One Big Society issue 1

September 2015

www.onebigsociety.co.uk

Housing Shortage: Demand Outstripping Supply

Devolution: An Evolution in Government?

Government Committed to Free Schools

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Are You Leading the NHS to Success?

Growing Management Numbers in the NHS. Is This Fact or Fiction?

Value of Assistive Living Technologies

Multiplex PCR Panels at the Point-of-Care MiniLab empowers clinicians with molecular diagnostic results on demand

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Contents

Welcome to the September Edition of One Big Society Magazine.

In this issue, we explore Guy’s and St Thomas’Trust, with Jessica Barrett analysing a new MiniLab that is set to drastically improve diagnostics. We also examine the trust’s charity and the exciting projects it has helped deliver, as well as speaking to Vinayak Bapat on a pioneering heart operation he performed earlier this year with help from the charity and trust.

Are growing numbers of managers in the NHS a myth or a genuine issue? We explore how management in the service is affecting the outcomes of the Five Year Forward View, as well as discussing the issue with Ruth Warden, Assistant Director of Employment Services at NHS Employers, to see just where the NHS stands currently and what more needs to be done.

Turning the spotlight on sustainable transport, we have a series of features exploring how the Government is attempting to raise the profile of lower emissions transport following the recent Supreme Court ruling. As part of this series we spoke to Gary McRae, manager of the largest fleet of electric cars of any local authority in the UK about how corporate fleets could pave the way for an electric car revolution.

4. Foreword 6. Overview 12.

Minister Focus

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Health and Social Care Guy’s and St Thomas’ Charity: A Hub for Innovation Multiplex PCR Panels at the Point-of-Care GSTT Funds Pioneering Heart Operation 2020 Vision: Digital Efficiency and Innovation in the NHS Growing Management Numbers in the NHS The Five Year Forward: NHS Employers Prospective Are You Leading the NHS to Success?

Substance Abuse: The Frontline Benenden National Health Report 2015 Increase in Diabetes Cases in UK The Importance of Designing Dementia Friendly Care Environments Value of Assistive Living Technologies New Ways for Prevention Primary Care in the Post Five Year Forward View World

Education 48.

Rise in STEM Subject Take-Up 50.

Government Committed to Free Schools

Grants from the Department of Transport have helped get people in the New Forest out of their cars and using alternative modes of transport. Mark Holroyd, Transport and Tourism Manager for the New Forest National Park Authority talks to us about how this is impacting the environment at the park and helping other park authorities reduce the emissions of their visitors.

Transport 52.

Dundee: The Electric Car City 54.

Bio-Bus: Is This Fact or Fiction?

56.

Charging Points Infrastructure in the UK 58.

Compressed Natural Gas Vehicles

Elsewhere, free schools, the issues surrounding providing more small businesses with opportunities for Government procurement contracts, and encouraging more women into the IT and technology sectors are all topics covered in this edition.

60.

62.

Environment and Sustainability The New Forest Goes Green New Plan Will Boost Starter Homes in Rural Areas

We hope you enjoy this issue.

64.

66.

Built Environment Housing Shortage: Demand Outstripping Supply How the Skills Shortage is Affecting Construction

At One Big Society, we want to talk to representatives from all sectors to provide an inclusive platform for sharing ideas and initiatives.

With this in mind if you have any ideas or comments about any of the features in this issue, or ideas for the future please contact our editor, Hannah Stevenson at hannah.stevenson@ai-globalmedia.com

We hope you enjoy this issue.

IT 68.

Digitalisation: How to Get More for Less

and Make the Future Brighter for All 70.

National Digital Conference 2015: Keynote Speech Procurement 74.

Government Set Ambitious Procurement Target

to Help Small Businesses 76.

New Rules Shake-up NHS Agency Staff Procurement

78.

80.

HR and Training Devolution: An Evolution in Government?

Plugging the Engineering Brain Drain One Big Society Magazine 3

September 2015

Foreword

Luen Thompson

Hi, I’m Luen Thompson and as a Director of Carers Trust I am proud to introduce the very first edition of One Big Society Magazine.

As the largest UK charity supporting unpaid carers, we at Carers Trust understand the importance of the message of One Big Society Magazine; that everyone, from local authorities and Government departments to businesses and community services, works together to ensure every member of society is safe and cared for.

There are approximately seven million carers in the UK, with that number set to increase. Three in five people will become an unpaid carer at some point in their life, although many do not recognise themselves as such and so can miss out on vital support.

This is why our partnerships are so important to us. We work across a number of sectors to ensure those who act as carers to members of their family or friends are recognised and provided with information as to where they can find help and support.

These partnerships include working with pharmacists to help them recognise carers, because as part of frontline community care pharmacists are ideally placed to notice people picking up

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prescriptions for other people, mark them out as a potential carer, notify them of the support available and direct them to local services.

In the private sector, we have worked with Barclays who have set up a number of carers forums in their branches and have been training their staff to recognise customers who are carers.

We have also worked with supermarkets, advising staff on noticing potential carers - for example, customers who buy two lots of shopping at once.

The healthcare sector also plays a key role in helping identify and signpost unpaid carers. GPs provide free flu jabs to unpaid carers, so we work to help them provide carers with details of where to find further help at the same time.

New legislation has put a duty on local authorities to identify young carers and provide them with the same assessments and support available to adult carers, so Carers Trust are working with local authorities to help them achieve this. We also work in schools helping staff to identify young carers and show them how to access support and guidance.

These partnerships are vital as often people caring for others do not recognise themselves as carers, and are therefore unlikely to put themselves forward for support. Unpaid carers save the UK economy an estimated ÂŁ119bn a year and in the future, with the aging population and cuts to the welfare system and Local Authority spending hitting hard, our work is going to become increasingly important to ensuring these people are supported.

It is imperative that people work together to identify carers and also that carers themselves know where they can get support to meet their needs. Caring can make people feel isolated and stressed, have an impact on their health and wellbeing and leave the carer in financial hardship.

In the future unpaid carers are going to be even more important to society, so working together to reach unpaid carers and support them is only going to become more vital.

Foreword

One Big Society Magazine 5

September 2015

Overview

Cicero Group Appoints Iain Anderson as New Executive Chairman The public relations firm, which specialises in Government and business relations, has announced the appointment of its co-founder to the role of Executive Chairman.

The move will see the current Director and Chief Corporate Counsel and co-founder of the business step into the role focusing on strategy and continuing the ongoing development of the integrated communications agency.

Anderson takes over from outgoing Chairman Stephen Knight who has chaired the Board since 2008.

He will now chair the eight-strong Cicero Group Board, which was last expanded in May 2014. He will continue to service Cicero’s UK and international client base with strategic counsel.

In addition to his role at Cicero, Anderson is the current Chairman of the Association of Professional Political Consultants (APPC) and a past Chairman of the CIPR Public Affairs Group as well as is contributing Political Editor at Square Mile Magazine.

Iain Anderson commented on his new role.

“During the 15 years that Cicero Group has been in operation, the communications industry has changed absolutely immeasurably. Having recently moved to our newly designed headquarters in the City and with our growing global blue chip client base, I am thrilled to be leading the Cicero Board at one of the most exciting times in our development.”

Jeremy Swan, Cicero Chief Executive also expressed his opinion on the appointment.

“In Iain we have a dedicated, inspiring leader and one of the top industry figures of his generation. I can think of no better person to lead the Board as we enter the next phase of growth and strategy.

“I would also like to place on record my enormous gratitude to Stephen Knight for his immense contribution to the Cicero story.”

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Overview

£500,000 Flooding Support for Rural Communities New funding for six rural areas making it easier to apply for flood protection.

Six rural areas are to receive a share of a half-amillion pound fund making it easier for them to apply for flood protection, Floods Minister Rory Stewart announced today.

The ‘Pathfinder Projects’ pilot schemes will look at cutting red tape and costs for small communities at risk of flooding across the country.

Each pilot will support local authorities in developing innovative ways to apply for funding, combining smaller projects into larger and more effective flood risk management packages for each area.

Floods Minister Rory Stewart said: “We are investing in flood protection across the country at record levels, with an unprecedented six-year commitment of £2.3 billion to better protect an additional 300,000 homes by 2021.

“These pilots will make it easier for local authorities to apply for flood protection funding so they can better protect people’s homes and businesses. Our rural and small communities will also have the opportunity to play a key role in developing these schemes.”

projects in Bishopstone, Saunderton/Bradenham, Hughenden Valley and Monks Risborough.

Kirklees County Council Addressing a range of surface water risks for communities within Honley, Moldgreen, Huddersdfield and Kirkburton.

Warwickshire County Council Developing and assessing a package of flood risk management measures for groups of properties in small communities in Warwickshire.

Hampshire County Council Addressing a combination of ground, surface and river flood risks in the county. The project will explore possible solutions for communities near Andover, in Vernhan Dean, Upton, Hurstbourne Tarrant, Stoke and St Mary Bourne.

Lancashire County Council Addressing largely surface water and ordinary water course flood risks The communities being considered are within Whitworth, Stackstead, Strongstry, Rawtenstall and Cloughfold (all in Rossendale) and Ewood Bridge.

More information 1. Once these trials have taken place, local authorities will report on their findings and will then have the opportunity to apply for funding from the Government’s £2.3bn six year flood defence programme.

2. The results from these trials will be shared with other local authorities and allow them to use similar approaches when developing schemes which benefit small communities.

3. The Pathfinder scheme enables communities at significant or greater risk of flooding to work with key partners, including local authorities, to develop innovative local solutions that: • enhance flood risk management and preparedness in ways which quantifiably improve the community’s overall resilience; • demonstrably improve the community’s financial resilience in relation to flooding; and • deliver sustained improvements which have the potential to be applied in other areas.

Reproduced by kind permission of Crown Copyright.

The local authorities receiving funding to investigate and assess options are: Northamptonshire County Council Addressing flood risks in parts of Daventry, Helmdon, Grimscote, Cogenhoe, Quinton, Grendon and Grafton Underwood.

Buckinghamshire County Council Addressing surface and ground water risks in four locations in Buckinghamshire and will support One Big Society Magazine 7

September 2015

Overview

Eastern Shires Purchasing Organisation is Making Life Easier With Cashless Online Payment Solutions The organisation’s improved framework for Online Payment and Engagement Solutions and Cashless Catering Systems (978) launched on 1 July 2015.

Customers will be excited to learn that this framework now offers a wider range of suppliers who will adapt their offering throughout the lifetime of this framework. This will enable customers to have the most up-to-date systems to operate their online payment and engagement solutions and cashless catering systems.

New and improved framework The benefits of the previous framework remain, for example more cost efficient and streamlined meal provision service which enables organisations to reduce back office cash handling.

Additional benefits are: • a wide range of market leading suppliers who have the knowledge and experience to deliver these solutions.

• a number of authentication methods can be used, such as: photo cards, swipe cards, proximity cards, and biometric systems.

• a quicker, secure and convenient way to make payments • users can make quick and easy payments using debit or credit cards which lessens the opportunity for cash being lost in transit • Quick and easy top-ups can be made at cash loading machines • On line purchase history • Allergy and special diet alerts at point of sale Further to this there is now improved system functionality and engagement solutions available, better integration of systems and customers will now have the ability to either Call-Off directly from the framework or take the Further Competition route for new solutions tailored to your needs.

Established suppliers There is an extensive list of supplier’s available allowing customers to make an informed choice and seek suppliers who offer competitively priced solutions. The framework has also been separated into two lots, so a supplier can be approached with a specific requirement or work together to provide an overall solution over both lots. Suppliers now offer additional modules and functionalities for existing customers.

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Separated lots There are two lots within the framework: Lot 1: Online payment and engagement solutions • Cunninghams Cash Registers • Integrated Payment Solutions • Parent Mail Ltd • ParentPay Ltd • Schoolcomms • SF Software Ltd t/a Pebble • sQuidcard Ltd • Tucasi Ltd • Uniware Systems Lot 2: Cashless catering solutions • AIT Ltd • AMI Education • Biostore Ltd • Bluefish Education Design

• • • • • •

Cunninghams Cash Registers Integrated Payment Solutions Nationwide Retail Systems SF Software Ltd t/a Pebble sQuidcard Ltd Uniware Systems

ESPO provides public sector services, including government departments, education services and charities with procurement frameworks designed to save money and streamline procurement processes. The improved framework is just one of a number of frameworks designed to improve procedures throughout the public sector.

The full framework can be downloaded here.

Reproduced by kind permission of ESPO.

Overview

Nursing Recruitment Rules Too Stringent Says Employers Organisation Stringent Home Office rules puts patient safety at risk by denying nurses entry into the UK according to NHS Employers.

Around 1000 nurses from outside of the European Union have been rejected to date by the Home Office with a further 1000 nurses expected to apply to work in the UK in the next 6 months.

NHS Employers warns that immigration rules are compromising patient safety, cost controls and leaving a shortage of nurses and doctors at a crucial time.

If NHS Trusts are not able to recruit overseas nurses there is a risk that clinical services will be compromised especially in the coming winter months when demand for care is highest. This could lead to delays for patients, their families and risks operations being cancelled and treatments being delayed. Figures from NHS England show there is increasing demand on the NHS to meet patient need at a time when there is a nursing shortage in the UK. Trusts need to recruit large numbers of nurses from outside of the EU to provide a sustainable workforce in the NHS.

clude Sir Robert Naylor (UCLH), Sir Len Fenwick (Newcastle) and Sir Andrew Cash (Sheffield).

Danny Mortimer, Chief Executive of NHS Employers, said: “Hospitals strive constantly to deliver the same high standard of care to patients amid rising demands. Even with Government commitment to additional training places for nurses and a focus on retention, we need to employ staff from outside the EU to meet current demand for staff. Due to the high demand for immigration certificates in June and July, for example, all of the applications for nurses were rejected. Whilst there was some improvement in August, with 200 certificates being issued there remains significant

numbers of outstanding applications for entry to the UK to take up nursing posts in our hospitals.

If Trusts are unable to employ these nurses it will impact on their ability to meet safe staffing levels and support the effective provision of services particularly in the winter months.

“Non-EU nurses are invaluable to the NHS. Whilst we are experiencing a mismatch between supply and demand we are asking that this is recognised and that nursing be placed on the shortage occupation list for the next two years.”

While plans are in place to train more nurses in the UK, it takes four years to commission and deliver the training so we will not see the benefit until 2017 at the earliest. In the meantime, the NHS’ priority must be to ensure that there is sufficient staffing to deliver good patient care in hospitals across the country. The NHS values migrant doctors and nurses who have contributed a significant amount to the way we deliver care to our patients.

The organisation NHS Employers has written to the Home Secretary Theresa May to raise these concerns and is keen to be helpful to the Home Office’s policy implementation in these and related issues. The letter is signed and supported by many trusts across England and co-signatories inOne Big Society Magazine 9

September 2015

Overview

HS2 Inspires Future Generations of Female Engineers HS2 Ltd is supporting National Women in Engineering Day by meeting pupils in Hemel Hempstead to talk about HS2.

To mark National Women in Engineering Day on 23 June female engineers from HS2 Ltd met with pupils at a school in Hemel Hempstead to talk about the wealth of opportunities in the industry.

The event, part of HS2 Ltd’s science, technology, engineering and maths (STEM) inspiration programme, will be attended by 40 year 9 girls from The Cavendish School.

Organised in partnership with The Smallpeice Trust, one of the key aims of the day is to teach the students about the applications of STEM subjects, introduce them to our successful women engineers, and promote the engineering industry as an exciting, challenging sector in which to work.

Students will mix with the engineers in ‘speed networking’ where they will get the opportunity to find out how our engineers got where they are today, and what their daily work involves.

The students will also take part in practical activities that allow them to start thinking like engineers and understand the real-life applications of engineering.

Beth West, HS2 Ltd Commercial Director, said: “Our female ambassadors are working to spread the message that being a woman is not a barrier to working in the rail industry.”

“HS2 is a 21st century project and we want to lead by example on diversity. We strongly believe in the value of women in the workforce and currently a third of our engineers and our executive team are female. We will build on that along with the wider industry, where only six per cent of the engineering workforce is female.”

10 One Big Society Magazine

Simon Kirby, HS2 Ltd CEO, added: “Over the life of the project HS2 Ltd will be offering 2,000 apprenticeships to young people and 100,000 jobs.

75 per cent of students have a better idea about how academic choices affect their career path after speaking with an employer. So, days like today are really important as we need young qualified people to move into these roles and drive forward our future infrastructure development.”

Lord Ahmad, Transport Minister, said: “This government’s investment in world-class infrastructure, like HS2, will create jobs and opportunities across the country as part of our long-term economic plan.

“We need to make use of all available talent to ensure Britain stays on the right track. Women currently make up a tiny proportion of our surveyors, engineers and construction professionals. We need to overhaul the sector’s image, so engineering and construction are a more attractive career option for women. A diverse workforce means a more successful workforce, which is why I am backing this campaign.”

Overview

One Big Society Magazine 11

September 2015

Minister Focus

The Rt Hon Nicky Morgan MP, Secretary of State for Education and Minister for Women and Equalities

The Rt Hon Nicky Morgan was appointed Education Secretary and Minister for Women and Equalities on 15 July 2014. Since then she has spearheaded a number of important initiatives including a scheme using the skills of rugby coaches to instil character in disaffected and disadvantaged children and inviting business leaders to help improve social diversity in schools, which is a key focus of Morgan’s alongside reducing NEET (not in education, employment or training) among young people and encouraging women’s education.

As part of her ministerial duties Morgan leads The Women’s Business Council, which was established in 2012 to advise the Government on how women’s contribution to economic growth could be improved.

Another of her key schemes this year was a celebrity backed initive designed to improve child literacy and to help make English students the most literate in Europe.

Collaborating with children’s author and comedian David Walliams, Morgan launched the scheme in August. Alongside existing reforms that have helped tens of thousands more pupils to read confidently, the new scheme saw Morgan announce plans to create at least 200 new book clubs across the country and an ambition to see every eight year old enrolled at their local library.

The new campaign is part of the government’s ‘one nation’ approach to extend opportunities to every child, regardless of background.

Morgan commented on the scheme and how it would affect children and social diversity in schools.

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“No matter where they live or what their background, every single child in this country deserves the opportunity to read, to read widely, and to read well - it’s a simple matter of social justice.

“Our reforms have already helped tens of thousands more pupils to leave primary school as confident readers but we must go further.

That’s why I am pleased to team up with David on this national mission to make our young people the most literate in Europe.”

Prior to her appointment as Secretary of State Morgan has served as Parliamentary Private Secretary to the Rt Hon David Willetts MP, Cabinet Minister at the Department of Business, Innovation and Skills, and before that was a member of the BIS Select Committee. She served as an Assistant Whip in the coalition government, until her appointment as Economic Secretary to the Treasury on 7 October 2013. She was appointed as Financial Secretary to the Treasury and Minister for Women on 9 April 2014.

Minister Focus

One Big Society Magazine 13

September 2015

Health and Social Care

Guy's and St Thomas' Charity: A Hub for Innovation

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Health and Social Care

The charity funds innovative and exciting projects, working closely with the Guy’s and St Thomas’s Hospital Trust to deliver ground breaking new solutions in healthcare. We spoke to Oliver Smith, Director of Strategy and Innovation at the charity, on how the funding works and how the programme has been so successful.

The charity prides itself on funding innovative projects to help change the face on the NHS, working principally with Guy’s and St Thomas’s Trust as well as further afield, working within local communities to help transform healthcare for the benefit of both patients and healthcare workers. £20 million a year is invested in projects by the charity, primarily through the Health Innovation Fund. Projects which receive money from the fund are chosen through a two stage process, with the initial stage involving a concept note, a three page brief designed to provide the charity with enough information about what problem they are looking to solve and what impact they think their solution will have.

The second stage of the process requires the fulfilment of a number of key criteria which ensure that the project has significant potential benefit and that it has a specific audience and a means of being funded further once it is implemented.

Additionally, the charity asks how the project will be evaluated, how patients and hospital staff will engage with the project and what their plan is and how they intend to deliver it.

The team is also looked into, with the charity examining whether they have the correct assortment of skills to do perform all the tasks required within the project. The final aspect of the project that is addressed within the plan is value for money, and whether the potential benefits of the proposed project are enough to justify the cost of it as well as examining their budget and what other organisations the team has sought funding from.

Oliver is keen to emphasise that the plan is not designed to be rigidly adhered to: rather, it is an overview which highlights the skills of the researchers.

“Because we are asking people to do quite innovative things and be really ambitious we know that that in most cases a project plan is going to be wrong. After all, how can you know at the beginning of a three year project, when you are doing something that is really cutting edge, exactly how it is going to work? You probably don’t. Why we ask them to give us this project outline is so we know they can plan, so we know they can think about risks and take into account all of the various elements of a project.”

Ultimately the charity is looking for projects which are not just innovative, but which could potentially make a vast difference within the health service, whether that be solving a particularly large problem or helping an existing aspect of the service to run more efficiently. Oliver made it clear that overall

there was one key word to encapsulate what the charity was trying to achieve: “Basically, we like to test ideas with big ambitions”.

There are three priority areas for the charity when considering funding: cancer research, population health and system transformation. These are very broad areas and the charity is always keen to fund projects which have good ideas regardless of the area of research.

The charity is funded by an endowment which has been building up over around 100 years, as well as fundraising and donations.

Projects recently funded by the charity include the purchase of a 3D scanner for Evelina, the children’s hospital at St Thomas’, to cut down on the time taken to conduct heart surgery by making a model of the heart to practise on prior to the procedure.

There is also an initive currently undergoing testing called Transforming Outcomes and Health Economics Through Imaging (TOHETI), which is an initiative which aims to show how better use of imaging technology can improve patient care. This project aims to make imaging technology more accessible to patients by changing the system through which it is provided to them, as well as adjusting how this technology is applied so that it is used to its full potential.

A major part of the reason so many ground breaking initiatives come through Guy’s and St Thomas’ is because as a teaching hospital and a tertiary centre it attracts some of the best healthcare staff from around the world which, when combined with an experienced and dedicated leadership and the resources to facilitate through testing, gives these staff the ideal environment to develop these innovations.

Oliver believes that ultimately, both the Trust and the charity have a vital role to play in the future of the NHS. “As we look to the future of the NHS, clearly times are really tough across the entire system, I think in times like this there is an even greater premium on organisations that are willing to innovate because it is really easy for hospitals to develop a fortress like attitude and decide to simply weather the storm and take care of themselves, so I think what the Trust is doing, to ensure it is still innovating and still working with others, is really vital work. The Trust recognises is not a standalone organisation but a part of a wider system and I think the need to still be innovative and search for new ways of doing things in order to help not just itself but the wider NHS, is very admirable.”

One Big Society Magazine 15

September 2015

Health and Social Care

Multiplex PCR Panels at the Point-of-Care MiniLab empowers clinicians with molecular diagnostic results on demand.

By Jessica Barrett, Commercial Director from Enigma Diagnostics Limited.

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Health and Social Care

Enigma Diagnostics Limited Building 224, Tetricus Science Park, Dstl Porton Down, Salisbury, Wiltshire, SP4 0JQ T: +44 (0)1980 590131 F: +44 (0)1980 590132 E: info@enigmadiagnostics.com W: www.enigmadiagnostics.com

Clinical laboratories are increasingly using molecular diagnostic tests for infectious diseases, since they generally provide higher sensitivity and specificity along with a shorter turnaround time than traditional methods.

tridge is not expired and more. These checks are configurable to meet the needs of different clinical settings. Additionally, the Control Module has a number of configurable options, such as whether to print and/or transmit the results.

Due to the increasing acceptance and demand, manufacturers are developing a range of platforms that have evolved from manual to fully automated sample-to-result systems requiring less training, experience and technical skills. Molecular diagnostic tests have evolved from clinicians ordering a series of tests to detect single pathogens to simultaneously detecting multiple pathogens along with their drug resistance that are associated with infectious syndromes using one patient sample.

The MiniLab’s lowest throughput configuration is a single Processing Module attached to the Control Module making the adoption of this inexpensive platform attractive. The MiniLab’s throughput is easily expandable by adding up to a total of six Processing Modules, which can run different syndromic panels simultaneously with independent random access.

These molecular diagnostic syndromic panels enable accurate etiologic diagnosis by reporting comprehensive results simultaneously for multiple pathogens associated with infectious syndromes; however, the downside for physicians is that they wait 6 to 48 hours to receive these results from the central laboratory. For critical care patients, time to diagnosis is precious. Enigma® Diagnostics is focused on empowering physicians with comprehensive actionable molecular diagnostic results on demand by providing a range of syndromic panels for the MiniLab, an easy-to-use Point-of-Care (POC) highly multiplex PCR platform.

Enigma Diagnostics’ MiniLab is the world’s first POC Highly Multiplex PCR platform that provides clinicians 24/7 access to laboratory-quality molecular diagnostic results using a range of highly multiplex PCR syndromic panels for the simultaneous in vitro diagnostic detection of pathogens reducing test result waiting times to about one hour.

The easy-to-use sample to results MiniLab has a small footprint. It is well-suited for a range of clinical settings where fast laboratory-quality results are imperative. Its fast comprehensive actionable on demand results empower clinicians by providing molecular diagnostic results at the POC thereby eliminating the long wait time associated with sending specimens to the central laboratory.

Another benefit is that these comprehensive results do not require interpretation. It is well documented that an accurate fast diagnosis and targeted treatment improves clinical outcomes while reducing costs and supports good antimicrobial stewardship, since the team can act on results in real time.

Each Processing Module is fully automated from sample preparation, nucleic acid amplification and target detection using single-use dedicated cartridges without requiring the operator to be familiar with PCR technology. These single-use cartridges contain all of the reagents required for sample processing and nucleic acid detection.

These comparatively inexpensive cartridges can easily be stored next to the MiniLab, since they are stable at ambient temperature.

The easy-to-use fully integrated and automated MiniLab requires simple training and has nil operator variance. It is designed to be used in developed and emerging health care programs.

In developed health care programs, the MiniLab provides the central laboratory with a cost-effective method of decentralizing their services by providing clinicians with short test result waiting times when time is precious, especially for critical care patients. A faster test result waiting time allows patients to be tested, isolated and treated before they are able to spread the infection to other patients resulting in reduced outbreaks. In emerging health care programs, it enables rapidly-expanding health care systems the opportunity to build a diagnostic health care architecture that is cost-ef-

The MiniLab features a fully integrated Control Module that has a touch-screen computer for user input, display of operating status and results, barcode reader to scan the users’ identification, patient specimen and type of cartridge, as well as a printer and connection for data transmission. The MiniLab display provides on screen feedback and animations at each step in the process assisting the operator thereby reducing the chance for mistakes. The MiniLab carries out built in checks, such as ensuring that the user is approved to run the test, quality control checks are up-to-date, carOne Big Society Magazine 17

September 2015

Health and Social Care

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Health and Social Care

fective and patient-centric across multiple testing sites, unconstrained by traditional laboratory costs and limited physician availability.

The MiniLab platform and Influenza A/B RSV Panel are CE marked in compliance with IVD directive 98/79/EC. The company’s first syndromic panel is for detecting respiratory viral pathogens, especially since respiratory infections have a high morbidity and mortality rate and patients present with similar clinical symptoms making it difficult for clinicians to determine the causative pathogen(s). Despite respiratory infections causing high morbidity and mortality for all age groups, very young pediatric patients and patients with comorbidity factors have higher mortality rates. The MiniLab enables clinicians to test patients presenting in the emergency department to quickly determine optimal treatment, send the patient home or admit the patient. In a few months, Enigma Diagnostics plans to launch a more comprehensive respiratory panel that includes Influenza A, Influenza B, RSV and Rhinovirus.

Currently, the company is developing a range of high value yet cost-effective syndromic panels targeting the large and high growth area of infectious diseases for critical care patients. The list of syndromic panels includes a Respiratory Viral Panel, Respiratory Bacterial Panel, Bacterial and Viral Meningitis, Carbapenemase Producing Organisms, Multi Drug Resistant Tuberculosis, Pneumonia, Sepsis directly from blood and others. The plans are for several panels to be launched each year.

The MiniLab benefits from global manufacturing and supply chain providing scalability and an attractive cost base enabling Enigma Diagnostics to forge a solid leadership position in developed and emerging molecular diagnostic health care markets.

As molecular diagnostic testing is replacing conventional methodologies for the diagnosis of infectious diseases and syndromic panels are replacing serial pathogen detection testing, Enigma Diagnostics is now pioneering the use of molecular diagnostic syndromic panels in the POC to empower clinicians with the high value comprehensive molecular diagnostic results that they need on demand to quickly initiate targeted treatments.

The new paradigm of using molecular diagnostic syndromic panel testing in the POC will quickly increase with the advent of easy-to-use cost-effective platforms, such as the MiniLab. The MiniLab provides physicians with the much needed decentralized solution for accessing quick comprehensive results for patients, especially critical care patients, whose clinical presentation make it difficult to determine the causative pathogen.

Note: MiniLab Products are CE-IVD marked not FDA cleared.

The benefits of using syndromic panels measured in clinical evaluations, includes improved outcomes and increased satisfaction for clinical staff, as well as patients and their family. Enigma Diagnostics is working with key opinion leaders to identify needed syndromic panels, as well as clinically evaluate them.

Enigma Diagnostics was founded in 2004 to develop and commercialize technology and intellectual property from the United Kingdom Government’s Defence Science and Technology Laboratory (Dstl).

Leveraging its extensive range of proprietary technologies and intellectual property, the company developed the MiniLab combining the speed and sensitivity of PCR with the simplicity needed for clinicians to use it without changing their workflow.

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September 2015

Health and Social Care

GSTT Funds Pioneering Heart Operation Earlier this year, the heart team at St Thomas’ Hospital replaced competitive strongman, Kamil Wojniak’s leaking aortic valve through an anterior right thoracotomy, a 5-6cm keyhole opening in the chest. The operation left Wojniak able to return to competition without issue. We spoke to Vinayak Bapat, the trailblazing surgeon who performed the operation, to find out more about the operation and how it has paved the way for greater understanding of the revolutionary technique in the wider NHS.

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Health and Social Care

Tell us more about the operation you performed on Kamil Wojniak.

Traditionally, when heart valve surgery is performed we have to split the breastbone down the middle.

From there, we can then access the heart, which we connect to the heart-lung machine that, in turn, allows us to isolate and stop the heart while keeping the rest of the body alive. When the operation is complete, everything is sewn back into place, the heart reconnected and the machine removed.

Alternatively, we can split the breastbone halfway, allowing us to access only the top portion of the heart – the only part needed for an aortic valve replacement – and we connect the patient to the heart-lung machine either through the groin, the leg muscles or the top of the chest.

In my opinion, the keyhole procedure is the better option, as it does not require us to damage the breastbone at all.

We begin this procedure by analysing the CT scans and from these we can see exactly how close the aorta is to the breastbone and the ribcage. We then make a small cut of around five to seven centimetres, which allows us to enter between the ribs.

By doing this, we access only what we need to and we are able to connect the patient to the heartlung machine through the arteries and the vessels in the leg. This is a very safe option when it comes to connecting the machine. It is also possible to do this through the keyhole itself, however this can raise complications as this is where we would be performing the operation.

Of course, inherent in this method are a number of significant challenges. Among them is the fact that, as this is still a fairly new technique, those looking to carry out the operation must train with an expert surgeon who is experienced in performing the procedure, however, there are currently relatively few anywhere in the world.

How has Guy’s and St Thomas’ Trust supported you on the road to developing and popularising this operation?

First of all, the American surgeon from whom I learned this technique came to visit me at St

Thomas’ to learn the technique in which I specialise, TAVI (a heart valve procedure, involving the use of a catheter). The idea for this project started from there.

Many come to St Thomas’ to watch us because the hospital is well known for being forward thinking and innovative, as well as very welcoming to overseas experts.

Following the meeting with this expert, I decided I wanted to take my team to America to learn the technique. At this point, I required some funding from the hospital and some additional money from the charity and the industry.

Upon returning from America, we were faced with needing to buy extra equipment – usually traditional instruments converted with a long handle so you can operate through a small hole - and this required some initial investment also. The trust very generously spent around £30,000 on buying three sets of these instruments.

The Trust was more than happy to do this as they understood immediately that it was a good investment. They saw the huge potential in bringing in experts to learn this technique and realised that it would go a long way to establishing the programme, which will, ultimately save lives and greatly reduce discomfort for patients.

The technique seems to possess myriad advantages for patients. Why, until now, hasn’t it been more widely performed in the UK? There are many reasons for this, one of which is that you need an experienced surgeon to take this technique on. The surgeon needs to be experienced enough both to do the operation and, if required, to call it off if they do not believe that it is progressing in a satisfactory manner.

The technique also requires a great deal of skill and patience, both from the performing surgeon and their team. Every surgeon attempting this technique needs a good team who understand the procedure fully. If the team do not know the procedure well enough, it can greatly compromise the operation and reduce the chances of complete success.

This is why the support from Guy’s and St Thomas’ hospital trust has been so vital. They have provided us with all the time, equipment and training we needed to ensure the project has been a success at all stages and levels of its development.

Thank you for speaking to us, was there anything else you would like to add?

I think an important aspect of all this is that patients should be aware of the options open to them. We are working hard to address this issue and increase awareness through contact with GP forums, cardiologists, patient forums.

Our overall aim is to increase and expand this programme, not only in St Thomas’ but in additional centres also.

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September 2015

Health and Social Care

2020 Vision: Digital Efficiency and Innovation in the NHS

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Every year The King’s Fund’s Digital Health and Care Congress brings together a diverse group of people, united by an interest in digital health, to share and discuss the ways that digital products and services are changing and improving health systems. This year’s congress was sold out yet again, demonstrating the huge interest in this area. Matthew Honeyman, Researcher, The King’s Fund.

Among the many fascinating talks and discussions, two key points to highlight involve a number of important announcements that are very relevant as the NHS races to meet two prominent policy commitments by 2020: to achieve an unprecedented £22 billion of productivity savings, and to make all patient records digital and accessible in real time across all settings for patients and staff.

First, the top-down view. At the National Information Board’s leadership meeting, held at the Fund at the same time as the congress, there was a notable new focus on the contribution that better use of information and technology can make to the £22 billion productivity challenge. For the first time, chair Tim Kelsey shared the board’s estimate of that contribution, saying that digital efficiency and innovation could make around a third of the savings required (up to £8.3 billion in total). This eye-catching figure is supposed to come from the role technology is expected to play in enabling many of the ambitious reforms and new models of care outlined in the NHS five year forward view.

The credibility of this top-down estimate will be tested in the coming months, as the board works to join it up with any savings realised from work on the ground. In future, expect to see a lot more emphasis on how technology can save money as well as improve the quality of care for patients, an assumption that has been questioned in the past.

Tim Kelsey also trumpeted the progress that the NHS has already made in some areas. For example, nearly all GPs (97%) now offer patients online appointment booking, repeat prescriptions and access to summaries of their records. That’s up from just 3% a year ago. But while the technical capabilities are now in place, they are not always easy to use. The challenge is to make these channels as routine to use as others, like phoning or dropping in to a GP surgery. GPs and their suppliers would do well to learn and spread lessons from design-thinking to improve the ways these systems operate and fit into patients’ lives, seeking and harnessing user feedback to continuously improve the experience, making it easy to use. The same will be true for the many new uses of technology and data due to be introduced before 2020 for both staff and patients.

– a single patient record shared by multiple NHS organisations, GPs and the local council in Leeds.

They invited other areas to join their ‘Ripple’ programme to work together to understand how an NHS with a single record can be achieved across the system, not just in Leeds. Ripple will develop and document a set of open tools, systems architecture, the governance and the ways people can use it. The team plans to make this all open source, publishing it freely and allowing its reuse; a gift to the rest of the NHS and its patients.

So what are the benefits of using an open-source model? One benefit is that anyone can use or adapt the code for their particular application without having to buy it and without being locked in to an individual software supplier. Open source is most commonly used to develop software but can apply to the design and production processes for any product or service.

Open source is a model that has struggled to gain traction in the NHS; its advocates blame ‘vendor lock in’ to proprietary platforms, its critics claim it lacks a viable business model without ownership.

But now that could change. The Leeds team’s ambition is that the NHS benefits from an approach that helps new innovators to build on the work of others, instead of starting from scratch or buying into proprietary platforms.

Though it’s early days, the Leeds Care Record is an example of innovation from within the NHS. And this is the sort of innovation that needs to be spread, sharing the lessons and tools for replicating it; something Leeds hope to achieve with its new community. Along with strategy and standards set from above by the National Information Board, this is the kind of change from within needed to meet the challenges for 2020.

This article originally appeared on The King’s Fund website: www.kingsfund.org.uk

The second announcement comes from the local level, but it could have system-wide impact too. Rob Kenyon and Tony Shannon shared the achievements to date of the Leeds Care Record One Big Society Magazine 25

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Growing Management Numbers in the NHS Is this fact or fiction?

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In the build-up to the 2015 general election, David Cameron referred to NHS Management as “a bureaucrat with a clipboard”. Media coverage has questioned the comparison between the numbers of doctors, nurses and other clinical staff with the high numbers employed in management of the NHS. National reports show that the perception of bullying behaviours is increasing in the NHS. Could this behaviour in any way be connected to the increased disparity between the numbers employed in management and those responsible for the medical and clinical needs of the NHS? Is it also one of the reasons for an abundance of whistleblowing cases?

What has happened to the NHS structure and culture? How could an organisation that was launched in 1948 out of the ideal that good healthcare should be available to all, regardless of wealth, reach a position of so much negative publicity and behaviours?

Is the growing number of clipboard holders fact or fiction? Has the growth of managerial bureaucrats been responsible for a growth in perception and belief of bullying behaviours?

Above all, would the NHS be better for patients and the tax payer if non-clinical managers were instead replaced with clinicians who were empowered with leadership skills?

To answer these questions we need to take a step back, remove the rhetoric and consider some of the facts.

The NHS Confederation stated in their July 2015 statistics that managers and senior managers accounted for 2.67% of the 1.388mn staff employed by the NHS in 2014. It stated that the number of managers and senior managers increased slightly in 2014, having declined in each of the previous four years. This data suggests that the growth of managers in the NHS is not significant.

In contrast, the findings from a 2014 survey of 2000 NHS staff by the King’s Fund revealed a consistent disconnection between the views of executive directors and of other NHS staff. For example, 63% of executive directors said there was a “pride and optimism” among staff although only 20% of nurses and 22% of doctors felt these emotions.

Alongside national reports, social media contains a plethora of personal experiences about bullying in the NHS. According to the findings of a 2015 inquiry led by some of the most senior British doctors, infighting amongst overworked departments and disciplines in Trusts has led to trainees feeling “bullied and undermined”. When the word “whistleblowing” is used we see a similar effect.

Lord Rose, in his June 2015 NHS Leadership Review titled ‘Better Leadership for Tomorrow’ demonstrated that the level and pace of change in the NHS is unsustainably high. This demonstrates that significant, often competing, demands are placed on all levels of its leadership and management. The administrative, bureaucratic and regulatory burden has already become insupportable and shows no early signs of abatement. With David Cameron’s electoral pledge to make the NHS a truly 24/7 service, the pressure will only increase to breaking point. Rose identifies three areas of particular concern. Firstly, that there is a lack of “One NHS Vision” and of a common ethos.

Secondly, that although the NHS is committed to a vast range of reforms, there is insufficient management and leadership capability to effectively deal with the scale of challenges associated with these changes. Finally, there is a need for a specific direction and development for careers in managerial roles across the medical, administrative and nursing cadres.

“…although the NHS is committed to a vast range of reforms, there is insufficient management and leadership capability to effectively deal with the scale of challenges…”

Lord Rose, Better leadership for tomorrow, NHS Leadership Review, June 2015 In 1948, three principles were established to guide the newly formed NHS. In 2011, these three were increased to seven principles by the Department of Health. These were derived from extensive discussions with staff, patients and the public. The third of these seven principles states:

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“Respect, dignity, compassion and care should be at the core of how patients and staff are treated – not only because that is the right thing to do, but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported.”

In 2015 Hillcroft House, the research and training provider, conducted surveys which asked 220 managers in the NHS if they were aware of the seven core principles. Did they know principle three? The findings showed that 100% were unaware of their existence. More concerning still, 100% were unaware that their employer, the NHS, has seven core principles that underpin its core values.

Further surveys, again by Hillcroft House, have found that the majority of NHS front line staff value thoughtfulness, teamwork, humility, stability and harmony. In contrast, the majority of NHS managers value results, independence, achievement, decisiveness and success.

The detailed work by Hillcroft House shows that the way people behave and communicate dictates which of these values are of highest priority. The impact of this can result in significant misunderstandings. Frustration, combined with low levels of self-awareness can lead to unacceptable behaviours. For example, people felt they were being bullied even though, after investigation, it was found that this was neither the intention nor the motivation of the other party. When bullying appears rife, stress levels rise, absences escalate and the duvet days increase.

Approximately 9.5 sick days per year per employee are lost according to HSIC figures covering 2012 for total sick leave, and irrevocable damage is done to service provision and morale. Human beings on all sides suffer. Trust in one another is lost.

needed for teams to give people choice and control over their care. Tippett said: “Although no one local area, organisation, or team has got all the answers, between us we have many of the elements needed to make it happen here.

We need to enable teams to learn from each other, challenge positively and rapidly adopt changes that will benefit the people we are here to support. To do this we have to invest in increasing our peoples’ self-awareness and understanding of the impact of their behaviours. By communicating more effectively they are more likely to positively influence colleagues from a different professional discipline or organisational culture, breaking down barriers to integration”.

“…we have to invest in increasing our peoples’ self-awareness and understanding of the impact of their behaviours…”

Frances Tippett, South West Integrated Personal Commissioning (IPC) programme

Perhaps extensive reports like Francis and Berwick will initiate a review of the self-awareness levels of all the committed people within the NHS. Maybe learning from the work of South West IPC will lead toward better behaviours, cleaner communication, greater trust, improved patient care and a demise of the extensive negative publicity that the NHS receives. Could the solution be as simple as Adam Crizzle, MD of Hillcroft House believes, “Understanding behaviours makes outstanding people, creating extraordinary organisations”?

Frances Tippett

Case studies have shown that when people invest time to understand their own behaviours and their effect on others, they are able to create a culture of success which breeds further successes.

Frances Tippett heads up the South West Integrated Personal Commissioning (IPC) programme (a national demonstrator site for NHS England, Local Government Association and TLAP (Think Local Act Personal). The South West IPC team invited Hillcroft House to assist them with understanding differences in communication and behaviour styles and the impact on team and organisational dynamics.

They believe this is essential if they are to successfully tackle the cultural changes One Big Society Magazine 29

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The Five Year Forward: NHS Employers Prospective We spoke to Ruth Warden, Assistant Director of Employment Services at NHS Employers about how the NHS can support staff wellbeing through the changes inherent in the implementation of the five year forward view.

“As the NHS invests a lot of money and time hiring highly qualified staff they are keen to have them in work supporting the service ad helping patients. This is why supportingpeoplewhoareoff sick and creating an environment to reduce stress related sickness is very important to the health service.�

Ruth Warden - Assistant Director of Employment Services at NHS Employers

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The Five Year Forward View is an initiative developed in 2014 by NHS England which sets out how the health service needs to change, arguing for a more engaged relationship with patients, carers and citizens in order to ensure the NHS is capable of promoting wellbeing and preventing ill-health in our modern society.

The forward view examines numerous aspects of the NHS with regards to how it will have to adapt to cope with future challenges. Changes to models of care moving forward are an integral part of the concept, with Warden explaining that these changes will have an impact on NHS staff and that NHS employers is working to support the staff as they look towards implementing these changes.

“Our role with regards to implementation of the Five Year Forward View is to examine how the workforce needs to shift to support the delivery of the new models of care. This means looking at whether staff need to perform slightly different roles, whether additional training is required, whether staff need to work across different boundaries or work in new teams etc. We are helping employers within the NHS to think about these workforce implications of the Five Year Forward View and then helping them put the required actions in place so that the workforce is fit to deliver the models of care outlined in the Forward View.”

change will be stressful for the staff.

“We are also working with NHS Trusts to analyse how they can support people who are unwell and help them get back into the workplace. It is about creating an environment where people don’t feel that they have to be off work sick with stress but if they do chose to take time off for stress related sickness, then we have to facilitate their return to work as quickly. Evidence shows that the longer someone is off work sick the harder it will be for them to return to work.

“As the NHS invests a lot of money and time hiring highly qualified staff they are keen to have them in work supporting the service ad helping patients.

This is why supporting people who are off sick and creating an environment to reduce stress related sickness is very important to the health service.”

The ongoing drive for greater efficiency savings in the NHS also contributes to current stress in the health service, Warden adds.

“Messages are coming through that the NHS has to be more efficient, that it has to change the way it is doing things, and this is challenging on number of different levels and puts staff under a variety of different pressures.”

Warden works primarily on the education and shape of workforces within the health service, and finds that projects beginning now with regards to the Forward View often focus on examining whether new job roles are required, which means Trusts are examining the possibility of new training for staff, with possibilities such as adding new competencies so existing staff can perform slightly broader roles and work more flexibly between teams.

A particular challenge NHS employers have is around opening up a dialogue among staff around mental health issues, with problems often being exacerbated by stress. NHS Employers is supporting the health service to ensure that line managers and senior staff feel competent enough to deal with mental health issues and staff feel comfortable with having these conversations. Warden stressed that these conversations are vital to ensuring staff do not become so ill that they have to take time off work.

Staff experience is also a vital issue which NHS Employers is working with Trusts to address, so that employees working within the health service can be more positive and open to change, as well as reducing stress related staff absences within the service, which is an issue Warden feels is important and needs to be addressed moving forward.

“There is still quite a stigma about mental health, both in the NHS and in society as a whole. This is one of the major challenges that we have found and we are working with employers within the NHS, with Trusts and other organisations to support staff in the NHS to start talking about their emotional wellbeing and the stress of working within the organisation.”

“The NHS can be a challenging workplace and this is part of the reason why many choose to work there, although it also means there can be times of person stress. When you add this to the challenges being faced by the service at the moment such as financial challenges, increased demand and the changes to how the service delivers being outlined by the Forward View then it increases the stress in the working environment.

Some key ways to reduce this include supporting line managers so they can support the staff working under them and improving the health of the overall NHS staff. Simon Stevens, chief executive of NHS England, has recently announced a health plan for NHS staff to reduce levels of absence. By creating a healthier workforce the NHS will be better placed to deliver the best possible patient care as well as reducing costly sickness absence, which recent figures from HSCIC put at 4.72% in January this year.

“As a result of this what we are seeing, what Trusts are telling us, is that sickness absence which is attributed to stress is on the increase. We need to keep the NHS workforce healthy so what we are doing to help this is looking at how we can support NHS organisations to make the changes which are happening within the organisation as stress less as possible and acknowledging that any type of

Changes to the Five Year Forward View’s vision of an evolving NHS are important and inspiring but, of course, change can be difficult and brings challenges at all levels. With active engagement with staff, changes will run more smoothly and we will have a resilient workforce in our world-leading health services.

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Health and Social Care

Are You Leading the NHS to Success?

“Asking ‘Who ought to be boss?’ is like asking ‘Who ought to be the tenor in the quartet?’

Obviously the man who can sing tenor.”

Henry Ford

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Leadership is a priority for the NHS as evidenced by the last 10 years’ rise in management positions to 1.4 million. There have also been massive changes post Francis Report, with the areas of wellbeing, mindfulness and making people “want to change” being particularly topical.

Yet absenteeism is still high, stress is still high and whistleblowing rears its head from time to time.

At the risk of being controversial, much of the stress could easily be lifted.

IDENTIFYING THE CHALLENGE IN THE NHS However we look at it, most staff would seem to love the caring for patients side of their job but we cannot ignore the fact that there are three commonly quoted areas of discontent, each of which could be significantly eased with a different approach. They are: 1. Management Style 2. Paperwork 3. Stress

FILLING THE GAP I’m going to present an idea that may sound familiar, but we are going to look at it differently here. That idea is one of Accessible Leadership from all management levels right down to the Team Leaders.

MANAGEMENT STYLE When I think back to the various managers I have had during my career, I have to say they were a mixed bunch! Of course, the way I’m assessing their success – or not - is by how happy I was in the job: how motivated I was, how optimistic I was, how much I had the opportunity to learn, how supported I felt, how much I belonged to my team and how much I looked forward to going to work.

I would say that some of the managers were good [i.e. met my needs] and some weren’t.

But this is fearsomely subjective. After all, the list of what might make me happy and content at work is likely to be quite different from what would make another person feel that way. And unfortunately we don’t come with a User Guide!

PAPERWORK It is a fact that some people are better at paperwork than others. It is also a fact that notes have to be written up. But speaking to many people in the NHS, I’m not convinced that paperwork per se is the issue. I think there are two competing problems here. The first is Time (or most usually the lack of time) to enter the information into the system. The other is a heartfelt Incongruence, where professionals are utterly torn between completing paperwork and seeing clients.

STRESS This is still causing huge problems in both the delivery of care and also the cost of covering absenteeism – not to mention the opportunity for some of the Press to exploit the new and creative ways that are being adopted to ease the pressure! The opposite of Stress is Flow.

Personal flow comes from following your natural path. Team momentum comes from each team member following his or her natural path. A team member out of their flow - or managed in a way that is outside their preference – is likely to experience stress.

If we go back to my previous managers, you’ll remember that I gauged their success by how happy I was at work; and the challenge is that many people in the NHS are not happy at work. So I decided to unpack what one of my particularly ‘good’ managers – we’ll call him Barry - did and how he did it.

Firstly, he consistently adopted good management practice whereby I bought into and was excited by his vision for the team, understood how my role fitted in and supported both his vision and the rest of the team.

Secondly, Barry had a unique [in my experience] ability to bond with his reports both separately and as a team, so that each of us trusted him and pulled together to meet targets and fulfill the vision. We did work hard. We did enjoy it. And there was very little absenteeism as we wanted to come to work.

People skills are of course valued in management.

But how do you transport standard management practice to a level of Leadership Expertise that will unleash momentum and performance?

“Managers Solve Problems, Leaders Create Momentum” - John C Maxwell

ACCESSIBLE LEADERSHIP Anyone managing or leading a team is only too aware that that we’re all different. Now, different can be good, but it can also mean that people face elements of their job where they struggle to deliver and are not happy. Yet in other parts of their job, these very same people will do amazing things with consummate ease and enjoyment. A good example of this is paperwork.

Right back to the days of Aristotle, it has been acknowledged that individuals are different in four specific ways: Thinking – which can be Intuitive or Sensory, and Action – we are predominantly Introvert or Extrovert.

DRIVER, EXPRESSIVE, AMIABLE and ANALYTICAL are four ‘frequencies’ that lead individuals to notice, interact and respond most frequently in quite different and predictable ways. We all have some of each frequency but are typically strongest in one.

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For example, DRIVERS make the best Leaders of new departments and teams as their focus is to create the service and align themselves with the community. EXPRESSIVES are the best Leaders for consolidating departments and teams that are growing their reputation, as they will forge strong relationships with co-workers, patients and clients.

AMIABLES are perfect Leaders for the successful departments and teams who have a trusted niche and a busy schedule, as they will naturally focus on quality of care and patient support. ANALYTICALS are the best Leaders for departments and teams with a demanding community base who would benefit from a keep a keen eye on stretched budgets.

One of the biggest errors made – and this applies across all industries - is putting the wrong person into the wrong position, with the choice being based more on their qualifications and knowledge than their natural passions and talents.

“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”

How does it work when a particular type of manager has different frequencies in their team? The answer is that by recognising their predominant frequency and that of their staff they can adjust their communication style easily and effortlessly.

HOW DOES THIS ADDRESS THE THREE AREAS? MANAGEMENT: By understanding your own frequency and those of your staff, Leaders can begin to bond with the individuals and the team. This helps build trust and confidence in the manager, and will encourage staff to feel they belong. The ripple effect of team bonding is lowered absenteeism as staff enjoy coming to work.

PAPERWORK: This is a classic example of where being a particular frequency doesn’t let you off doing those parts of your job you may not enjoy. One of the main problems though is people randomly switching frequency rather than selecting the right one to do the task in hand!

- Albert Einstein

Trying to fit in the paperwork around answering the phone or caring for patients is exhausting. Setting aside some quiet time to get it all done will make the job more manageable and enjoyable. Mind you, enlisting help from an Analytical would make it even easier…

Down at the grass roots are the professionals and staff carrying out the work of the NHS, and they can be loosely profiled too. But each of the frequencies requires a different foundation to flourish. You may already be wondering which of the four frequencies you and your staff are. See if you can recognize yourself from these slightly tongue in cheek descriptions.

STRESS: The opposite of stress is Flow. When you are in Flow, big problems become insignificant as you solve challenges and see opportunities at a different level. We’ve all experienced this in our life, when we cope so well despite the demands made upon us. Identifying the areas in which you will always excel and handling issues from your preferred style is the fastest way to lift stress.

Drivers are great at starting things. Ask them a get a new project going or launch a new idea and they will take off like Google Earth envisioning the big picture. Trouble is they’re not so good at finishing things and there could be many loose ends; but then there’s always an exciting new project just over there...

NEXT STEP To identify your real strengths and talents - and have a complete understanding of why certain things are more challenging - is nothing less than liberating.

And as it all begins to make sense within the team there can be a huge sense of relief as people are able to increase their support for each other; because they know instinctively when they are the best person to help.

Expressives love talking to people. They’re great at building and working in teams. Mind you, they can be difficult to locate because they hate to be tied down and they walk around a lot. Trouble is that sometimes they’re not so good at the spreadsheets and detail part of the job.

Amiables are fabulous at being well-organized and always deliver on time! Richard Branson [Driver] may have started an airline, but it’s the Amiables in his company that get the people on the plane.

With the clarity of Google Street View, they’re good at noticing things others may have missed. But you wouldn’t choose them to envision and launch a new initiative.

Analyticals are fantastic at knowing exactly where things are and keeping track of figures. They’re perfect for monitoring performance and budgets.

But they’re not so hot on the people side of things; which can be a challenge if you are a manager.

But there’s another really good reason to identify team frequencies – and that is because it’s a real FUN thing to do. Of all our work, this is the one where there is most laughter, most bonding, most co-operation and most optimistic planning for a great future.

If you would like to increase your ability to bond with and lead your team, the best place to start is by taking The Frequency Test. Click [http://bit.ly/FrequencyTest] for a Token to The Frequency Test.

To comment on this article or discuss solutions, please contact Caroline directly on: t 020 8213 5898 e info@wellbeingdynamics.com w www.wellbeingdynamics.com One Big Society Magazine 35

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Substance Abuse: The Frontline

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As the Government increasingly moves frontline care from the community to private homes, we examine how agencies urgently need to educate their staff on how to recognise and interact with substance abusers.

Substance abuse is a particularly difficult to deal with, as addicts tend to have their perspective skewed by their need for a particular substance and a loss of inhibitions which can easily be misinterpreted as aggressive behaviour or another illness.

In particular, substance misuse alters behaviours, with figures by the Health and Social Care Information Centre from 2014 showing that there were 7,104 admissions to hospital with a primary diagnosis of a drug-related mental health and behavioural disorder. This is an 8.5% increase from 2012/13 when there were 6,549 such admissions.

There were 13,917 admissions with a primary diagnosis of poisoning by illicit drugs. Overall there has been a 76.7% increase since 2003/04 when there were 7,876 such admissions.

Overall, between 2003/04 and 2013/14 admissions have decreased by 11% to from 7,869 to 7,104.

Alarmingly, these figures also showed that there were 1,957 deaths related to misuse of illicit drugs in 2013, which is an increase of 321 from 2012 when there were 1,636 such deaths.

This is a stark warning of the effects of substance abuse, which can often be addictive, with substances such as alcohol, cocaine and heroin all particularly addictive with the potential to cause patients serious harm. The report found that cocaine, ecstasy, LSD and ketamine use had increased between 2012/13 and 2013/14, all of which are potentially addictive substance.

als sent to an addict’s house to take them to hospital needlessly or expose both themselves and the patient to unnecessary stress and potential harm.

Alan Long, the Managing Director of the Mears Group, which provides home care workers in various fields, such as care and property maintenance to local authorities, as well as offering some services to private clients, commented on how his firm ensures the safety of its staff.

“Before sending any of our employees into a situation we always conduct a risk assessment first.

When we feel that we are able to continue with the care or the repair of the property or individual then we do so. Our visiting officers are trained on all aspects of risks that our care worker might come across, whether that be a dangerous dog or if the property is unsafe, through to substance abuse or the individual having a particular form of mental health problem.”

These risk assessments are vital to ensuring that carers know what they are dealing with when entering a property to deal with a patient.

Ultimately homecare industries, including but not limited to care, need to ensure that staff are provided with full training to ensure they deal with substance abuse correctly in order to ensure the safety of their staff as well as the patients they are caring for.

The full report from HSCIC, entitled Statistics on Drug Misuse, England 2014 is available online here.

However, the symptoms of drug abuse and addiction can often be overlooked by those visiting homes, for example home carers, who may potentially misdiagnose addicts and treat them incorrectly.

For example, the National Institute on Drug Abuse highlights the symptoms of heroin withdrawal as such:

“Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements.”

However, these could equally be confused with other illnesses, leading carers or other professionOne Big Society Magazine 37

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Benenden National Health Report 2015 Lifts the Lid on the Nation’s Naivety About the Cost of NHS Care Dr. John Giles, Medical Director at Benenden

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There is little argument with the fact that the National Health Service is stretched to near breaking point, but new figures show a major discrepancy between the cost of services and social expectation.

The Benenden National Health Report 2015 reveals the worrying truth that we, as a society in the UK, now take the NHS for granted to such an extent that we’re crippling it with our demands on its resources. Regardless of whether we are truly in need, we expect the service to be there for us. Whilst in many cases people will fall ill or need the help of the NHS through no fault of our own, there are also instances where poor lifestyle choices contribute heavily to illness, which leads to costly procedures.

The considerable disconnect between what people think treatment costs and the reality of the actual cost is placing enormous strain on an already hard-pressed service. There is a vast gap between public knowledge and the reality when it comes to understanding the cost of medical technology and medical care, with treatment being taken for granted due to its availability and accessibility on the NHS. Take for example childbirth; the public is generally poorly informed and uneducated when it comes to estimating this cost, with almost half of people (47%) thinking it is less than £500 for women to have a natural birth in hospital, without any complications. Even taking all survey respondents into account, the average cost of a natural birth is estimated to be £1,288 by our respondents, which is more than £500 short of the true figure of £1,824.

It is known from the 2014 Benenden National Health Report that although people were generally aware of what they should be doing to maintain a healthy lifestyle, they tended to struggle to implement this, possibly because of the lack of public knowledge of the financial cost of the associated health issues to the NHS. The problem with the Government’s continual reassurance that the NHS is ‘free’, and that users do not have any upfront costs for treatment, is that they have unwittingly created a culture around this assertion which in turn leads to increased consumption. The reality is that the contributions being made by the taxpayer are no longer enough to cover the cost of the increasing demands for healthcare being generated by the public. The public has been confidently told and regularly reassured by politicians, for understandable reasons, that they have one of the best and most cost effective healthcare services in the world. They are repeatedly informed that they will continue to have access to some of the best possible care which will ultimately remain free at the point of delivery. This continued rhetoric has led to public ignorance around the true cost of treatment.

that we are approaching a huge funding gap in the NHS and there is no real consensus as to how that will be resolved.

Traditionally, the easy answer has been to increase funding. The NHS spend as a percentage of National income has doubled since 1948 and the NHS budget itself doubled between 1994 and 2009. Even with the recent austerity measures, annual funding has continued to increase, albeit more slowly. Fortuitously this has coincided with some stability in the number of those individuals born 70 years ago who inevitably require greater care and support. This aging population is only set to increase in the coming years and such an approach is no longer sustainable - there is no bottomless supply of funding and, if coupled with the increasing demands being placed by an ailing and aging UK population, the pressure on the NHS is poised to increase dramatically. The increasing life expectancy of the UK population, which is to be welcomed is a massive obstacle that the NHS has to overcome. The average annual spend per person in the UK is about £2,000. It has been estimated that the average person up until the age of 60 costs around £1,000 per year, but this total starts to increase significantly as we age - rapidly rising to closer to an estimated £11,000 per year by the age of 85.

This report raises some difficult but recurring questions about the future of the NHS, with education of the public key to helping guide awareness of the implications of poor lifestyle choices on the future viability of the National Health Service.

Additionally, the NHS itself will have to evolve to cope with a variety of different public health demands being placed by an increasingly aging and ailing population. The NHS cannot continue to be all things to all people; healthcare professionals, the Government and society as whole need to decide what it represents and how it can help the UK public to help themselves.

Read the Benenden National Health Report here.

The responsibility partly rests with the Government to change the public perception of how and when to use the NHS. However, educating the public raises some unpalatable truths, which some people would rather ignore. Most authorities accept One Big Society Magazine 39

September 2015

Health and Social Care

Increase in Diabetes Cases in UK

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The number of people living with diabetes in the UK has soared by 59.8% in a decade, according to a new analysis by Diabetes UK.

The new figures, extracted from official NHS data and analysed by the charity, show that there are now 3,333,069 people diagnosed with diabetes, which is an increase of more than 1.2 million adults compared with ten years ago with figures from 2005 showing that there were 2,086,041 people diagnosed with the condition. These statistics do not take into account the 590,000 adults estimated to have undiagnosed diabetes in 2013-2014.

commented on the alarming figures.

The charity is warning that this exponential growth in numbers reflects an urgent need for effective care for people living with diabetes, as well as highlighting the importance of prevention and that failure to act on this threatens to bring down the NHS.

“We need to see more people with diabetes receiving the eight care processes recommended

by NICE. It is unacceptable that a third of people living with the condition do not currently get these, putting them at increased risk of developing complications, such as amputations, heart attack or stroke.

At present only six in ten people with diabetes in England and Wales receive the eight care processes recommended by the National Institute for Health Care and Excellence (NICE). These are the checks identified as essential in high quality care for people with diabetes and include getting blood pressure and blood glucose levels measured, as well as the kidney function monitored, otherwise poorly managed diabetes can lead to devastating and expensive health complications such as kidney disease, stroke and amputation.

Diabetes UK made it clear that it is now critical that the government takes urgent action to ensure that everyone with diabetes receives the eight care processes, reducing their risk of further health complications and the costs these incur for the already strained NHS budget.

“Over the past decade, the number of people living with diabetes in the UK has increased by over 1 million people, which is the equivalent of the population of a small country such as Cyprus.

With a record number of people now living with diabetes in the UK, there is no time to waste – the government must act now.

“Diabetes already costs the NHS nearly £10 billion a year, and 80 per cent of this is spent on managing avoidable complications. So there is huge potential to save money and reduce pressure on NHS hospitals and services through providing better care to prevent people with diabetes from developing devastating and costly complications.

“The NHS must prioritise providing better care, along with improved and more flexible education options, for people with diabetes now, and give them the best possible chance of living long and healthy lives. Until then, avoidable human suffering will continue and the costs of treating diabetes will continue to spiral out of control and threaten to bankrupt the NHS. Now is the time for action.”

Barbara Young, Chief Executive of Diabetes UK,

“Over the past decade, the number of people living with diabetes in the UK has increased by over 1 million people, which is the equivalent of the population of a small country such as Cyprus.

Barbara Young, Chief Executive of Diabetes UK (right) One Big Society Magazine 41

September 2015

Health and Social Care

The Importance of Designing Dementia Friendly Care Environments Sarah Waller CBE, RGN, FRSA Developed and ledThe King’s Funds Enhancing the Healing Environment programme from 2000 to 2015. She is now an Associate Specialist, Association for Dementia Studies, University of Worcester. She can be contacted at dementia@worc.ac.uk It is estimated that there are 800,000 people with dementia in the UK and this number is expected to double in the next 30 years. The proportion of people with cognitive problems and dementia in general hospitals continues to increase and the need to make the physical environment of health and social care buildings more dementia friendly is now widely acknowledged. This article outlines some of the key features of dementia friendly design and introduces a suite of environmental assessment tools for care settings.

The Association for Dementia Studies, University of Worcester, is a multi-professional university research centre which draws on and contributes to the international evidence base for person-centred dementia care.

Using this evidence we deliver education programmes that empower people to provide skilled, competent and compassionate care.

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The scale of the challenge In 2009 an Alzheimer’s Society report (1) estimated that over 25% of people accessing general hospital services were likely to have cognitive problems or dementia. This figure is now believed to be an underestimate, with hospitals reporting nearer 40% of the over 75 year olds receiving hospital care being affected though many will not have received a formal dementia diagnosis. Unfortunately too many of these patients still lose the ability to undertake activities of daily living while in hospital and are unable to return home. An outcome that is both devastating for them and their families and has cost consequences for the care system.

The Prime Minister’s challenge on dementia 2020 (2) and the Dementia-friendly Health and Social Care Environments Health Building Note 08-02 (3) both attest to the need to continue to develop more dementia friendly care environments. However, there remains a significant knowledge gap about the critical role that relatively straightforward and inexpensive environmental improvements can play in improving care and supporting the independence and well-being of people with dementia.

Why are dementia friendly environments needed?

Normal ageing has an impact on the senses, particularly sight and hearing, and this is exacerbated by the distortions in perception associated with dementias such as Alzheimer’s disease, the most common form of dementia, and poorly designed care environments can lead to further disablement.

People with dementia may therefore experience increased agitation, disorientation and distress in hospitals as they are likely to: - be confused and agitated in unfamiliar environments particularly if they are visually over-stimulated for example by a plethora of signs and notices - be unable to see things, for example, handrails and toilet seats if these are the same colour as the wall or sanitary ware - experience shadows or dark strips in flooring as a change of level and therefore try to step over them - resist walking on shiny floors because they think they are wet - want to explore and walk around.

However, if hospital environments are appropriately designed it is possible to reduce confusion and agitation, encourage independence and social interaction, and enable people with dementia to retain their ability to undertake activities of daily living.

Developing dementia friendly design principles Key principles for dementia friendly design have been developed by The King’s Fund through a Department of Health commissioned programme (4). Working with over 25 clinically led multidisciplinary teams from NHS trusts, each of which included estates managers and carers, a set of overarching principles were developed and tested.

(Fig 1) Fig 1 – Overarching design principles

Each team completed an environmental improvement project based on the principles which involved: de-cluttering; maximising natural light and improved lighting; laying matt flooring; easing way-finding using colour and contrast, art and better signage. Large nurses’ stations have been removed with the staff now working in bed bays making them more visible and easing distress.

Creating social spaces and better access to gardens has improved general well-being as well as providing opportunities for meaningful activity.

Estates colleagues report that incorporating these design principles has cost no more than similar sized schemes, provided better value for money and improved sustainability. The completed schemes also demonstrate how the care experience for people with dementia can be improved and show how cost effective design can help to reduce falls and incidents as well as supporting increases in non-pharmacological approaches to managing challenging behaviour. There have been consequent improvements in staff morale, engagement, recruitment and retention.

Dementia friendly environmental assessment tools As a result of the programme a suite of evidence based, practical, assessment tools have been developed which focus on those aspects of the physical environment known to impact on people with dementia. They assess not only the physical environment, such as floor coverings and use of paint colours, but also the way that the environment encourages people to behave and interact.

A service user led approach was taken to their design so that the assessments can be undertaken by people with dementia, family carers and staff together. Over 8,500 copies of the tools have been downloaded and they are in use nationally and internationally. They have evaluated very positively and have helped to educate staff and to secure increased funding for environmental changes.

Further development of the tools, including an application for smartphones and tablets, is now being taken forward through the Enabling Environments Programme by the Association for Dementia Studies, University of Worcester.

For further information and to download the tools for wards, hospitals, care homes, health centres and specialist housing, free please visit http://www.worcester.ac.uk/dementia References 1. Alzheimer’s Society. Counting the cost. London: Alzheimer’s Society, 2009 2. Department of Health, Prime Minister’s challenge on dementia 2020, Department of Health, February 2015 3. Department of Health, Health Building Note 08-02, Dementia-friendly Health and Social Care Environments, Department of Health, March 2015 4. Waller, S, Masterson, A, Finn, H, Improving the patient experience: developing supportive design for people with dementia : the King’s Fund’s Enhancing the Healing Environment Programme 2009-2012.

London: The King’s Fund, 2013

One Big Society Magazine 43

September 2015

Health and Social Care

Value of Assistive Living Technologies In Providing Care Outside of the Traditional System We examine how assistive technologies can enable care to take place outside of hospitals, for example in private houses or care homes.

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E: info@talkingeye.net W: www.talkingeye.net T: +44 1223 421848

Home care and assisted living can bring about a number of problems for security, both external and internal, with patients often struggling to take care of certain tasks such as turning off appliances or locking doors.

An important element in the firm’s product development for Tecomms was an independent consumer survey, conducted across six consumer groups, to determine how people would react to the product.

A solution to this is assistive technology, which is designed to support aspects of wellbeing, safety and independence in people with disabilities and help their carers to take care of them remotely; reducing stress to the person they care for as well as allowing the caregiver more time to take care of other tasks.

The company was keen to emphasize the far reaching appeal of the technology among a range of customers.

An example of an assistive technology platform is Tecomms, the flagship product of Talking Eye Limited. The platform is an always-on, always-cloud-connected monitoring device that can be used for assisted-living as well as for security and appliance automation.

Tecomms consists of a powerful central unit that connects to the cloud through wifi or cellular with battery-backup. The central unit can interface with a wide range of sensors and devices, extending the choice of many applications to be available and used.

The product provides a number of features which enable assisted care, such as providing alerts, so that when unusual occurrences or emergencies such as trips, falls or unwanted callers to the home at unexpected times occur, the carer is made aware of this remotely and is able to use other functions such as remote communication function or the monitoring function to solve the issue.

The Tecomms patented technology is unique in providing voice-to-voice and data communications from the front door to anywhere in the world, over mobile networks, which means that consumers have access to technology from Talking Eye Limited that cannot be purchased from other firms.

The product is easy to use and requires little instruction, with set-up options designed to personalise the features and ensure that the product provides assistance to individual needs. There is also the option to remotely control other electrical appliances in the home remotely, enabling users to turn on or off any electrical appliance or device in their home that has been paired to the Tecomms system.

Tecomms also integrates with the majority of other technology solutions already established in the home. The product has been built on an ‘open platform’ making it compatible with a range of platforms and devices (Apple and Android, for example, and across all UK mobile network operators). This allows customers to use the platform with their existing devices rather than purchasing new ones to use on the product.

This open platform is a major part of Talking Eye’s ethos, with the company being dedicated to developing highly innovative solutions that work within existing mobile networks, allowing for greater application of the technology for customers. Since incorporation, the company has invested more than half a million pounds in Research & Development to ensure the technology is the best it can be.

“Tecomms has strong appeal and interest across all age ranges, with a particularly high intention to purchase from the Empty Nesters/Grey Market.

This group accounts for 65% of UK Homeowners.”

The survey outlined what customers thought of the technology, with key highlights including: • 97% of those surveyed expressed an intention to purchase • Product concept was exceptionally popular and performed remarkably well • They were very interested in purchasing the product as it covered a particular lifestyle need that no other product in the market offered • They confirmed the features were valuable • Consumers understood the device and all its functions very quickly and easily • The perceived cost was considerably more than actual cost.

The research also focused on both the functionality and convenience of Tecomms, with the fact that the technology is easy to use and the ability to identify visitors remotely without having to open the door being highlighted as important by those surveyed.

The product allows peace of mind for the carers of vulnerable people, particularly the elderly for whom safety can often be a major issue. This is also a major issue for those with memory affecting diseases such as Alzheimer’s and dementia.

The Alzheimer’s Society estimates that there are 850,000 people with dementia in the UK, with numbers set to rise to over 1mn by 2025 and 2mn by 2051.

Carers of people with the disease could use assistive technology such as Tecomms to help them juggle their schedules with taking care of their friend or relative, particularly in cases where the carer does not live in the same house as the person they are looking after.

Additionally, the technology has a place in care homes, where it could be used by staff to ensure the wellbeing of residents, for example ensuring that their appliances are all switched off after they have gone to bed without entering their room and frightening the resident.

Therefore Tecomms can be used to ensure peace of mind for the caregiver and safety and reassurance for the person they are caring for. It has far reaching and important potential in the assisted living environment, with the potential to revolutionise the way in which care is provided to the elderly and vulnerable outside of hospitals. Caring for people in their own homes can improve their peace of mind and make them feel more secure.

One Big Society Magazine 45

September 2015

Health and Social Care

New Ways for Prevention Paul Bomke, CEO, Pfalzklinikum

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The Palatinate region braces itself/you: roads to resilience - a Palatinate initiative for the promotion of preventive approaches beyond the health care system.

Strategies based on prevention improve the population’s mental health. Nevertheless prevention programmes are given less than 7% of the overall health system budget in Germany.

With regard to the treatment of the mentally ill, with complex needs, we have decided to think in a radically new way.

Our idea is to strengthen resilience on different social levels such as individuals, families, enterprises and communities.

The ability to advance personally in times of crisis and not to be broken by these crises, to be able to cope well with changes and with the ups and downs of life – this is what is known as resilience.

Resilience is of utmost importance both for individuals and organisations.

Resilience at an individual level, i.e. the strengthening of an individual’s mental resistance, is a key aspect of the services provided by the Pfalzklinikum für Psychiatrie und Neurologie - AdöR (Service Provider for Mental Health). Around 30,000 people are treated and cared for at their 12 locations annually, either as in-patients, in day clinics or as out-patients. In order to boost their mental health on a long term basis and to counteract any further increase in mental illnesses, the main focus of the efforts has to be on prevention.

The preventive fostering of individual resilience will therefore play a central role.

Preventive measures concerning this topic are very important in working life and in daily social situations but also in the context of professional training and leisure activities. Especially at work there is a high risk that, due to permanent excessive demand, you are trapped in a vicious circle of chronic stress and the resulting risk of a mental disorder. Stressful working conditions can even make those people ill who are very robust by nature since innate and acquired stress protection can also fail under permanent stress. Therefore it is the responsibility of almost all social institutions and employers to create healthy social conditions and labor practices as well as positive environmental factors.

Above all, however, there is need for action in the fostering of organisational resilience. Technological advances, growing market dynamics or aging workforces are just a few examples of megatrends that may trigger crisis situations. These situations are cropping up in organisations such as companies or administrations ever more frequently. Such situations almost invariably call for rapid and comprehensive change to ensure a company’s survival.

We also have to think about ways to improve resilience on a community level. These three levels (Individual, Organisation & Community) are helpful to build a powerful and sustainable prevention strategy.

To achieve this, we have brought together experts from different institutions in the field of science and practice (sociologists, anthropologists, economists, pedagogues, psychiatrists, communication scientists, ergonomists and so on) in order to promote salutogenesis at community level through the thematic fields of work/school/leisure (instead of pathogenetic approaches on which the health system has mainly focused so far).

The foremost requirement for this is preliminary, comprehensive, communication research aiming at the identification of stigmatising attitudes and their replacement by new relevant information (for example by means of metaphors). It is only sound knowledge of how communication works or does not work that offers the possibility of establishing a broad know-how of resilience-promoting factors and framework conditions among citizens.

The results are reflected in a binational project with a similar, newly founded initiative (Blackpool Better Start) in Blackpool, Great Britain.

With this concept we also tread new paths when designing the context of health communication.

The Palatinate region braces itself/you initiative as a socio-ecological and multi-agency approach is aimed at building networks for “knowledge mobilisation“, establishing action alliances and learning platforms and various projects to be presented using the example of resilience in enterprises and resilience promoting programmes in schools and at a community level..

One Big Society Magazine 47

September 2015

Health and Social Care

Primary Care In The Post Five Year Forward View World Mary Chant is a partner in the health and social care team at Blake Morgan

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The NHS, its financial position, its sustainability and its services, are at the centre of attention and the subject of copious column inches in both the general and specialist press. Primary care is very much at the heart of the NHS, focussing around the concept that everyone in the population has access to a family doctor through the system of registered patient lists.

GPs are, however, facing a tidal wave of issues: a steadily growing requirement for accountability leading to greater administration and more paperwork; regulation by the CQC; pressure to open seven days a week and for extended hours; a reducing number of GP candidates; a partner recruitment crisis and a general diminution in financial returns despite the increased hours and increased stress.

It is vital that we do not forget or underestimate the importance of primary care. One of its great strengths is its geographic accessibility and, for the patient, a practice to which they “belong”.

Many would probably say that their GP is at the core of their access to medical care and that the “free at the point of delivery” concept is fundamental to healthcare in this country.

The importance of primary care is acknowledged in some of the new models of care which have been identified in the Five Year Forward View. Both the Multi Speciality Community Provider (MCP) and the Primary and Acute Care Systems (PACS) anticipate the integral involvement of primary care. The models in the Five Year Forward View are not prescriptive and the MCPs and the PACSs are described in such a way that gives flexibility. Indeed, there has been speculation that in due course the two models could well morph into one.

There are already examples of new structures.

Southern Health, a community and mental health trust and one of the MCP vanguards, has announced a model which includes opening a shared branch surgery to deliver eight am – eight pm access seven days a week to support the local GP practices, as well as arrangements with GP practices where there have been recruitment crises. Lakeside Healthcare, also an MCP, is a growing partnership of GP practices with ambitions to expand its combined list to 300,000 patients. In Birmingham and Sutton Coldfield “Our Health Partnership”, although not officially one of the vanguard new models of care, is embracing the opportunity to look at new structures, new approaches and new services.

Reading comments in the specialist press about these new models reveals GPs’ concerns. Expressions such as “the end of general practice as we know it”, “privatisation”, and practices “ripe for the picking by the chaps in red braces” abound, and there are concerns that patients won’t like it.

It is important that we do not confuse structure with substance. Times have changed since 1948 – bigger population, growing percentages of elder-

ly patients, more chronic illnesses. The reality is that the nation’s health and care budget has to do more for more people.

GPs want to retain their clinical autonomy and be able to deliver the best available care for their patients, two objectives which resonate with patients.

Today, however, that means a closer relationship between primary and secondary care and breaking down the barriers between health and social care. In turn that means rethinking structures of delivery, for the longer term benefit of the patient.

The transition may not be easy. No-one knows what primary care is going to look like post the Five Year Forward View. However, now is the time for GPs to get involved in shaping the future.

The move towards GP federations in many areas has enabled GPs to take better control of their destiny. As a federation they can present themselves as a unit, for external purposes, whilst retaining their autonomy as far as their patients are concerned. Whilst many want to continue to run practices from premises in their existing localities, there are others for whom the responsibilities of premises and funding are not attractive. They may want the federation to employ them, take on their premises and de-risk their practices to enable them to survive. A federated structure allows flexibility. For those who want to retain their “independence”, membership of the federation can provide back office support, remove the administration and allow GPs to focus on clinical services.

The federation’s ability to employ specialist staff means that all member practices can offer a wider range of services to their patients.

The federation can also be a single entity which can enter into arrangements with NHS Trusts, Foundation Trusts, voluntary organisations and others to deliver a more joined up service for patients.

And what of the concern that patients won’t like a new model of care? If patients are receiving good quality clinical care, free at the point of provision, have access to a wider range of services and therefore less visits to hospital for out-patient services, and an ability to book an appointment within a sensible timescale, they are likely to be happy. That may involve some changes to the patient experience – on-line booking of appointments, checking in on a computer screen on arrival at the practice, triage, more nurse practitioners.

That does mean patient education particularly by the practice. However, if patients can see that they are getting what they need and are introduced to the changes in an appropriate way, they are more likely to accept them.

GPs don’t want to work in a land of corporates but they need to be involved, both for their own benefit and for their patients, in the change process. By embracing change now and helping to shape the offering, they stand a far better chance to remain in control of their own destiny.

One Big Society Magazine 49

September 2015

Education

Rise in STEM Subject Take-Up Recent exam results highlight increased interest by young people in valuable STEM (science, technology, engineering and maths) subjects thanks to Government initiatives.

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Education

The UK Government’s increased emphasis on core academic subjects has been vindicated by recent figures which show a rise in participation in STEM subjects.

The number of a-level entries in science and maths subjects has increased by more than 38,000 since 2010, up by 17.3%.

Since 2010, the government’s plan for education has included a focus on encouraging more young people, especially women, to study STEM subjects which has resulted in 16,000 more a-level entries for women in these subjects. Overall entries for girls in STEM GCSE subjects were also up by more than 30,000, including more than 14,000 in maths.

The number of entries in facilitating subjects by women has also increased by around 27,000 since 2010.

Overall the number of entries in the facilitating subjects at a-level that are more often required by top universities than others are up by more than 15,000 since last year and 13.3% since 2010 meaning more students are now studying the core academic subjects that will open doors to their future.

At the same time, entries into non-facilitating subjects are down by almost 12% compared to 5 years ago with big falls in subjects like general studies, which are often not recognised by universities, with almost 30,000 fewer entries since 2010.

These figures, released by the Department for Education, highlight the success of the Government’s focus on these subjects, with initiatives including the championed the study of academic qualifications at GCSE and a-level through the introduction of the The English Baccalaureate (EBacc) performance measure.

Schools Minister Nick Gibb commented on the release of the a-level results and the success of the EBacc initiative.

“This year’s A level students are among the best qualified in a generation and I want to congratulate them on today’s results which reflect the dedication of teachers and young people across the country.

“These results provide the clearest proof that the introduction of the EBacc and our drive to persuade more pupils to study core academic subjects has been a success.

“As a result, thousands more pupils from all backgrounds are studying subjects that will secure them a place at a top university or an apprenticeship and that will help to secure well paid employment.”

spite claims to the contrary, the EBacc measure has not led to a fall in wider subjects with almost 300,000 entries into religious studies this year the highest level since 2002, as well as increases in entries in the arts subjects.

Compared to last year the figures also showed that entries into art and design subjects rose by 1.7% to almost 200,000 and entries in music also rose by 2.2% to almost 50,000.

The EBacc introduction was particularly important at GCSE level as it ensures that students have a good fundamental grounding in important life skills such as numeracy and literacy.

Another initiative designed to ensure young people have the fundamental skills of literacy and numeracy is the introduction of changes to the education system that saw all young people who do not achieve at least a C at GCSE in English or maths at 16 continue studying until they reach that standard.

The figures show the impact of these reforms on STEM subjects. For 17-year-olds and over, entries in maths are up 30% while English entries have risen 23%. As a result there are now over 4,000 more passes in English by students aged 17 and over, and over 7,500 more maths passes.

Speaking on the day of the GCSE results this year, Education Secretary Nicky Morgan commented on the results.

“Today marks the culmination of years of hard work for pupils, teachers and parents and I want to congratulate them on their achievements.

“Thanks to our reforms focused on extending opportunity, a generation of young people from all backgrounds are now securing the GCSEs that help give them the widest range of options later in life - whether looking for a rewarding job or a top apprenticeship.

“This not only benefits the students involved, it means our workforce for the future is properly trained to compete in a global economy.”

Ultimately, the success of this initiative to encourage greater study of STEM subjects at GCSE and a-level will benefit the UK economy as well as schools, which have seen an increase in pass rates for these qualifications. Figures from the Joint Council for Qualifications show the proportion of pass rates has risen by 0.1 percentage points this year to 98.1%.

The number of entries into EBacc subjects at GCSE are up this year but figures show that deOne Big Society Magazine 51

September 2015

Education

Government Committed to Free Schools

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Education

Prime Minister David Cameron has announced commitment to free schools with 500 in the pipeline, although greater support to current system could be better in the long term.

The first wave of free schools has been approved in Parliament and Cameron has pledged to deliver two waves of new schools every year until 2020.

The Government’s commitment to open 500 free schools, which are government funded but not controlled by the local authority, over the next five years will create 270,000 school places across the country.

The UK already has 252 established free schools and 52 free schools which have just opened at the beginning of this school year.

In order to encourage more groups to invest in free schools the Government has stated that it is “committed to streamlining the process for existing high performing schools and encouraging businesses, charities, cultural and sporting bodies to enter the programme”.

Education Secretary Nicky Morgan commented on the positive outcomes of the Government’s commitment to free schools.

“The free schools programme has sent out the message loud and clear, that parents should never have to settle for anything less than the best for their child. Right across the country, these innovative, community led schools are helping to fulfil our ‘one nation’ commitment to educational excellence for every child.

“We know that free schools don’t just give parents greater choice, they also force existing schools to up their game. Today’s news sends a clear message that we are committed to extending this unprecedented level of choice to more parents than ever before.”

Nick Timothy, Director of New Schools Network, a charity which supports the creation of free schools, was also positive about the announcement.

certainty. As free schools are not co-ordinated by councils like other schools and parents have to apply to the school directly for a place, these late openings could cause issues for both parents and the existing school system.

Councillor David Simmonds CBE, Deputy Chairman of the LGA, commented on this.

“When a new free school fails to open on time, it can have huge implications for families. It is absolutely crucial that parents know what is happening at the earliest opportunity. In order to minimise disruption, councils are calling on government to ensure any postponement is made before national offer day, so we don’t have a repeat of the situations that councils have witnessed in local areas over the past couple of years. Councils can help those mums and dads provided government has made its mind up on time.

“For many families, they will have already have paid for new school uniforms and will have organised their transport plans to ensure their child is able to travel to and from school safely. When last minute delays are announced by government, it is the council that picks up the pieces to reassure mums and dads that their child will have a place at a school before September.”

Russell Hobby, General Secretary of school leaders’ union the National Association of Head Teachers (NAHT) emphasized that he believed any form of new school should only open if there was a shortage of places.

“Local planning of school places across maintained, academy and free schools is necessary.

We need a local agency able to commission both new schools and new places in all of these sectors – doing it little by little from a desk in Whitehall is not the way forward.

“Since 2011, the powers of local authorities in planning school places have been significantly reduced without an alternative system to take their place. We have a balkanised system with authorities, academies and central government taking decisions in isolation.

“The government’s own figures show they are expecting that at least 200,000 more primary school places and 80,000 more secondary school places will be needed in the next five years. The Local Government Association puts the cost of creating all the necessary places over the next decade at £12bn.

“There is a desperate need for long-term planning that spans all sectors. With the massive increase in pupil numbers and over-stretched budgets, we cannot afford inefficiency and conflict. The government’s approach makes this problem worse.

“Until some agency at the local or regional level has the information and the authority to prioritise school places where they are most needed, parents and children will always be unsure that the system will give them what they want.”

Therefore, whilst free schools offer the potential to give parents more choice and children a better standard of education, the Government also needs to consider the idea that greater investment and support for the current council run system would ensure the system provided a better standard of education to every child in the system. As free schools increase the Government is also going to have devise a system to ensure that they operate in a way which supports parents, children and the existing system.

“The pledge to approve 500 new free schools over the course of the Parliament is very welcome news for parents and teachers across the country. The fact is, we urgently need more good new schools – not just where there is a shortage of places but where standards have been too low for too long.

“Free schools are better placed to drive up standards and give parents what they want because they give more control to heads, teachers and governors, rather than politicians and bureaucrats.

They are twice as likely as other state schools to be rated outstanding by Ofsted – and we need more of them.”

However, The Local Government Association stated that there are many potential issues with free schools, which can fail to open, causing unOne Big Society Magazine 53

September 2015

Transport

Dundee: The Electric Car City Dundee City Council has the largest fleet of electric cars of any local authority in the UK. Improved infrastructure has led to increased take-up of the technology by the public and fleet manager Gary McRae believes this will only get better.

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The council currently has a fleet of 62 pure electric vehicles, which are situated within a number of different areas, including 30 which are used for corporate car pools servicing between 300-600 council employees.

The remaining vehicles are driven by individuals from various different council departments including the parking team, corporate laundry, operational supervisors, corporate mail run and individual trade’s people.

Electric vehicles work well in the city thanks to significant infrastructure to support charging the vehicles. At present Dundee has one of the largest Urban Rapid Charging networks in the country, along with an extensive fast charging network which is capable of supporting the initial phases of growth in the public EV sector.

Going forward the council is exploring an expansion of a private infrastructure for their fleet, which presently shares charging infrastructure with public cars, in order to allow for increased availability of the public chargers as public use of the vehicles increases.

Increased charger availability forms a key aspect of the council’s bid in the Go Ultra Low City Scheme, a Government initiative which provides funding for cities willing to centres of excellence for low emission vehicles, with the council seeking new ways to considerably increase the availability of charging infrastructure within the city for both private and public use.

The Go Ultra Low city scheme is a Government project which rewards cities that demonstrate the most potential to become internationally outstanding examples for the adoption of ultra low emission vehicles (ULEVs) in a local area with a share in £35mn fund. Dundee City Council is one of twelve councils being shortlisted for the scheme, with the funding due to be shared out between two or four of this shortlist.

Corporate Fleet Manager Gary McRae explains why the council is so keen on electric vehicles and how it has integrated them into various projects in addition to their impressive fleet.

“We were initially attracted to electric vehicles due to them having the backing of the major vehicle manufacturers with the large scale of money they had invested in the technology we felt it would have a long term future. The range of these vehicles and their reduced impact on the environment meant they sat well within our current operations and became the obvious choice for us.

“In addition to our fleet the council has been promoting EV’s within the city over the past four years and have spoken at many events for businesses and public to try and promote the new technology.

We have also taken at stall at the local Flower and Food Festival in the last two years to try and help educate the public. The city has seen a substantial investment in EV’s for taxis over the years.

“We have also talked at a number of Transport Scotland led events as well as Green Fleet Scotland and E-cosse events as well as giving a number of individual local authorities any guidance and assistance we can. Additionally the council has been visited by other local authorities and members to show them what we have done and how we have achieved this.”

Recent statistics from the Office for Low Emission Vehicles entitled Uptake of Ultra Low Emission Vehicles in the UK: A Rapid Evidence Assessment for the Department for Transport shows a significant expansion in the ultra low emission vehicles market, with the ULEVs representing over 1% of new car sales for the first time during the last quarter of 2014 and first quarter of 2015. However, this may not be enough to reach the Government’s ambitious target that by 2040 every new car in the UK will be a ULEV. McRae believes that the reason electric cars are not more popular is because the public has limited knowledge of using the technology on a permeant basis but is keen to emphasise that fleets such as his own will play a key part in encouraging public take-up in the technology.

“I think one of the major barriers to an increased take up of EV’s by the public is a lack of knowledge and understanding of not only the technology but the whole life costs of the vehicles. One of the main challenges the council has faced has been in getting people to change their mind-set around charging the vehicles.

“It is my belief that the current strategy of investing in fleets will over time give individuals confidence that the technology does work in real life situations and will dispel some of the myths around the technology.

“In our recent experience the aftersale service from some manufacturers has not been great as they do not have any expertise in the local area which has meant we have had to send the vehicles further afield. Investment in fleets in the future will also help to create a second hand market which will help improve this and hopefully also help consumer confidence.”

With air pollution and traffic reduction key concerns of the Government and public use of ULEVs a focus it is clear that investment in council fleets will only be increasing in the future, leading to better fleets and increased funding for charging infrastructure which will only improve public use of electric cars in the future. Dundee City Council are clearly trailblazers for councils, many of whom will doubtless soon have fleets of electric cars similar to theirs.

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September 2015

Transport

Bio-Bus: Is This Fact or Fiction?

Public Transport, whilst already better for the environment than conventional car use, is becoming increasingly sustainable, with new initiatives such as the Bio-Bus, which runs exclusively on human waste and food scraps.

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Public transport has seen many changes over the years but the advent of new, environmentally friendly ways to travel are set to decrease the environmental impact of an already sustainable form of transport further.

At the end of last year the Bath Bus company launched a Bio-Bus, the UK’s first ever bus powered on food and human waste, which engineers believe could provide a sustainable way of fuelling public transport and cut emissions in polluted towns and cities.

The 40-seater Bio-Bus, which runs on gas generated through the treatment of sewage and food waste that’s unfit for human consumption, helps to improve urban air quality as it produces fewer emissions than traditional diesel engines.

Running on waste products that are both renewable and sustainable, the bus can travel up to 300km on a full tank of gas generated at Bristol sewage treatment works – a plant run by GENeco, a subsidiary of Wessex Water.

In November 2014 GENeco became the first company in the UK to start injecting gas generated from food waste and sewage into the national gas grid network and at the same time installed a gas refuelling plant for the bus.

GENeco general manager Mohammed Saddiq commented on this and the Bio-Bus: “Through treating sewage and food thats unfit for human consumption we’re able to produce enough biomethane to provide a significant supply of gas to the national gas network that’s capable of powering almost 8,500 homes as well as fuelling the Bio-Bus. “Gas powered vehicles have an important role to play in improving air quality in UK cities, but the Bio-Bus goes further than that and is actually powered by people living in the local area, including quite possibly those on the bus itself.

“Using biomethane in this way not only provides a sustainable fuel, but also reduces our reliance on traditional fossil fuels.”

The Bio-Bus can travel up to 300km on a full tank of gas, which takes the annual waste of around five people to produce.

Using the annual waste generated from one bus load of passengers, would provide enough power for it to travel a return journey from Lands End to John O’Groats.

Speaking at the time the bus was launched Collin Field, engineering director, at Bath Bus Company, said of the initiative: “Up to 10,000 passengers are expected to travel on the A4 service in a month, which is available not only for airport travel, but also local journeys along the route through Saltford, Keynsham, Brislington, Knowle and Hengrove.

“As part of the RATP Dev UK group, this represents RATP Dev’s involvement in the latest of a number of initiatives to gain experience of alternative fuels, with sister companies also experimenting with different alternatives. The information we gain, will be shared with other group companies across the UK and Europe.

“The timing of this initiative could not be more appropriate as we approach 2015 when the City of Bristol itself becomes European Green Capital.

With so much attention being directed towards improving air quality generally, the public reaction to the appearance of this bus on a service between a World Heritage City and an airport will further focus on the potential for this particular fuel.”

Melanie King, Bristol Airport’s environmental manager, added her comments: “Sustainability and surface access are key areas of focus for us and we welcome new technologies which could reduce the environmental impact of getting to and from the Airport. With Bristol set to be European Green Capital in 2015, this is one of several exciting initiatives we hope to be involved with over the course of the year.”

Bristol sewage treatment works treats around 75 million cubic metres of sewage waste and 35,000 tonnes of food waste, collected from households, supermarkets and food manufacturers, every year.

Through a process, known as anaerobic digestion, 17 million cubic metres of biomethane is generated a year at the Bristol plant – the equivalent of meeting the power needs of 8,300 homes. A newly built state-of-the-art gas plant injects the gas into the grid.

Charlotte Morton, chief executive of the Anaerobic Digestion & Bioresources Association (ADBA), said: “GENecos Bio-Bus is an excellent demonstration of biomethane’s unique benefits; decarbonising areas other renewables can’t reach. A home generated green gas, biomethane is capable of replacing around 10% of the UKs domestic gas needs and is currently the only renewable fuel available for HGVs. “The bus also clearly shows that human poo and our waste food are valuable resources. Food which is unsuitable for human consumption should be separately collected and recycled through anaerobic digestion into green gas and biofertilisers, not wasted in landfill sites or incinerators. The Bio-Bus will also help to demonstrate the true value of separate food waste collections, which are now obligatory in all other regions, to the English government.”

The Bio-Bus has received backing from a number of businesses including the manufacturer of the bus, Scania, as well as companies including Roadgas, CNG Services Ltd, Dampney’s Agri Environmental, Trant, Grontmij and AIR Decker.

Ultimately the bus could pave the way for future initiatives as local councils increasingly look for new and innovative ways of reducing the environmental impact of their services.

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September 2015

Transport

Charging Points Infrastructure in the UK New report from the Department of Transport suggests that Government’s Plugged in Places scheme, designed to provide charging points across the country to encourage electric car take-up is working.

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The Ultra Low Emission Vehicles (ULEV) market in the UK has undergone a particularly significant expansion, and in the last quarter of 2014 and first quarter of 2015 they represented over 1% of new car sales for the first time.

There have recently been interesting developments in the market. ULEVs represented a similar proportion of new car sales in the UK in 2014 as they did in the US, France and Germany, while California (3.2%) and Norway (17.8%) had two of the largest Electric Vehicle (EV) market shares globally.

The evidence showed that the vehicles are being used for a variety of purposes, with businesses increasingly involving them in their fleets. The data showed that most fleet EV owners are currently private sector businesses, working in a range of industries, with fewer than 500 employees and a small-medium sized fleet.

Private use of electric vehicles is also on the increase as ease and convenience make them increasingly appealing to private motorists. Most private owners are satisfied with their EV and positive about buying another in the future, which appears to be owing to EVs’ performance, comfort, low fuel costs, and the ease and convenience of home charging.

The figures, released by the Department of Transport recently, show that there is still a long way to go before electric vehicles are commonplace but the developments in customer take up are significant.

These increases prove the success of the Government’s Plugged in Places scheme, an initiative which set up a nationwide charging point infrastructure in order to facilitate increased customer take up of electric cars.

The funding and fact finding programme, conducted by the Office for Low Emission Vehicles, offers match-funding to consortia of businesses and public sector partners to install electric vehicle charging points.

Data from the programme detailing how drivers wish to use and recharge their electric vehicles is being used to provide the necessary evidence base to help the industry create a UK network of recharging points that meets the needs of plugin vehicle drivers, helping to create infrastructure needed to support and encourage further growth in the industry.

A major aspect of the programme is to facilitate Government engagement with the electric vehicle industry to provide infrastructure that delivers greater interoperability, better accessibility and helps with longer journeys.

Eight specific ‘Plugged-in Places’ have been developed across the UK, in the East of England, Greater Manchester, London, Midlands, Milton Keynes North East England, Northern Ireland, Scotland.

Additional charging points have been installed by a number of additional councils across the UK and by private sector providers.

The scheme has seen rapid progress. At the end of March 2013, over 4000 chargepoints had been provided through the eight Plugged-in Places projects. Approximately 65% of these are publicly accessible. The Office for Low Emission Vehicles used data provided by chargepoint manufacturers and concluded that an estimated 5000 chargepoints nationwide had been installed in areas not listed among the eight Plugged-in Places organisations.

Initial analysis of the project made in late 2013 in the report Lessons Learnt from the Plugged-in Places Projects identified a framework and strategy for the initiative, outlining key factors which needed to be taken into consideration to ensure the ongoing success of the scheme. The report also highlights the need for the scheme, outlining why it is so vital to ensure a strong charging point infrastructure.

“Having adequate infrastructure in place is fundamental to the UK’s favourable market position, encouraging car manufacturers to locate vehicle production in the UK and providing new opportunities for associated supply chains.”

The more recent data suggests that the programme has been a success. This shows that the Government’s ambitious plans for the electric vehicle market. The Government aspires that by 2040 every new car in the UK will be a ULEV, which considering the vastness of the new car market and the fact that most car manufacturers still offer a wider range of fossil fuel powered cars than they do electric vehicles, could prove to be a difficult target to reach.

Following from the Clientearth Supreme Court case the UK Government has also made reducing carbon emissions and air pollution a greater priority, which will lead to an increased focus on electric cars, which will play a vital role in helping to meet targets and reduce air pollution and emissions.

This increased focus on electric cars will encourage a greater focus on charging infrastructure, which is a key component of ensuring that electric cars are adopted further by UK consumers in the future.

Full document Lessons Learnt from the Pluggedin Places Projects available here.

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September 2015

Transport

Compressed Natural Gas Vehicles Making an Impact in Sheffield

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CNG Vehicles were a popular choice before electric cars became popular, and still have a foothold in Sheffield, where innovative uses for the technology are sparking a resurgence in their popularity.

Compressed natural gas, or CNG, is natural gas which is put under immense pressure to be turned into a colourless, odourless and non-corrosive fuel.

Although vehicles could potentially use this as either a liquid or a gas, most vehicles use the gaseous form compressed to pressures above 3,100 pounds per square inch. They are an environmentally friendly alternative to traditional vehicles as it burns cleaner than traditional oil based fuels, reducing the amount of air pollution created.

A key user of the technology is Sheffield City Council, who previously had one of the largest fleets of CNG vehicles, which are used primarily for waste collection in the city.

Councillor Terry Fox, cabinet member for environment and transport at Sheffield City Council, commented on the use of the vehicles.

“We introduced 10 compressed natural gas (CNG) vehicles in 2010, and at that time ours was the biggest fleet of refuse collection vehicles in the UK. “These vehicles are still in use on our recycling rounds. As and when these vehicles become available on the market again, which we understand may be the case in 2017, we will be discussing the possibility of replacing or expanding our current fleet.

“Here in Sheffield, where we’re currently building upon our reputation as The Outdoor City, reducing air pollution is a main priority for us – and opting for CNG vehicles was part of this.”

The council listed a number of reasons for using CNG vehicles, notably that they: • Produce 20% less CO2 than a vehicle that is powered by traditional fossil based fuels; • Reduce local air pollution; • Are quieter than a normal collection vehicle; • Give out less odour than a traditional diesel engine; • Can travel just over 300 miles on a full tank; • Working conditions are improved for their collections teams using these vehicles as they benefit from the reduced odours and vibrations; • CNG will have more stable energy prices as it is not so reliant on oil.

Additionally, Sheffield has had funding from the Department of Transport’s Clean Bus Technology Fund, which provides grants to local councils to go towards reducing oxides of nitrogen (NOx) emissions from local buses.

A source from the Department of Transport confirmed that a new round of funding for the Clean Bus Technology Fund is due to be announced at some point this year, although was unable to comment on how this funding would be allocated.

Sheffield City Council has already been a recipient of the fund, as they received grants to convert a number of local buses to run on natural gas in 2013. The move from diesel engines to CNG ones will reduce costs as well as air pollution, which can be harmful to people in built up city areas where there is a high density of fumes from vehicles.

Stagecoach, a key provider of bus travel in the city, has committed to environmentally friendly alternatives to diesel, however has so far eschewed using CNG in favour of investing in 40 hybrid buses, which also reduce the city’s carbon impact.

The reduction in air pollution which CNG vehicles provide could potentially lead to further take-up of the vehicles across the country as the Government seeks to comply with the outcome the recent Supreme Court lawsuit by ClientEarth, an organisation of environmental lawyers.

ClientEarth argued that the UK Government’s plans to cut air pollution, which it is legally compelled to submit by the European Union, could not possibly be met by the deadline. The Supreme Court agreed with this and ordered the UK Government to create a new comprehensive plan to cut air pollution with workable targets and clear development frameworks.

This has led the UK Government to seek drastic measures to cut the level of air pollution, and the scheme to use CNG powered vehicles in Sheffield could potentially pave the way for further use of the vehicles across the country for similar purposes, as road traffic is a key contributor towards Brittan’s air pollution.

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September 2015

Environment and Sustainability

The New Forest Goes Green

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Bikes and Buses play a key role in project to reduce congestion in the national park thanks to grants from the Department for Transport.

Major infrastructure improvements at the New Forest aimed at encouraging visitors to partake in car-free travel are having the desired effect.

The improvement programme is part of a 2012 initiative in which Hampshire County Council, the New Forest and South Downs National Parks, and five partner authorities were awarded £3.8m from the Department for Transport through the Local Sustainable Transport Fund (LSTF). This funding is designed to reduce the impact of car traffic in the National Parks by encouraging visitors to switch to car-free modes of transport.

The programme is a key part of the recently updated Partnership Plan for the New Forest National Park, the formal Management Plan for the National Park area designed to help protect the area for future generations to enjoy. A large part of which involves increasing the use of more sustainable modes of transport around the park.

This plan has clearly been a success, as the New Forest Tour, a open-top bus service designed to ferry visitors around the park, saved an estimated 226,000 private car miles in 2014, and provided a boost to local businesses, contributing an estimated £680,000 to the local economy.

Additionally in 2014, LSTF funding was used to add new stops at Hythe Ferry and attractions like New Forest Wildlife Park and Longdown Activity Farm near Ashurst, which contributed to an increase in passenger journeys to a record 41,877 that summer.

The tour is designed to provide passengers with an enjoyable experience without the use of their car, with the buses providing audio commentary and offering other perks, such as discounts at attractions en route. Their seasonal Beach Bus service also offers a free ice cream to every ticket holder. One of the hopes is that the increased take-up in bus travel within the park and the positive experience provided leads visitors to use buses more frequently when they get home as part of a national effort to reduce carbon emissions. Mark Holroyd, the Transport and Tourism Manager for the New Forest National Park Authority (NFNPA), believes that the rise in bus use within the park is having a positive effect on the environment at the park by reducing the number of cars on the roads.

So successful is the New Forest Tour that the NFNPA has developed a Visitor Bus Toolkit, designed to help other protected landscapes to create commercially viable bus services which appeal to visitors.

Cycling infrastructure is also a key aspect of the improvements, with funding from the DfT Cycling Ambition fund helping to improve the cycle routes around the park. So far, 55 miles of cycle routes around the park have been upgraded thanks to the funding, with an additional three miles of new routes being added.

In order to help encourage those casual cyclists, grants have been given to local cycle hire firms so that staff can be trained to set tourists off on their journey, providing advice and routes in order to give those cycling around the park a positive cycling experience, which Holroyd believes is key to encouraging visitors to cycle more once they leave the park.

The campaign has not been entirely based on infrastructure, with social media playing a vital role in targeting visitors who are eager to experience the park on their bike. By partnering with various tourism industry members locally, such as the New Forest Tourism Association and local hotels, the NFNPA has increased awareness by providing literature and maps of the park to businesses which come into regular contact with tourists.

Holroyd is keen to emphasise that the approach to encouraging visitors to cycle more instead of driving has been firmly focused on the positive aspects of the biking around the park, rather than the negative of car use. “It’s very much carrots rather than sticks”.

ing pollution and improving air quality.

“The impacts of traffic on the national park include the obvious one, that car traffic increases air pollution and C02 emissions, which impacts on our international commitments to reducing climate change on a wider scale, but also in the Forest we do have some significant congestion problems.

This is unusual for a national park so sites such as Lyndhurst and Brockenhurst have unfortunately developed a reputation for quite significant traffic queues.

“This has two impacts: firstly it is not a very nice welcome for visitors who are arriving in the park to find themselves in a long queue of traffic as it takes away from the visitor experience and slows down the local economy, making it difficult for goods and services to get in and out of the park.

Secondly, traffic produces a large amount of air pollution. Lyndhurst is what they call a Local Air Quality Management Zone; again it is quite rare for a national park to have one of those, and this is entirely because of the traffic queues.”

The New Forest ponies, which are a famous attraction at the park, are also affected by traffic, with around 70 to 100 accidents a year occurring as a result of vehicles hitting the animals. This has been declining in recent years but is still significant.

Moving forward, the park has committed to exploring whether a more formal park and ride style shuttle service from the surrounding towns to specific destinations within the park may be an effective solution. Additionally, the park authority is developing a children’s book and online game to be distributed to schools, with the aim of encouraging young people to pester their parents to enjoy the area car-free.

Holroyd also states that the reduction in car use at the park was not only vital to the park itself, but also had wider implications with regards to reduc-

“The second purpose of a National Park is to promote opportunities for people to enjoy and understand the qualities which make it special so we have commentary on board the New Forest Tour that tells people why the forest is so important, about the history, the cultural heritage, the landscape”.

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September 2015

Environment and Sustainability

New Plan Will Boost Starter Homes in Rural Areas

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The government has published its first Rural Productivity Plan to grow the rural economy.

Villages and towns in England’s rural communities will be allowed to build starter homes for local residents as part of plans set out by the Chancellor of the Exchequer, George Osborne, and Environment Secretary, Elizabeth Truss in the Government’s first ever Rural Productivity Plan.

The plan, announced as latest figures show thousands of people are moving to rural areas, will set out measures to boost the rural economy by investing in education and skills, increasing wages, improving infrastructure and connectivity, and simplifying planning laws for rural businesses and communities.

Measures covered by the plan include: • Amending planning rules to allow Starter Homes to be built on Rural Exception Sites for the first time. This will allow local areas to allocate more sites for Starter Homes specifically for people who already live in the area, or have an existing family or employment connection to the area.

• Working with private sector providers to assess alternative solutions to deliver broadband further into rural areas.

• Improving rural transport connections by feeding the views of rural stakeholders into the second Road Investment Strategy for 2020 to 2025 • Ensuring fairer funding for rural schools and work with schools and colleges that are currently underperforming or ‘coasting’ to ensure that, where appropriate, they are entering into collaborative arrangements and formal partnerships to raise standards.

• Encouraging rural Local Authorities and providers to make innovative early expressions of interest to deliver 30 hours of free childcare to working parents • Setting a new ambition to provide high speed broadband to businesses in all Enterprise Zones in rural areas.

• Considering proposals for increased devolution of powers and greater freedoms to maximise economic growth in areas across the country that put in place strong and accountable local governance.

• Improving connectivity by providing improved transport connections for businesses and passengers in local areas with fifteen brand new routes on the Regional Air Connectivity funding shortlist.

British economy has been reliant on businesses based in our cities and towns. We want to create a One Nation economy that taps into the potential of all parts of our country.

“That means setting the right conditions for rural communities and businesses to thrive, investing in education and skills, improving rural infrastructure, and allowing rural villages to thrive and grow.”

Environment Secretary Elizabeth Truss added: “Our rural areas could be generating billions more for the UK and providing many thousands of new jobs – this plan will make that a reality, unleashing the full potential of our countryside to create a true One Nation economy.

“We’re connecting the countryside to make it just as simple to run a business from Cornwall as it is in Camden. But it’s not just about transport and technology. Our plan will help us create thriving towns and villages where generations of families can open and expand their businesses, buy a home and educate their children at first class schools.”

Communities Secretary Greg Clark said: “We’re determined to ensure anyone who works hard and aspires to own their own home has the opportunity to do so – whether they live in cities, towns or rural communities.

“But all too often young people find themselves exiled from the place they grew up as they are forced to move away to find a home of their own.

“That’s why we’re putting power directly in the hands of rural councils to give the go-ahead for new Starter Homes in their area so local young first-time buyers can continue to be a vital part of their communities.”

To unleash the full potential of rural areas and im-

prove the quality of life for people living in some of the most beautiful parts of the country, the government will deliver: • Strong conditions for rural business growth – cutting red tape, including 20,000 farm inspections to be cut this Parliament, and cuts to corporation tax.

• Better mobile coverage – ensuring 98% indoor coverage for 4G by 2017 • Modern transport connections – improving connectivity of rural areas including through the £15 billion Road Investment Strategy and the £38 billion rail investment programme.

• Access to Enterprise Zones in rural areas – giving 100% business rate discounts on businesses located within them, saving each company up to £275,000 over five years.

• High-quality education – raising standards through fairer funding and working with underperforming schools.

• Expanded apprenticeships in rural areas – tripling the number of food and farming apprenticeships from 6,000 to 18,000.

• Extensive, fast and reliable broadband – making superfast broadband available for 95% of UK premises by 2017 and working with providers to address challenges reaching the final 5%.

• Improved planning and better regulation for businesses – supporting delivery of Starter Homes on rural exception sites and reviewing the planning constraints affecting rural areas.

• More devolution of powers – calling on local areas to propose what further powers they would like to see handed to them.

• Housing for future generations – increasing the availability of housing in rural areas to ensure our villages thrive.

Reproduced by kind permission of Crown Copyright.

Together these steps will boost productivity and ensure the countryside becomes an even more attractive place for people to live, work, start a business and bring up a family.

Commenting on the launch, Chancellor of the Exchequer George Osborne said: “For too long the One Big Society Magazine 65

September 2015

Built Environment

Housing Shortage: Demand Outstripping Supply Despite the Homes and Communities Agency announcing earlier this year that they had exceeded housing delivery targets by over 11,000 homes figures from the Royal Institution of Chartered Surveyors show housing prices are rising as demand rises and supply drops.

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The announcement by the Homes and Communities Agency was made in June of this year, when they stated that the agency had overreached Government targets with regards to affordable housing.

The Government’s aspiration for affordable housing was to deliver up to 170,000 new affordable homes, from programmes set out in 2011, over the spending period to March 2015. The HCA’s anticipated contribution to that total was 123,000.

Collectively, these programmes delivered 134,526 homes, exceeding the target by over 11,000. In addition, completions from new programmes introduced during the spending period take the overall number of affordable homes delivered by March 2015 to 149,291.

According to the HCA’s set of six-monthly housing statistics for June of this year, of the 51,187 homes completed in 2014 to 2015, 41,312 or 81% were affordable, an increase of 50% on the previous year. The remainder, 9,875, were for sale on the open market, an increase of 45% on the year before.

During the year, there were a further 27,414 homes completed with the assistance of the Help to Buy equity loan programme, designed to help people, particularly first time buyers, into home ownership.

The agency added that a further 35,503 new homes were also started on site during 2014 to 2015, of which 26,498 or 75% of the total were affordable. As this was the final year of delivery of the spending period, this was in line with expectations, given the focus for delivery on completions.

5,764 of these starts were accelerated from new allocations under the 2015 to 2018 Affordable Homes Programme, and support delivery of a pipeline of completions over the coming spending period.

The HCA’s Chief Executive, Andy Rose, commented on the triumph at the time.

“2014 to 2015 was a strong year of delivery for the agency. It was the final year of the 2011 to 2015 spending period, and I am pleased that we exceeded our completion forecasts across the range of our programmes which all help to support the housing ambitions of local places and communities. In doing so, we have exceeded our anticipated contribution to government’s aspiration of up to 170,000 new affordable homes.

“In addition, the number of open market homes built with the assistance of our land and recoverable investment programmes, along with Help to Buy delivery, have continued to gather pace, further contributing to overall housing supply.

“We look forward to working with the new government to help maintain the momentum in delivering new homes across all tenures, and ultimately, create successful places with homes and jobs.”

However, recent figures from the RICS UK Residential Market Survey show the other side to the story.

The report shows that while 44% more chartered surveyors saw prices rise in July, supply to the market continued the decline with 22% more surveyors reporting a drop in new instructions.

Additionally, the shortage of housing inventory worsened further during July, with the average number of properties for sale per surveyor slipping to a record low. Consequently, all areas of the UK are projected to see sizeable house price gains over the next twelve months, with confidence most elevated in East Anglia and Northern Ireland.

The report did show some evidence of potential improvement, however, as there is a little more optimism looking ahead regarding the prospects for activity with 37% more respondents to the survey expecting sales to gain momentum over the next three months and 40% more taking the same view on a one year perspective.

Jeremy Blackburn, RICS Head of Policy, highlighted that although the Government initiatives were working they did not address the real issue.

“This government has put home ownership at the very heart of its agenda, with Starter Homes and extending Right to Buy the strongest evidence of that ambition. However, this continues to be demand driven and fails to address the real issue of supply.

“A coherent and coordinated house building strategy is required across all tenures. This should include measures that will kick-start the supply-side, such as mapping brownfield, addressing planning restrictions and creating a housing observatory to assess the underlying economic and social drivers of housing and provide the impetus for solutions.

“The changes brought in through Fixing the Foundations, the Chancellor’s productivity plan, were welcome and refreshingly on the supply side – such as zonal planning, dispute resolution for S106 and local plan enforcement. But these alone are not a strategy for increasing housing supply across all tenures.

“In the lettings market, tenant demand continued to rise while landlord instructions, despite increasing slightly, failed to keep pace once more. Consequently, 34 % of respondents expect rents to increase right across the UK with members in the West Midlands (4%) and the South East (3.3%), projecting the sharpest growth over the next twelve months.”

Therefore, the Government has a difficult task ahead of it to ensure supply can keep up with demand which shows no signs of slowing down.

Current initiatives may not be enough to secure the future of Britain’s housing market and therefore tough new measures may need to be implemented, for example freeing up previously protected land for house building and the assessment strategies outlined by Blackburn, which will give a greater insight into how to deal with this vital issue.

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September 2015

Built Environment

How the Skills Shortage is Affecting Construction The number of skilled workers in the construction industry is dropping, threatening Government housebuilding pledge as well as private projects.

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The UK wide construction industry skills shortage is affecting all sections of the industry, with projects often coming in over budget or being delayed thanks to the year-by-year reduction of skilled workers entering the industry and an aging population leading to many skilled workers retiring as the demand for houses increases.

and fewer are entering into the industry from the bottom.

Housing is the sector seeing the most urgent demand, and local councils have recently warned that the shortage could derail the Government’s plans to build 275,000 new affordable homes by 2020.

Additionally, diversity is also a key problem. Although Integral Build has a team of which 25% are female and partners with the Women in Property organisation, which aims to raise the profile of women in construction, there are still not enough women in the industry as a whole. Again, Stringer believes that a change in image is crucial, with the perception of a dirty all boys club needing a drastic overhaul in order to encourage more women to study construction skills whilst in education.

New analysis by the Local Government Association (LGA), which represents more than 370 councils in England and Wales, reveals a growing mismatch between the construction industry’s increasing demand for skills and a falling number of people gaining construction qualifications.

While the construction industry’s forecasted annual recruitment need is up 54% from 2013, there are 10,000 fewer construction qualifications being awarded by colleges, apprenticeships and universities.

The number of people gaining construction skills has been falling for some time. There were 58% fewer completed construction apprenticeships last year than in 2009. Meanwhile, industry has increasingly struggled to fill vacancies. A worrying 56% of skilled trade construction vacancies are hard to fill, up from 46% in 2011 and almost triple the proportion of skilled hard to fill vacancies across the economy as a whole.

As the economy continues to improve, demand continues to rise, with private contractors often seeing profit margins reducing or passing on the cost directly to the consumer, which could impact on inflation over the coming years if the skills shortage is not addressed.

Recent figures released by Ionic Recruitment, a specialist recruitment consultancy within construction, show that skilled operative have seen their salaries sore over the past year. Quantity Surveyors had a 45% increase in salary since 2014.

Temporary workers have also had pay hikes, with painters and decorators seeing a 46% rise, ground workers 23% and joiners 15%.

Martyn Makinson, Managing Director of Ionic Recruitment, commented on this surprising development: “Some may predict that permanent workers see bigger increases in wages as temporary workers tend to barter more to secure contracts. Our figures show that, actually, the wage increases are pretty similar across both, which is good news in general for the construction sector as a whole.”

Tim Stringer, Director of Integral Build, believes that the key reason for the shortage is that the industry is not appealing enough to young people.

The recession led to staff leaving the industry to retrain and other staff have retired or moved into management roles within the industry, whilst fewer

Stringer describes the industry as “old fashioned”, and feels that this is a key problem which needs to be resolved in order for UK construction to move forward and overcome the skills shortage.

In terms of moving forward, the Director of Integral Build, a specialist fit out and refurbishment contractor, believes that automation is not a route which will be successful, but that rather efficiency needs to become a top priority.

“There are lot of things that can be done to make us more efficient as an industry. I know that some of the very large construction companies have started to suggest that there are some automated processes that could take place on site but I think we are a long way away from seeing those being an everyday reality across the UK. “I think, in general, we are quite a wasteful industry in terms of how we procure projects, how we build things on site, we need to be looking at more efficient ways of procuring projects and the tendering process that a lot of clients go through and we’ve got to look into how we can be more efficient onsite, using better materials, more efficient methods, looking at ‘lean techniques’.

“These are all things we need to be doing, as traditionally the construction industry has been very old fashioned and that’s something we need to change to ensure we are offering the very best value to our clients and the best environment for new staff to enter.”

Overall, a complete image overhaul for the industry can do no harm, and with the skills shortage showing no signs of abating, action is required sooner rather than later to stop the industry from running out of skilled workers.

One Big Society Magazine 69

September 2015

Information Technology

Digitalisation How to Get More for Less and Make the Future Brighter for All Debra Charles is Founder & CEO at smartcard technology company Novacroft.

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Not a day seems to go by without another charity bowing to financial pressures, downsizing their operations or, in some cases, shutting their doors altogether. Sadly, this is not surprising. For the reality is that charities are battling on many fronts.

They are not just fighting, as ever, to reduce the pence in the pound spent on administration.

They’re also facing what might be described as a perfect storm of challenges, among them an increasingly competitive market, losing government funding, motivating the next generation of volunteers and, perhaps most distressing of all, coping with the fallout from recent reputational issues.

There is a way, though, that charities can get technology to do battle on their behalf - by embracing digitalisation and being smart about it.

Making existing funds stretch further by cutting the cost of administration is the cornerstone of sustainability. Take out the waste involved with manual processes and more money is released for the cause. Reducing the paper drain of postal applications, cheques and cash donations by replacing time-consuming, resource-intensive hand sorting with digital processes has the potential to deliver significant cost-efficiencies. Raise awareness of your cost-effectiveness and more money could be forthcoming from supporters and government too.

This is just the start of what smart digitalisation can do. The second step, using online systems to simplify the complexity of all manner of processes, can help charities make life easier for themselves and their supporters. Online processes enabling supporters to upload their own details directly to a database not only save organisations time and money. They also boost accuracy and the morale of employees freed up to do less mundane tasks.

Communication becomes easier, cheaper and greener online too, opening up opportunities to take messages directly to supporters’ devices and into their lives.

This is where digitalisation gets really exciting and potentially game-changing. If charities make it easier and quicker for people to pledge their support, donate, sign up to volunteer and get involved in discussions and activities, they can - like never before - put their supporters at the heart of everything they do. In a split second, they can keep them updated with news, send tailored messages to target groups or say thank you to individual donors - all while keeping costs down.

That is not to say it was the most effective collection method in every case, particularly given how recent a development contactless payment is.

What is important is that in responding to current payment trends and making it easier for people to donate on the go, Save the Children will have been able to simplify its collection processes and dramatically reduce time spent counting cash donations.

The power of digital does not have to stop there.

There is a third step charities can take: harnessing technology to find out more about their donors and volunteers and what motivates them. Charities that use data to understand what influences and activates their supporters can communicate and interact with them in ways that are more meaningful for both. They can suggest fundraising activities that match their interests. They can even reward them for their support in ways that are relevant to their passions, making it possible to tap into the rise of the ‘selfish volunteer’ - those as interested in what they get out of volunteering as what they put in.

Reaching this group could be as simple as charities adopting loyalty schemes similar to retailers and supermarkets to encourage repeat custom at their stores, like the British Red Cross, or increased donations of items to sell, like Oxfam.

If you take this idea further, though, and look at who your supporters are outside their charitable activities, you can do even more to strengthen your bond with them. You might find for example that your volunteer is a keen traveller or likes shopping with certain brands. From there, you could offer tailored rewards of real value based on what inspires your volunteers to get active. Not only does this enable you to appeal to fundraisers, it could also open the door for potential corporate sponsors looking to reach the market.

Already, younger, more agile and tech-savvy charities are managing to enter the market and thrive despite its challenging backdrop. There is no reason why others who choose to embrace the digital revolution cannot do the same. And if more charities can become more efficient, operate more effectively, give their supporters a fantastic experience and generate more income, the sector will have the best possible chance of facing down today’s challenges - and being there for everyone it supports tomorrow.

A great example of digital putting the supporter first is a project Visa Europe ran earlier this year in partnership Charities Aid Foundation (CAF) and Save the Children to test contactless collection tins – both in the street and in Costa Coffee cafés around London. It revealed that as many as 30% of people were likely to donate this way if given the option - perhaps not surprising given the phenomenal rise in contactless card payments over the past year or so.

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September 2015

Information Technology

National Digital Conference 2015: Keynote Speech Matthew Hancock spoke about simplicity, iteration and transformation in government services at the National Digital Conference 2015.

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“Almost everyone, almost everywhere, carries with them one of the most profound symbols of digital transformation the world has ever seen.

I’d bet a large sum you’ve got one on you. That everyone reading this has one on them. And that if you’re reading it online, you’re probably using it right now.

The smartphone.

In my lifetime this didn’t exist. Ten years ago it was a communications device.

Today it’s an office in miniature, a London A to Z, an entertainment centre, a digital camera, a fitness monitor – for some of my younger officials it’s a dating agency – and hundreds of other things besides.

You couldn’t even use one in 1990. If you tried, the equivalent memory and components alone would cost around $3.6 million.

Today over a quarter of the world’s population own one. It’s both a symbol and a cause of the change we’re living through.

And one of the biggest questions for government today is how do we use that technology to govern better? How do we drive digital in government to improve the lives and the finances of millions?

The fastest growing economies of the East have made rapid progress by tailoring Western market institutions to their own local circumstances.

Yet in a digital world we’re much better placed to understand and detect those risks. For example, if a welfare claim is being made from a non-UK IP address, that sets alarm bells ringing and we can ask the claimant more questions.

The flipside is we can then design the system to make life easier for everyone else, with fewer hoops to jump through. And because digital forms talk back, we can also tackle costly error, prompting users: ‘did you really mean that’ if the answer doesn’t look right.

In the last Parliament we focused on making some of the most important transactions between government and the citizen digital by default.

Everything from viewing your driving licence to booking a prison visit. Twenty of them are now live and more are on the way.

We always start with the question ‘what does the user need’ and work from there. And the standard we must set is that government digital needs to be as good as anything in the private sector. In step with, or in front, not lagging behind.

We believe all our citizens should have the chance to benefit from these services, which is why we’re committed to making sure as many people as possible have the skills they need to get online.

But simplicity doesn’t end with the citizen. It’s not just that services need to be user-friendly, they also need to be Whitehall-friendly.

We can’t copy and paste. On digital government we, and a handful of other countries, are the source code. There isn’t a playbook for this, so over the last 5 years we’ve had to innovate and experiment, seeing what works and what doesn’t.

There are around 700 interactions between government and citizen, many of which could be digitised. Yet one of the biggest barriers to widespread adoption of digital services is that it’s time-consuming and expensive for departments to build the underlying infrastructure.

Today I want to set out some guiding principles based on the lessons that have been learnt.

That’s what ‘Government as a platform’ is designed to tackle.

Simplicity The first principle is simplicity. I can’t stress this enough: simplicity is the end. Digital is just the means.

Many of the most successful companies in the world take a platform-based approach, companies like Google, Apple and Paypal. We too are building a common set of platforms, core digital plumbing which can be used by services across government.

The point of using complex technology is not to make things more complex, but to make them easier: for the public, for frontline staff and for government itself.

For the public, when government services are on paper they’re almost inevitably designed for the demands of the machine, rather than the needs of individual users.

If you want to access a service you have to fill out a form. Many of the questions aren’t aimed at you, but at the small minority who want to exploit the system. Yet everyone has to plough through them.

It’s a dragnet approach and it’s why paper government means a one-size-fits-all service.

For example, almost every part of government maintains a separate system for making and taking payments, often from the same people. A common payments platform can help integrate services while saving money.

And we know citizens care about the status of their transactions. They’ve been able to track their parcels online for years. We should be aiming for the same level of service in the public sector, at the bare minimum.

Around a quarter of phone-calls to the DVLA are drivers checking up on the status of their applications.

That’s why we’re prototyping a status tracking platform that could be used by any service, allowing citizens to track and trace an application, a request, a purchase or a repayment in a few simple clicks. We’re thinking of calling it ‘where‘s my stuff.GOV’.

So whether you’re tracking a passport, or a driving licence application, a common platform has the potential to give better service at a lower cost.

It makes life simpler for public servants too, freeing them to focus on what really matters: delivering their core service.

And with common platforms it’s not just that we bring new services online quicker, we can also rebuild them quicker if they’re not working out as planned.

Which brings me onto my second principle: iteration.

Iteration Iteration is the opposite of the big bang model of policymaking.

We’ve all seen it. The big announcement, the big contract for ‘big IT’, the endless delays, the grand launch… the thing falling over when you press the ‘on’ button.

Iteration is all about small: small teams of developers taking small steps: getting a small prototype out quickly and cheaply, watching to see how people actually use it, then incrementally improving the design. Rinse and repeat. Rinse and repeat.

Take the Office for National Statistics’ (ONS) website, once described in the FT as a ‘national embarrassment’.

A small, highly skilled team built a new alpha version in 3 months and it went live just before Christmas. The feedback has been fantastic, and the ONS team are about to finish their beta version, catering to the needs of everyone from A-level students to academic economists, at a fraction of the cost of the original.

Iteration means basing decisions as much as possible on observation not prediction.

Come with me to Helsinki for a moment. In Finland, town planners will visit a local park immediately after a snowfall, because the footprints reveal the paths that people naturally choose to take. These ‘desire paths’ are then paved over the following summer.

We too must pave the paths people travel. How? Let’s take a small example.

Registry offices are officially known as register offices. That’s what it says on the forms. But everyone knows in real life they’re called registry offices, so no-one ever really searches for register offices One Big Society Magazine 73

September 2015

Information Technology

Matthew Hancock

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online. We’ve paved the path that people travel, so the GOV.UK page comes top of the search results, even if you search ‘registry’ office.

GOV.UK is the total of thousands of little observations.

Let’s take another. People search for ‘pay council tax’, but they don’t usually say where they live.

We’ve paved the path so you’re taken from GOV. UK to the relevant page of your local council website in just one click.

And it’s not just about making websites more user-friendly. As we adopt this approach more widely we will transition from a target culture, where ministers try and manage services from on high, to a data culture, where services adjust in response to user-feedback.

Iteration also has profound implications for policy design.

Traditionally, policymakers relied on a model of human behaviour borrowed from neoclassical economics: one in which rational well-informed individuals, responding to incentives, always made rational well-informed choices. This allowed for confident predictions about the take-up of a new scheme, or the impact of a new regulation. Confident, but wrong. In fact the only thing you can be confident about is the predictions will be wrong.

Because real-life isn’t like that. People aren’t rational. Some schemes sink without a trace. Most regulations have unintended consequences.

In a digital world we can test our core policy assumptions easily and cheaply, building a representative sample of users, presenting them with a working model of the new service, then using data and feedback loops to iron out the problems we can’t foresee. We pave the path people travel.

This lesson is broader than just digital. When I was a minister at the Department for Business, Innovation and Skills we encountered a policy problem: a gap in support for people not yet ready for an apprenticeship. Our answer was traineeships, which combine mentoring, work experience and extra help on English and maths. We designed it openly, iteratively and starting small. Now we’re scaling up.

Now paving the path like this might sound like we’re resigned to marginal improvement. No. Our ultimate goal is not just to improve, but to transform. To get how people actually behave in real life: and not just change the technology but transform the whole business model. Tight budgets and rising demand mean we have to reimagine the way government is done.

And Moore’s Law means you really can do more for less, if you use technology.

So my final principle is transformation.

Transformation It’s been a long time coming. We’ve had a paper-based government since around the 12th century. The centralised Westminster bureaucracy developed around the Court of Chancery, which responded to royal petitions, and the Exchequer, which dealt with tax.

And to this day we continue to operate on paper foundations. The 19th century structures we’ve inherited, of government departments running services from Whitehall, reflect the fact that decision-makers and information needed to be in the same place. Paper files, which could only be moved around on trolleys, had to be within easy reach.

This has led to silos, to information hoarding, and to people with complex needs getting lost between the cracks. I suppose it was better than the vellum that came before.

But now, for the first time, we are in a position to build digital foundations: made of data not paper, holding up platforms not silos. Common registers, common payments platforms, and common licence systems, all based on common data standards.

This digital infrastructure is the modern equivalent of the canals and railways that made industrialisation possible. And once it’s established we can build platforms on top: integrated public services with the citizen at their heart.

So we can deliver on simple company registration for new business. This could see your bankruptcy status verified, HM Revenue and Customs notified, your company name confirmed as unique, and an application for a trading licence filed with your local authority – all in one go, simply by tapping into the data.

Quick and painless: think what an economic boost this would be.

This is our chance to build a new state, crafted around the needs of the user. Using the best and most innovative technology to cut costs and improve services.

Not the all-encompassing state of the 20th century, but a state you can hold in the palm of your hand.

And as if to show that the onward march never ceases, the symbol of transformation is no longer the iPhone in your hand, but here, miniaturised in the iWatch on your wrist.

These are exciting times. Technology marches on.

And we who see the transformative power of technology, we who would pave the path people travel: we have work to do.”

Reproduced by Kind Permission of Crown Copyright.

One Big Society Magazine 75

September 2015

Procurement

Government Set Ambitious Procurement Target to Help Small Businesses The government have announced that they are setting themselves the ambitious target that ÂŁ1 in every ÂŁ3 government spends will be with small businesses by 2020, offering opportunities for small businesses in the future.

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The target, designed to get more small businesses working on central government contracts, was recently announced by Matt Hancock, the Minister for the Cabinet Office.

John Manzoni, Chief Executive of the Civil Service commented on how the new target would complement the Government’s existing measures to help small and medium sized businesses.

The Government is already an advocator of using small and medium sized businesses. In 2013 to 2014, central government spent an unprecedented £11.4bn with small and medium-sized businesses, which are defined as those employing 250 employees or less. This figure is equivalent to 26% of central government spend.

“Further opening up our marketplace to small businesses is good economic sense all round – making it easier for them to access and win government business opportunities, whilst encouraging increased competition and market innovation to deliver best value for the taxpayer.”

By 2020, the government is looking to increase this to a third, which will mean spending an extra £3bn per year (in 2013 to 2014 terms) with small and medium-sized firms directly or through the supply chain.

Matt Hancock commented on what this announcement could do for the small business environment.

“This is such an amazing opportunity for the country’s diverse and innovative small businesses, and today I urge them to get stuck in. From computers to uniforms – there are so many opportunities for small businesses to work with us, and I want to see more of them providing value for money for the taxpayer and benefiting from our spending.”

John Allan, National Chairman for the Federation of Small Businesses (FSB), added his comment.

“The government has much to gain from opening up public procurement to smaller businesses and we welcome the government’s commitment to achieve this ambitious target. To meet it, the government will need to focus on robust monitoring and challenge of poor practices wherever they are found. The FSB will play its part, and will work with ministers on this important goal.

“Tier 1 contractors should already be passing good payment terms throughout their supplier chain, but we think more can be done. The Government is now in a unique position to set an example to the rest of the economy by being an exemplary customer. Departments should therefore actively create and promote more opportunities for small firms, package larger contracts into smaller ones, and reward suppliers who promise to work with the UK’s small business community.”

The Government has already introduced measures to help enable small business to bid for Government contracts more easily by ensuring that the entire public sector supply chain to be paid within 30 days and abolishing pre-qualification questionnaires for low value public sector contracts, making it simpler and quicker to buy.

Additionally, the creation of the Contracts Finder, an online database where all public sector contracts have to be advertised ensures that companies of any size have access to information about public sector buying.

Each government department and the Crown Commercial Service will make sure that the Government target is met by setting out individual plans and targets for spending with small and medium-sized businesses over the next five years.

Sarah McMonagle, Head of External Affairs at the Federation of Master Builders, praised the target but also argued that the scheme needed to be extended to include all public centre contracts, not just central government ones.

“The Government’s announcement that every £1 in £3 is spent with small businesses is welcome but only applies to central government contracts.

We want to see an increase in spend with small and micro firms across the board and by every public sector body. In many parts of the country, it is still the case that small firms are all too often squeezed out by larger competitors when bidding for public sector work.”

McMonagle continued: “There are lots of good reasons why the wider public sector to spend as much as possible with small firms. In particular, using construction SMEs has been proven to provide real local economic and environmental benefits. SMEs employ local people, meaning that the money spent is likely to go to local suppliers and remain within the local economy. Furthermore, in the construction sector, two thirds of apprentices are trained by micro firms, meaning that spending more with these businesses could help towards the Government’s target of creating three million new apprenticeships by 2020. An even more ambitious target could go further towards the governments stated aim of 3 million apprenticeships by 2020.”

“Some local authorities and housing association are better at engaging with SMEs that others but we’re urging all public sector clients to set a target for increasing the proportion they spend with SMEs. Some may already be spending £1 in every £3 but then they should be working towards spending £2 in every £3. One way the wider public sector can boost engagement in public procurement by small firms is to ensure they are implementing the EU Public Procurement Directive which was brought in earlier this year. The Directive states that public sector clients must break down their contracts into small lots and this makes public contracts much more appealing to small businesses – especially in construction where forming part of the supply chain can be particularly problematic due to late payment.”

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September 2015

Procurement

New Rules Shake-up NHS Agency Staff Procurement The NHS Trust Development Authority and Monitor have published new rules designed to support NHS providers to get the best quality agency staff whilst reducing their overall costs.

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Increases in agency staff allocations within the NHS to around £3.3bn per year has led to new rules being put in place to ensure trusts get the best value and highest standard of agency workers.

The new rules involve setting an annual ceiling for total agency spend for each trust between 2015/16 and 2018/19, which has already been sent out to trusts, which will have the opportunity to apply for exceptions if there are specific local needs.

There will also be a mandatory use of frameworks for procuring agency staff and limits due to be put in place on the amount of money individual agency staff can be paid per shift.

Peter Blythin, Director of Nursing at the NHS Trust Development Authority commented on the new rules.

“Whilst a number of existing local frameworks work well to support local nurse directors to find high quality agency staff, there is a recognition that more can be done to give trusts greater powers to have more control over their use of agency staff in the future.

“The creation of an assurance process to make sure local frameworks are providing high quality staff at the right price, the introduction of ceilings to ensure boards can have a focused programme on reducing over-reliance on agency staff where it exists and future measures to limit the inflated costs associated with some agency arrangements, will all help to ensure that local providers can, in future, be better equipped to focus on the important issues of high quality staff and patient safety whilst becoming more efficient.”

Ruth May, Nursing Director of Monitor, added her comment.

“Trusts are working hard to reduce the amount of agency staff they use, and this is something we’re actively supporting through initiatives like our agency support team.

“We’ve worked hard with the NHS to develop this set of rules which will support boards and in particular chief nurses to reinvest the money currently spent on agency staff into providing the best care for patients. Today’s guidance is another step in delivering a safe and secure NHS that will meet the needs of patients long into the future.”

“It’s encouraging to see that the Government is taking steps to crack down on unscrupulous staffing agencies which operate outside of NHS approved staffing frameworks. Largely unregulated ‘off-framework’ agencies have been free to set their own rates and are not subject to the stringent compliance audits that ‘on-framework’ suppliers must undergo to maintain their approved supplier status. These new rules will set a transparent and level playing field which will benefit all parties.”

However, not everyone was as accepting of the new rules, with specialist healthcare recruitment agency, MSI Group, warning that trusts must take a strategic approach to workforce planning if they are to maintain patient safety levels amid rising cost pressures with Nick Simpson, CEO of MSI Group, commented that the reports did not take into account the chronic lack of staff in NHS trusts.

“It’s worrying, although not altogether unsurprising, that 84% of acute trusts failed to meet their nurse staffing targets for both day and night in at least one hospital in April this year.

“As an agency working on the front line of NHS recruitment, we hear time and time again from clients that last year’s introduction of staffing guidance for acute wards by the National Institute for Health and Care Excellence has meant that finding the adequate number of suitably qualified staff – at the right price – is increasingly difficult.

“There are simply not enough trained nurses working on a full-time basis to fill shifts in accordance with the new safe staffing guidelines. This, coupled with historic cuts in training places, a nurs-

ing retirement cliff, and new immigration rules, mean that there is simply not the supply to fulfil demand.

“Against this backdrop, Monitor’s advice to only fill ‘essential’ vacancies seems absurd, and is likely to anger trusts which are already failing to meet safe staffing guidelines.

“NHS leaders must apply some joined-up thinking if they are to pipeline talent to solve the staffing crisis long term. However, in the meantime, the strategic use of contract professionals to cover absence and times of increased demand is an efficient way of maintaining front-line services without the cost of increasing permanent headcount.

“With this in mind, it’s encouraging to see that the Government is taking steps to crack down on unscrupulous staffing agencies - operating outside of NHS approved staffing frameworks – which take advantage of hospitals’ desperation to maintain patient safety levels.”

This clearly shows a discrepancy between the number of staff needed and the number available, which may be helped by recent announcements of a health package for NHS staff designed to make their working lives more enjoyable. However, more needs to be done to ensure the disconnection between senior level management and ground floor staff.

Despite the criticism there is potential for the new rules could to be rolled out in other areas of the NHS, as cost efficiency is a key aspect of the Five Year Forward View, the plan designed to ensure the future of the NHS in an ever changing modern environment.

Nick Simpson, Chief Executive of healthcare recruiter MSI Group, believes that the new rules are a positive step for the NHS. “Data we obtained under the Freedom of Information Act revealed that a total of 248 agencies supply the sector – 60% of which do not work within any of the three NHS approved staffing frameworks. This clearly highlights the scale to which individual NHS Trusts have been forced to work with off framework suppliers which take advantage of hospitals’ desperation to maintain patient safety levels amid chronic staff shortages.

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September 2015

HR and Training

Devolution: An Evolution in Government?

The Cities and Local Government Devolution Bill, which is currently due to be read for the second time by the House of Commons, seeks to provide local councils with additional power.

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The bill would allow the Government to devolve far reaching powers over economic development, transport and social care to large cities which choose to have elected mayors, allowing for further legislation to provide for an elected mayor for the combined authority’s area who would exercise specified functions individually and chair the authority.

The elected mayor would also have the power to act in place of the Police and Crime Commissioner for their area of governance. By decentralising certain Government powers the bill has the potential to streamline local governance as agreed by councils.

The Government has made it clear that it is committed to devolution. There has already been devolution in the form of City Deals, Growth Deals and the more recent devolution agreements between the Government and Greater Manchester, Leeds City Region and Sheffield City Region as part of the Government’s “Northern Powerhouse” initiative.

The Government’s first devolution agreement with Greater Manchester, made on 3rd November 2014, provided for an offer of powers and budgets from Government on the basis that Greater Manchester would deliver certain reforms and measures. Central to this agreement is a reformed governance system for the Greater Manchester Combined Authority which will involve adopting a model of a directly elected mayor covering the whole of the Greater Manchester area, and the Combined Authority receiving a number of new powers from local authorities, other local public services and devolved powers from Government Departments and agencies.

By handing over powers for a variety of sectors, such as transport, housing, skills and healthcare to an elected mayor the Government aims to ensure that the people of the area have a single point of direct accountability.

The bill will only extend to Wales and England, limiting the reach of the proposed bill to certain areas of the UK. Crucially, the explanatory notes for the bill make it clear that the Secretary of State will provide the elected mayor with their power only if a variety of criteria are fulfilled and the governing bodies of the area involved consent: “the Secretary of State can make an order for there to be an elected mayor of the area of a combined authority following a proposal being made by each county and district council within the area of a proposed, or existing, combined authority, or by an existing combined authority (the appropriate authorities) or with their consent.”

Therefore, if the bill is passed it does not necessarily follow that every city and county will immediately elect a mayor and have devolved powers.

Manchester, UK Tupungato / Shutterstock.com

The elected mayor will not have sole responsibility for the devolved area, with the explanatory notes for the bill stating that the mayor is required to nominate a deputy mayor from the members of the combined authority.

This deputy mayor would take over the functions of the mayor in the event that the mayor is unable to act (e.g. due to illness) or the office of mayor is vacant (e.g. the mayor resigns). Overview and scrutiny committees would also be in place to oversee the elected mayor’s governance.

The voting system for an elected mayor will be by simple majority unless there are three or more candidates, in which case it will be by supplementary vote. In the supplementary vote system, electors give a first and second preference so that if no candidate has a majority of first preference votes, the second preference votes will be taken into account.

The Government is keen to outline that this bill will increase democracy and allow local people more influence over the way their local area is governed.

“In the Government’s view city-wide, elected mayors for combined authority areas will achieve this and ensure the continuation of strong democracy.”

The explanatory notes also make it clear that whilst the Government expects there to be some expenditure, ultimately it believes that the plan will not cost the Government any money.

“The powers within the Bill enable the Secretary of State, with consent from appropriate authorities, to establish the position of an elected mayor for the area of a combined authority and broaden the functions that combined authorities are able to undertake. This can lead to activity which can incur expenditure, such as needing to hold elections to the position of the elected mayor for the areas of a combined authority. However, where combined authorities are established the Bill requires the Secretary of State to consider that doing so would improve the exercise of the statutory functions ‐ which includes improving their value for money. Exercising any of the powers conferred by the Bill is within the discretion of the Secretary of State, and it is open to the Secretary of State to refrain from exercising them if he were to consider this would lead to greater costs in the delivery of local services. Furthermore, where the mayor is also to take on the functions of the Police and Crime Commissioner, there will be no separate election for the Police and Crime Commissioner. Therefore it is expected that the establishment of a combined authority and / or the position of mayor would lead to greater efficiencies and greater local transparency and decision making, and therefore not increase public expenditure. The context in which the powers are to be exercised is expected to be where Government has agreed devolutionary deals with particular areas. For example, in November 2014 such a deal was agreed with Greater Manchester, the implementation of which is being enabled through the provisions in this Bill; the Greater Manchester deal will be cost neutral to the Exchequer.”

These plans could potentially see a new era for the Government, but as the bill is still being viewed and approved there is still potential for change.

The full explanatory notes can be viewed here.

One Big Society Magazine 81

September 2015

HR and Training

Plugging the Engineering Brain Drain

By Eddie Coxon, Vice President of Buildings, Schneider Electric UK & Ireland

82 One Big Society Magazine

HR and Training

Much has been made of the IT skills gap that has emerged in the UK over the past number of years.

It is a gap caused by a phenomenal growth in the technology sector, and the single greatest period of wealth creation in the history of the world.

Giants like Google, Apple and Facebook battle it out for the best software engineers and developers, offering lifestyle and office perks as well as strong financial incentives. Meanwhile, smaller players often struggle to match the rewards of these giants, and we are constantly reminded that there are simply not enough graduates with the requisite skills to quench the demand.

There is, however, another skills gap that exists. It does not receive the same level of media and government attention as that of the technology sector, but it is undoubtedly more pronounced, and arguably more dangerous to the wider economy and society. That gap is in engineering.

Engineers, both in Britain and around the world, are becoming an endangered species. And, unlike the skills gap in technology, it has not been caused by an exponential growth in available jobs. By and large, the amount of engineers required to keep the economy running has not changed substantially in recent years.

The skills gap has arisen because there are simply not enough qualified graduates to replace the number of engineers that are retiring, and this is a creating a huge issue in the UK. Government figures estimate that we are coming up short by about 10,000 engineering graduates each year.

This is not just a shortfall – this is a gap that is threatening full-on collapse.

Twenty years ago, the technology sector was just beginning to find its feet, and the Internet was a nascent entity whose power and reach today could scarcely be imagined. Engineering was, for all intents and purposes, still at the cutting edge of all that was new and exciting, and still attracting some of the brightest minds. Career paths and opportunities in computer engineering and software were not as clearly defined as they are today, and those with a proclivity for mathematics and problem solving more often than not found themselves studying engineering.

On top of this, there was a bigger emphasis on apprenticeships and graduation paths, developing practical skills alongside classroom teaching and theory. Engineers used to be much more customer facing, selling in solutions rather than simply placed in front of a screen all day. The step changes in technology were slower and easier to comprehend, especially compared to the extreme evolution attributed to Moore’s law, and the rapid changes that computing technology has witnessed.

tex of talent that it has created, but if history has taught us one thing, it is that technological progress cannot be halted. The luddites did not win.

The irony of the brain drain is that the wheel is beginning to turn full circle. Engineering and technology are now more closely intertwined than ever before, and the physical and digital worlds are starting to converge. Smart buildings and cities are evolving all the time, and the Internet of Things is gaining momentum.

As a result, there has never been a more exciting time to be an engineer. They are the key holders to shaping our future, providing the link between software and the elements with which we actually physically interact – cars, buildings, trains, roads and bridges. The challenge now is to attract talent and numbers back into the profession, and provide the right education and career opportunities.

There have been some encouraging initiatives introduced by the UK government to address the issue of the engineering brain drain. Analysis by the Royal Academy of Engineering suggests Britain will need more than a million new engineers and technicians by 2020. Last year, Skills and Enterprise Minister, Matthew Hancock announced a £30 million fund to increase the supply of engineers, to encourage more women into the sector and to address engineering skills shortages in smaller companies. The fund will enable engineering companies to establish training programmes to develop the engineers of the future and to boost female participation in the profession. Early in 2015, the government also announced £5.6 million of funding for 6 projects with companies like Nissan and Tiger Trailers creating new specialist skills and careers in the engineering industry.

More however remains to be done, alongside further government funding, the industry itself needs to be proactive, investing in the future. Training academies and apprenticeships must be a priority, creating the right environments and infrastructure to not only attract the talent, but also foster and develop it. For too long engineering has lacked diversity, and new initiatives also present a chance to address that historic imbalance, as well as help secure the industry’s future. That future is one that is under threat, but with a coordinated strategy, and the right level of investment, engineering can once again thrive in the UK.

Undoubtedly, many who once would have become engineers have been ‘lost’ to the technology sector. The shortfall in engineering graduates might tempt some to decry Silicon Valley, and the vorOne Big Society Magazine 83

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