and therefore the need to improve under-represented groups’ access to apprenticeships will be vital to ensure that the quality of the Scottish workforce is able to meet the demand of growing innovative industry.

Final thoughts

In summary, the provision of apprenticeships has had a great deal of impact across Scotland. From developing the skill base of Scotland’s workforce to helping to improve the relationship between industry and education providers, the impact of apprenticeships goes far beyond providing young people with access to work-based learning and a formal qualification.

However, work still needs to be done to improve under-represented groups’ access to apprenticeships. Diversity has repeatedly been shown to increase workplace creativity and performance. Both of these traits will be critical in ensuring that Scotland is able to develop a workforce that can meet the needs of the innovative industries set to experience growth in the future.  


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Digital Leaders Week: Closing the digital divide

Today, in our final Digital Leaders Week blog post, we’re looking at the issue of digital inclusion.

As you look around, it may seem as if everyone is online. In the street, on the bus, in cafes and shops, most people seem to be glued to their smartphones. But a number of articles on our blog have highlighted the digital divide in society, between those who have access to digital technologies and those who don’t.

In 2018, we focused on digital exclusion among young people:

“One of the biggest myths of modern times is that all children and young people are ‘digital natives’. That is, they have developed an understanding of digital technologies as they’ve grown up, rather than as adults. But this view has been heavily contested, with research highlighting that young people are not a “homogeneous generation of digital children”.

Our blog went on to highlight research by Carnegie Trust UK which found that as many as 300,000 young people in the UK lack basic digital skills.

Schools and local authorities have been tackling digital exclusion in a number of interesting initiatives. We’ve reported on a ‘bring your own device’ scheme in secondary schools in Inverclyde, where children were encouraged to work in pairs or groups to help with communication, partnership working and sharing of knowledge. Another project – BBC Micro: Bit gave children the opportunity to learn how to code.

Recently, a new project was launched to ensure young people have equal access to digital technologies. During 2019, Digital Access for All (DAFA) will be working on a series of pilots to test out different ways of improving digital access for children and young people.

As our blog underlined, addressing digital exclusion among young people is crucial for their future development.

“Failure to tackle the issues of integrating “digital” successfully into the curriculum, and digital exclusion in schools and at home could also have serious implications. If a significant portion of the next generation is digitally excluded this potentially puts them at a significant disadvantage in terms of employment and further education.

However, the digital divide is not confined to the younger generations. This month, new research has shown that one-fifth of the population do not have foundational digital skills, such as using an internet browser or connecting a device to a wi-fi network. Nearly one in ten of the population have zero digital skills.

There are good reasons why people dislike going online, such as concerns about security and affordability. But being “digitally disadvantaged” matters because it can exclude individuals from earnings, employability, communications and retail transactions benefits. As government moves increasingly towards a digital by default position, the need for everyone to improve their digital skills will become more important.

A lot of work is going on to address digital exclusion, including research into its causes, funding initiatives and training programmes. Local government is also playing its part.

In 2017, the London Borough of Croydon was named Digital Council of the Year at the Local Government Chronicle (LGC) Awards – a showcase event for sharing innovation and improvement in local government. Among the initiatives that impressed the judges was Go ON Croydon, which aimed to help people struggling with technology or lacking digital skills.

“The Go ON Croydon project was introduced to support the 85,000 people in Croydon who do not have basic digital skills. Reaching out to organisations such as community and faith groups, this year-long programme set out to highlight and promote the council’s digital skills initiatives. One scheme promoted by the project was digital zones.  Staffed by volunteer digital champions and located in banks or retail stores, these physical spaces provided places where people could go to have their questions answered and to improve their basic skills.”

The Go ON Croydon project clearly made an impact, with digital skills levels in Croydon increasing from 70% to 79% within one year.

Throughout this Digital Leaders Week, we’ve highlighted just some of the ways in which the public, private and third sectors are working to help people make the most of the tremendous opportunities presented by digital technologies.

Digital doesn’t have all the answers, but it does provide examples of good practice from which organisations, communities and individuals can learn. As we enter a new “fourth industrial revolution”, where artificial intelligence, automation and robotics become more commonplace, our blog will continue to raise awareness of the challenges and opportunities presented by digital.


Some of our recent articles on digital technologies include:

To read more of our digital-themed blog posts, follow this link.

Autism-friendly cities: making a world of difference

At this time of year, high streets and shops across the country are bustling, decked out with lights and colourful decorations, and of course, the familiar Christmas tunes.

For many, this is part and parcel of the exciting run up to Christmas.  However, for autistic people, the added crowds, lights and noise can turn an already challenging experience into a sensory nightmare.

Indeed, although more than 1 in 100 people in the UK are on the autism spectrum, many still struggle to access local shops and services.  Places that many neurotypical people may take for granted – shops, theatres, cinemas, cafes and restaurants, hairdressers, libraries and museums, public toilets, and public transport – can be particularly challenging environments for autistic people.

Unpredictable and unfamiliar noises, lights, smells, crowds, queues, and other events can be overwhelming, and may cause sensory distress – ultimately leading to a meltdown.  Meltdowns may present as crying, screaming, kicking, biting or lashing out.  A lack of understanding and awareness of autism among the public – including unfriendly looks, judgements and comments – can further enhance the distress experienced.

In 2015, a YouGov poll found that 99.5% of people in the UK had heard of autism. However, there remains a lack of public understanding about how it may present, and the associated challenges autistic people face.  This is perhaps best illustrated by the recent case of a young woman with Asperger’s being forcibly removed from a cinema for ‘laughing too loudly’.  Unfortunately, this experience is not unique.  Research has found that as many as 28% of people have been asked to leave a public space because of behaviour associated with autism.

Indeed, many autistic people and their families have changed their own behaviour to reduce the chance of experiencing intolerance from the public.

It’s perhaps not surprising, then, that social isolation is a common issue – 79% of autistic people and 70% of parents feel socially isolated.  Almost half (44%) sometimes don’t go out because they’re worried about how people will react.

Increasing public understanding

The recent Too Much Information (TMI) campaign, delivered by the National Autistic Society (NAS), aims to increase public understanding of the five core features of autism.

Those five core features are:

  • anxiety in social situations
  • anxiety with unexpected changes
  • sensory overload
  • meltdowns
  • processing time

Creating an autism friendly city

One response has been the drive towards the creation of ‘autism-friendly’ cities.

According to Autism Together and Autism Adventures, an autism-friendly city is one in which autistic people can ‘use public transport, shop for food and clothes, take part in sports and leisure activities, visit cultural and tourist institutions and eat in restaurants.’

The NAS have established an ‘Autism Friendly Award’, which aims to help businesses make the small changes that make the most difference to autistic people.  Their Autism Friendly Awards toolkit sets out a helpful five-point checklist:

  • customer information: providing appropriate information to help support autistic people and their families’ visitor or customer experience
  • staff understanding of autism: developing staff understanding
  • physical environment: making appropriate and reasonable adjustments within the limits of the physical environment
  • customer experience: a willingness to be flexible and providing a clear way for autistic people and their families to provide feedback
  • promoting understanding: committing to helping increase wider public understanding of autism

Examples of good practice

In Glasgow, the council have been working to make the city centre autism-friendly.  The plans have focused initially upon shopping centres, transport hubs, museums, cinemas and key operational staff across the city centre.

The Glasgow Film Theatre (GFT), Scotland’s oldest independent cinema, recently became the first cinema in the UK to achieve an Autism Friendly Award for their work with children and adults.  This includes monthly screenings for autistic adults and children, with the volume slightly lowered, stair lights remaining switched on, house lights dimmed and a chill out zone provided. Trained ‘autism facilitators’ also answer questions at the end of each film.

Other organisations have followed the GFT’s lead. Glasgow Science Centre, for example, has recently introduced autism friendly hours.

In the North East, Aberdeen has also announced its intention to work towards autism-friendly status.

As well as raising awareness and making key shopping locations more accessible for autistic people, Aberdeen also plans to introduce autism-friendly libraries, including pop up sensory sessions designed for autistic children.

Research has shown as many as 40% of people with autism never visit a library – however, 90% have said they would be more likely to visit their local library if some changes were made.

Such adjustments include staff training, increased tolerance of noise and understanding from the public.  Dimensions have released free online training and top tips for libraries looking to become autism-friendly. It notes that while many people with autism need a quiet environment, they may make noise themselves – for example, by talking to themselves or others, becoming excitable or moving around. They highlight the importance of making clear to the public that the library is autism-friendly, which includes a tolerance of certain levels of noise.

Other cities that have been working towards autism-friendly status include: Bristol –  whose airport has won an Autism Friendly Award; Liverpool – where autism champions are being supported to recognise and respond to autism; and Newcastle in Northern Ireland – which has been named as Northern Ireland’s first autism-friendly town. It is anticipated that being autism-friendly will help boost the local economy and tourism.

Other ways to make cities autism-friendly

As well as organisations themselves making adjustments and promoting autism understanding among staff and customers, there are a few other ways in which cities can be made more autism-friendly.

Making public transport more accessible is a key challenge.  More than half of autistic people avoid public transport due to fears of disruption.  There are many things that can be done to help make public transport less distressing for autistic people.

From an architecture and design perspective, there are also many other things that can help to make urban buildings and spaces more accessible, in regard to ventilation, acoustics, heating, lighting, layout and outdoor spaces.

From a town planning perspective – there is currently a lack of research and guidance on the design of places for autistic people per se, however, there may be some transferability of lessons from work on the creation of dementia-friendly and child-friendly spaces.

For example, the provision of clear signage and removal of street clutter may be beneficial for autistic people.  Edinburgh City Council has recently banned on-street advertising structures in order to make streets more accessible for people with disabilities.

There have also been concerns raised that shared spaces – including the removal of road signs, traffic crossings and delineation between roads/walkways – may negatively impact upon autistic people, who may struggle with the uncertainty such schemes deliberately create.  This is an area where more research and guidance is needed.

The way forward

Creating a city that is autism-friendly requires a multi-faceted approach that includes both raising public awareness and understanding, and creating towns and places that allow for the specific challenges that are faced by autistic people and their families.

Many steps that can be taken are low cost and easy to implement – and support is available from a range of national and local autism organisations, such as the NAS.

Even just reacting with kindness and compassion when witnessing a possible autistic meltdown – perhaps offering some solution such as a quiet space – is significant.  The sum of these small changes can make a world of difference to autistic people and their families.

I wouldn’t change my son for the world but I will change the world for my son.” Julie Simpson, Founder of Autism Adventures


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Five current challenges facing Further Education

As well as developing the careers of school-leavers and adults and contributing to the economy, further education (FE) also plays a crucial, but unsung role in our daily lives. As one college chief executive has observed:

“Over the past 25 years, we have quietly gone about our work producing the people that matter most to our communities – those that build our houses, fix our boilers, our computers and our cars, care for our children and our parents, ensure the planes that take us on holiday are safe and look after us when we get to our destination, cook our special meals, entertain us live and on TV, enrich our lives with their art, cut our hair and make us even more beautiful!”

But now the sector is facing key challenges that are likely to change the face of further education in the years ahead.

  1. Policy reforms

According to the Institute for Government (IfG), since the 1980s there have been:

  • 28 major pieces of legislation related to vocational, FE and skills training
  • Six different ministerial departments with overall responsibility for education
  • 48 secretaries of state with relevant responsibilities

The FE sector has proved to be resilient and adaptable to these changes, but many believe this instability has left the sector unfit for purpose.  In 2016, the Sainsbury review of technical education recommended changes to England’s FE system to make it less complex. These were taken up by the government, which introduced a new Post-16 Skills Plan. The reforms will replace thousands of qualifications with fifteen new technical education pathways. The new ‘T-Levels’, in subjects such as construction, childcare and hairdressing, will be rolled out by 2022.

It’s too early to say what effect the reforms will have, but some already have misgivings. A senior civil servant at the Department for Education has advised deferring the start date for T-Levels, while the shadow education secretary Angela Rayner argued the changes would not make up for “years of cuts” to the FE sector.

  1. Funding pressures

The Social Market Foundation reported in 2017 that, since 2010, the adult skills budget in England has fallen in cash terms. “Alongside this reduction, the Institute for Fiscal studies (IFS) has shown that 16–18 education spending has reduced.”

Funding pressures on FE are likely to continue. In August, the Treasury instructed Whitehall departments with non-protected budgets, including FE,  to identify areas of “potential savings”. David Hughes, chief executive of the Association of Colleges, said “The news that the chancellor may be looking for further funding cuts from unprotected departmental budgets is very worrying for colleges. College students and staff have already taken on too much pain from the funding cuts in further education over the last decade.”

The government has announced a review of post-18 education funding, including further education. The review will be supported by an independent panel, led by Philip Augar, and is expected to conclude in early 2019.

  1. New apprenticeships

The apprenticeship levy was introduced on 6 April 2017. It requires all UK employers with a wages bill of over £3 million per year to invest 0.5% of their bill into apprenticeships.

Once they start making payments, employers can access the funds through a Digital Apprenticeship Service (DAS) account that allows them to pay for apprentice training, choose the training provider they want to provide the training, and find apprentices for their vacancies. Initially, this service is only available to those employers paying the levy. However, the government aims to extend access to all employers by 2020.

In May 2018, the Reform think tank published an assessment of the apprenticeship levy’s impact in its first year of operation. The report found that in the six months after the levy was introduced, the number of people starting an apprenticeship was 162,400 – over 40% lower than the same period in the previous year. Concerns about the levy were heightened in May 2018 with official figures revealing a 40% drop in apprentice starts across all industries in February, compared with the previous year. The statistics prompted further calls for reform of the levy. However, the Learning and Work Institute (L&WI) has argued that it is still too soon to judge the new system.

  1. Devolving FE

Central government continues to control FE funding, but local authorities and Combined Authorities are pressing for greater devolution of the adult skills budget. City mayors are also showing interest in bringing more of FE and skills under local control.

At the same time, the FE sectors in, Wales, Northern Ireland and Scotland have been experiencing their own challenges:

  • College funding in Wales has remained tight over the last few years, but a 2017 report from Colleges Wales highlighted the economic impact of FE in Wales. It reported a return of £7.90 for every £1 spent, an average annual return on investment of 24%.
  • A report by Viewforth Consulting report estimated that the FE sector generated over £524 million of output in Northern Ireland from college and student off-campus expenditure. A new further education strategy was launched in 2016, but the collapse of the Northern Ireland Assembly has presented the FE sector with additional uncertainties.
  • Between 2012 and 2014, 25 colleges in Scotland merged to create ten new regional ‘super colleges’ under a Scottish Government programme to make the sector more efficient and ‘responsive to the needs of students and local economies’. According to the Scottish Funding Council, the merger programme cost £72m, but delivered annual savings of more than £52m. However, Audit Scotland’s 2017 review of further education in Scotland found that student numbers at Scotland’s colleges fell to the lowest level for almost a decade. Performance figures on Scotland’s colleges published by the Scottish Funding Council (SFC) in February 2018 show that the success rate in almost two-thirds of Scottish colleges has dropped.
  1. The future

It’s clear that funding issues and policy changes will continue to affect FE in the UK. But other challenges are also looming.

The Social Market Foundation has highlighted market developments likely to present competitive threats to the FE sector. These include more employers moving in to provide training traditionally delivered by the FE sector, and the advance of educational technology, encouraging more learners to self-direct.

As for Brexit, the Association of Colleges believes the impact of the UK leaving the European Union may be less in FE than in other areas of national life,  but forecasts that Brexit has the potential to bring big changes to the demand for skills and training.


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

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

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

Purpose of the levy

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

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

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

Lower quality apprenticeships and bureaucratic burden?

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

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

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

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

Skills, Knowledge, Abilities

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

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

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

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

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

stacked pounds shutterstock_66808108

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

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

Way forward

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

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

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

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


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

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Going grey behind bars: meeting the care needs of older people in prisons

The population is ageing. People are living longer, and are in need of greater levels of care than ever before. But how is this increase in life expectancy and demand for care being met in prisons? Our prison population is also ageing, at a time when the sector is under increasing pressure, low staff numbers, higher levels of prison violence and disorder, and poor, crowded living conditions. In an environment which is largely designed to support young, able bodied men, how are prison staff and care teams liaising to help meet the needs of older prisoners?

A care plan for ageing prisoners

A report published in 2017 by the Scottish Prison Service called for a specific care plan for ageing prisoners to react to and provide planning to reflect the change in demographic of the prison population. The report found that between 2010 and 2016, the number of men aged over 50 in Scotland’s prison population rose by more than 60%, from 603 to 988. According to a Ministry of Justice report on prison population, the number of inmates aged over 50 is projected to grow from 12,700 to 13,900 by the end of June 2020, a rise of 9.5%, while the number of over-60s behind bars will grow by 20% from 4,500 to 5,400 over the same period.

In July 2017 Prisons and Probation Ombudsman produced the Thematic Review: Older Prisoners, which stated that HM Prison and Probation Service needs a national strategy to address the needs of the increasing numbers of elderly prisoners. It highlighted six areas where lessons still needed to be learned: healthcare and diagnosis, restraints, end-of-life care, family involvement, early release and dementia, and complex needs.

The difficulties older prisoners face on prison estates are far reaching. Not only are there physical barriers to moving around and living within a prison environment, but the increased mental health and social care burden is significant, as well as the potential need to begin end-of-life care. Many prison inmates suffer from multiple, longstanding and complex conditions, including addiction, and these conditions are exacerbated by a phenomenon known as “accelerated ageing”, which suggests that prisoners age on average 10 years faster than people of the same age in the wider community.

While some prisons have effective care plans which allow older prisoners to live with dignity, often older prisoners rely on the goodwill of officers and fellow inmates to meet the gaps in their care needs. And while in England and Wales the Care Act means that, a statutory requirement to provide care lies with the local authority within which the prison is located, this is not a guarantee. Calls have been made for care planning in prisons to become more robust, with minimum standards of care and a clear pathway of delivery, with accountability and responsibility of specific bodies being made explicit.

 

Prison staff, care teams and the NHS in partnership

Any care planning for older people needs input from a number of different sources, and care planning for older people in prison is no different. It will require input from professionals across health, social care, and housing and the criminal justice system as well as wider coordination support and legislative and financial backing from central and local government.

Prisoners with physical disabilities or diseases such as dementia need specialist care at a level that standard prison officers cannot give. Research has suggested that prison staff are being expected to shoulder this extra burden, often having to perform beyond their duty to care for and look for signs of degeneration in prisoners, particularly those who show signs of Alzheimer’s and dementia.

A number of research studies have looked at the provision of training and the use of additional, multi-agency staff to try to bridge the gap in care for elderly prisoners. In 2013 a review was conducted of multiple prisons, including some in England, the USA and Japan, which examined the training available on each estate for prisoners with dementia and similar conditions.

A number of schemes have been trialled, including extra training for staff, the allocation of specific wings or cells adapted to cater to the specific needs of older and vulnerable prisoners, and the use of peer to peer buddying or befriending services to help with care and support. Some prisons have also trialled the introduction of “dementia champions” to identify and support those with early signs of dementia or Alzheimer’s.

Extra challenges on release

As well as social care needs inside prison, specific rehabilitative needs of older prisoners being released from prison is also something that prison charities and reform bodies are keen to raise onto the agenda. A report from the Prison Reform Trust in 2016 highlighted the challenges of rehabilitative and parole needs of older prisoners, commenting that older people released from prison are being “set up to fail” by a lack of adequate provision to meet their health and social care needs on release. It highlights the limited and inconsistent housing, employment, debt and substance abuse advice available specifically for older offenders and suggest that their particularly vulnerable position puts them at risk of serious harm or reoffending.

Final thoughts

The population of older prisoners in our prisons is growing, and it is clear that a comprehensive strategy is needed to ensure that the specific, and at times unique care needs of these prisoners are met. This will mean greater cooperation from social care, health and criminal justice agencies, but will also mean reassessing how we think about social care, how it should be delivered and funded. The needs of older prisoners go beyond physical adaptations, to mental health, dealing with social isolation, the onset of chronic illnesses and at times the provision and planning of end of life care.

Follow us on Twitter to see what developments are interesting our research team.

If you enjoyed this blog, you may also be interested in our other articles:

Helping people with dementia to live well through good urban design

Planning for an ageing population: some key considerations

Co-production in the criminal justice system

Highlighting policy and practice: research briefings from The Knowledge Exchange

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So far this year, our team of Research Officers in The Knowledge Exchange have researched and written more than 30 policy and research briefings on a diverse range of subjects, from housing and planning to technology and training. Written in a clear and concise style, each briefing brings together examples of recently published evidence, alerts readers to new and continuing developments and signposts sources of further information. New briefings are available exclusively to members of our Information Service, and the choice of topics is driven by what our members are asking us about.

Today’s blog post offers a flavour of just some of the topics we’ve been covering during the year.

Housing

In many parts of the UK, people are struggling to buy or rent affordable housing. One consequence is a rise in homelessness. Our briefing – Delivering solutions to tackle homelessness – describes the complexities involved in defining homelessness, and the subsequent difficulties in measuring the scale of the problem. The causes of homelessness are no less complex, and the briefing lists some of the factors that lead to people finding themselves on the street, such as eviction, unemployment, health problems and relationship breakdowns. It also highlights approaches to tackling homelessness, such as social impact bonds and homeless health peer advocacy.

Planning

Closely related to housing is the role of planning in ensuring that individuals and families not only have adequate homes, but the infrastructure and services needed to support communities. One of the significant developments in this area has been the UK government’s policy on devolving more powers (including planning) to England’s cities and regions. Our briefing – Devolution of planning powers to city-regions – explains that each devolution deal agreed between the UK government and local authorities is tailored to the local area. In the West Midlands, for example, a directly-elected mayor will be given planning powers to drive housing delivery and improvements.

The briefing notes that, while there is widespread agreement that devolution of planning powers to local areas is a positive step, there is also concern that local areas won’t be able to deliver what they need to in terms of planning without control of expenditure, much of which is still retained by central government.

Technology

Our “Ideas in Practice” series of briefings presents case studies of projects and initiatives that have tackled a range of social issues, often resulting in reduced costs or improved efficiency. Our smart cities briefing on MK: Smart outlines a technology-led urban innovation project in Milton Keynes that aims to improve the town’s key infrastructure in areas such as transport, energy, and water. One of MK:Smart’s success stories is its Smart Parking initiative, which has encouraged drivers to use limited parking spaces more effectively, as well as providing the council with a better understanding of parking behaviour.

Another technology-focused briefing looks at the increasing development of “serious games” in the domains of planning, education, health and cultural heritage. Serious games in the policy field have borrowed elements from the video games sector, such as virtual reality, simulations and digital game-based learning. As well as improving skills and engagement among individuals, serious games have been used as a powerful way of introducing new concepts to the public, and providing people with an understanding of different points of view. The briefing showcases some examples of the application of serious games, including ‘B3— Design your Marketplace!’ which created an immersive and playful environment to encourage citizens to give their views on the design of a marketplace in Billstedt, a district of Hamburg.

Education, training and skills

A number of our briefings this year have focused on the all-important areas of education, training and skills. The Ideas in Practice briefing on science, technology, engineering and maths (STEM) education considers key trends and practical applications. Among the initiatives highlighted in the briefing is Third Space Learning, which connects primary schools in England and Wales with maths specialists via one-to-one online sessions.

In August, we published a briefing focusing on the impact of outdoor learning on educational attainment. It includes information on the implementation of the Forest School initiative in the UK, which places emphasis on children having contact with nature from an early age. The briefing highlights evidence that pupils with the highest connection to nature have been found to perform better in exams, and notes the positive impact on the attainment of those from deprived backgrounds.

Crime

Our briefing on urban gang crime highlights some of the ways that local authorities and organisations have sought to tackle the problem. One of the case studies focused on the exploitation of young women by gangs in Manchester. Delivered by women who have survived gang exploitation, it provides one-to-one support, allowing both mentors and victims to create lasting relationships and networks of support which help them as they transition from life within a gang. In 2013, the project won the Women in Housing award for best community/ training project for its work in rebuilding women’s lives.

Further information

This is just a taster of the variety of subjects addressed in The Knowledge Exchange’s policy and research briefings. A fuller list of briefings is provided here, and members of the Idox Information Service can keep up-to-date with newly-published briefings via our weekly Bulletin.

Reducing re-offending: rehabilitation and integration through employment

By Rebecca Jackson

Prisons in Britain have a poor record for reducing re-offending – 46% of adults are re-convicted within one year of release. And it’s estimated that each year, the financial cost to society of re-offending in Britain is £11bn.

In 2014, 68% of prisoners thought that ‘having a job’ was important in stopping re-offending.

However almost 50% of prisoners in the UK said that they had no qualifications, 40% needed help with education while in prison, and of these, 21% needed help with basic literacy and numeracy.

Government and academic research has supported the idea of employment post-sentence as being a key way to reduce re-offending and help integrate ex-offenders back into society. But opportunities within prison are often limited and once released, former offenders often find employers reluctant to hire them because their criminal record.

Roof Womens Prison Lincoln Castle, Creative Commons, rodtuk, July 2015.

Roof Womens Prison Lincoln Castle, rodtuk via Creative Commons, July 2015.

Building skills within prison

While in prison, inmates are given the opportunity to learn skills, trades and improve their basic literacy and numeracy ability. Some are allowed to do kitchen work within their prison; others work in offices alongside prison staff carrying out menial tasks in order to help strengthen their CV on their return to ‘normal life’.

However for many, there is little or no support, and the skills they learn are not sufficient to get them a job ‘on the outside’.

The prison service has introduced a number of schemes to attempt to improve this preparedness for work in the real world, but as the re-offending statistics show, success has been somewhat limited, with many struggling to stay in work or find work altogether.

Barriers to employment

While in some instances it is a lack of willingness or a lack of preparedness on the part of the former offender, another huge barrier to ex offender employment is the stigma associated with a criminal record and the reluctance of employers to consider people for roles who have served time in prison.

Efforts have been made by both government and independent employment and criminal justice organisations to reduce concern from employers.

Some firms have made a conscious effort, to deliver a series of very public and very successful ex offender training programmes, including companies such as National Grid, Timpsons, First Direct, Co-Op,Marks and Spencer, Virgin, Greggs and DHL.

And the Ban the box campaign, whcih aims to remove the tick box from application forms that asks about criminal convictions, hopes to reduce the impact of stigma even further by allowing ex offending applicants to reach the latter stages of an interview process, after it was found that many employers would automatically exclude someone who had checked this box on an application form.

Innovative offender employment projects

Creative Commons, Robert Fairchild, Cupcakes n sprinkles, 2011

Robert Fairchild via Creative Commons, 2011

The Freedom Bakery, based in Glasgow, is a social enterprise that employs ex-offenders, in the hope that employment will break the cycle of re-offending. The founder of the bakery said the aim of the scheme was to help encourage personal development as well as skills and integrate former offenders back into society. However he stressed that it is not about ‘pity employment‘ – people are given the chance to reform and develop, and the company hopes to make money.

Similarly Bad Boy’s Bakery, the brain child of TV chef Gordon Ramsay is now a well-established CIC (Community Interest Company) run by Working Links. Based at HMP Brixton in London, they sell goods to local Caffe Nero stores, as well as local sellers and within the prison canteen. Recruits are trained to industry standards in food quality and safety, including NVQ Levels 1 and 2 in Food Production, giving them skills in food preparation, baking, stock and time management, as well as knowledge of health and safety.

But it’s not just independent businesses who are engaging with ex- offenders. Well known high street chain Timpson’s also has one of the most successful and well established ex-offender employment schemes in the country. 16 of their shops in the UK are now managed by individuals who have spent time in prison and have come through their rehabilitation scheme.

The National Grid also offers offender training and employment programmes with people coming to the end of their sentences and provides training and a job on release for those selected. Over 2,000 prisoners have completed the scheme which has a re-offending rate of just 6%.

Our infographic breaks down some of the key facts.

Prisoners inforgraphic


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

What technology brings to health and social care: a case study of Calderdale and Idox

 

By Steven McGinty

In the second of our articles on health and social care and technology, we‘re going to look at the advantages of using technology, as well as a case study of an innovative partnership between Calderdale Council and Idox.

The ‘Digital working, learning and information sharing’ strategy, developed in partnership with the adult social care sector, identifies three areas where technology would bring a number of benefits:

  • working directly with those who need care and their carers;
  • supporting the learning and professional development of staff;
  • organisational business support and information management systems.

The use of electronic notes, for instance, would be a simple step that would have a significant impact on homecare workers (highlighted in section 5 of the Burstow Commission report on the future of the home care workforce).  At the moment, care workers usually make handwritten notes and leave them in a book in someone’s home.  However, if care workers moved from handwritten notes to electronic notes, information could be shared more easily. This would mean that care managers and families would be able to monitor an individual’s care and conditions remotely.

Organisations have also seen the advantage of incorporating e-learning into staff development.  The Skills for Care ‘Digital capabilities in social care’ report found that 95% of organisations used e-learning courses to support staff development, particularly in administration-related areas, such as health and safety and fire training. For instance, instead of sending staff on full day training sessions, e-learning courses can be completed by staff in an hour, offering greater efficiency and flexibility.

However, the report also highlighted that social care related e-learning courses, which looked at issues such as dignity and respect, were of ‘variable quality’ and not able to compete with the experience of face-to-face and group learning. Therefore, it’s possible that an opportunity is being missed by education and training providers, as technology should be able to provide better solutions than the simple tick box exercises described in the report.

Interestingly, the report also suggests this might not be too far off, as one of the organisations revealed that they were looking at more interactive options and were currently working on a research project with a university in Greece, which focused on the idea of ‘gamification’.

One local authority that’s certainly tried to capitalise on the benefits of technology is Calderdale Council. The council has developed an innovative case management tool to support their day-to-day work, in areas such as child protection, looked after children, and fostering and adopting. Parveen Akhtar, Early Intervention Service Manager, at Calderdale Council explains that:

“The Child Social Care solution was created in partnership with schools, health and police. Providing an intuitive system to meet the requirements of front line social care practitioners, it enhances our ability to provide better services to families within our community.”

The Child Social Care solution creates a single view of a child through combining information from several sources into one record. This means that practitioners are able to create, access and share information easily and securely, supporting informed decisions and putting in place appropriate support for children and their families.

The system has a number of benefits and features, including:

  • improving multi-agency communication and response;
  • reducing the amount of time taken by practitioners to locate another agency involved in a child’s case;
  • enabling practitioners to access information remotely;
  • offering comprehensive performance and reporting tools for providing vital statistics;
  • providing the ability to monitor and track the progress that children and families are making.

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

Over the coming years, health and social care will be facing ever greater demands with tighter budgets. For this reason, technology is going to be essential to support better outcomes and more efficient services.  It is therefore important that a strategic approach is taken concerning information technology, and that organisations look at its long term benefits, rather than the short term savings from cuts to investment.

The first article on health and social care and technology, “What’s preventing health and social care from going digital?”, can be found here.

Further reading: