Design Council – Written evidence (INQ0062)

About Design Council

Design Council’s purpose is to make life better by design. We are an independent charity and the government’s adviser on design. Our vision is a world where the role and value of design is recognised as a fundamental creator of value, enabling happier, healthier and safer lives for all. Through the power of design, we make better places, better products, better processes and better performance.

About this response

Our response focuses on the work Design Council has been involved in that focuses on some of the challenges of an ageing society. These spread across most of our programmes: our technology challenge fund Spark; our Design in the Public Sector programme which works with local authorities through a partnership with the Local Government Association; and Transform Ageing, another partnership-led project which has initially been running in the south-west of England, aimed at helping older people take control of their own ageing.

Responses to Questions

Technologies

Please note that we have answered Questions 5-8 below together.

5. What technologies will be needed to facilitate treatments for ageing and ageing-related diseases, and what is their current state of readiness? For example:

•              Drug delivery devices, for existing or future treatments

•        Technologies for monitoring conditions and providing personalised medical advice

•        Technologies for monitoring healthy living e.g. fitness, diet, etc.

6. What technologies will be needed to help people to live independently for longer, with better health and wellbeing? What is the current state of readiness of these technologies, and what should be done to help older people to engage with them? For example:

•        Digital communications for services, social interactions, etc.

•        Devices, machines, etc. for daily living in the home

•        Transport, infrastructure, services, etc. for involvement in community

•        Accessible public spaces

•        Smart homes

7. How can technology be used to improve mental health and reduce loneliness for older people?

8. What are the barriers to the development and implementation of these various technologies (considered in questions 5-7)?

a. What is needed to help overcome these barriers?

b. To what extent do socio-economic factors affect access to, and acceptance of, scientific advice and use of technology by older people and those who care for them?

Response

Design Council believes that technology can play a central role in improving the lives of older people and helping them to live independently and healthily. Our first principle is that people must be in at the start and at the heart of solutions. Design Council’s Framework for Innovation[1] is a design process that starts with defining the challenge and ensures that people who are faced with that challenge are a part of its definition. Our programmes embed this fundamental principle, and once a challenge is clearly and precisely defined, we help innovators, policymakers and people to work inclusively through potential solutions until finding those that can be most successful.

Spark 2014-19

Spark[2] is a leading UK innovation support programme and fund run by the Design Council. It helps people with ground-breaking product ideas to get their innovations from concept to market. Led by Design Council’s network of specialists, mentors and coaches, Spark involves a rigorous 16-week programme of design and business development support for finalists. This includes access to specialists working in IP, investment and marketing. Each finalist receives £15,000 each to develop their products and can pitch for a share of a further £150,000 as they progress through the programme.

Since 2014, Spark has helped more than 140 entrepreneurs across the country get their ideas off the ground, focussing on developing products which tackle societal challenges such as ageing. Some key products which address issues associated with ageing are briefly outlined here:

• Stablspoon – An affordable self-stabilising spoon for people with hand tremors.

• Raised seat bidet – A raised toilet seat which has been adapted to allow a wash wand to pass through it to facilitate the user to give themselves a warm water bidet wash whilst seated on the toilet. This product aims to give greater independence to the user and their carers.

• Helping Hand – A food preparation safety glove that will be made of smart materials so that it is cut proof and heatproof.

• TruRegard – An assistive door handle which supports the natural grip and twist motion with ease. It has been designed ergonomically to aid those with arthritis or other joint issues.

• Elba London – A stylish, well-fitting bra that is comfortable and easy to put on and take off. Specifically designed for those with dexterity or mobility problems.

• Keywing – A key turning tool that eases the grasping and turning action which is required to operate keys. Workey slides on and off keys to replicate a turn snib on the end of a key which is easier to hold and twist. It is primarily designed for people with reduced hand dexterity who may struggle with small or stiff hands.

• TickleFlex – An accessory for insulin pens. It improves the lives of insulin dependent diabetics by providing comfort, safety and convenience by having specially textured pads that pull inwards like a finger pinch as the pen is pressed against the skin. This distracts the local pain sensors making the injection more comfortable. It also creates a pucker making it more likely that the needle enters the desirable zone of subcutaneous tissue. The large pad area keeps the needle stable and prevents it going in too deep.

The success of the Spark programme in helping entrepreneurs and innovators to develop their ideas into products demonstrates the scale of the opportunity for the UK as the proportion of people living into older age increases. There is clearly a need for ongoing programmes such as Spark to help smaller, younger and less financially endowed innovators to access the support they seek. We recommend the Committee investigates how such programmes can be better supported.

Our response to question 11 below describes further products which have been developed through our Transform Ageing programme.

Healthier ageing

11. How feasible is the Government’s aim to provide five more years of health and independence in old age by 2035?

a. What strategies will be needed to achieve the Government’s aim?

b. What policies would be required, and what are their potential costs and benefits?

c. Which organisations need to be involved? d. Who should lead the work?

Response

Addressing the challenges of an ageing society requires collaboration and co-operation and, crucially, in thinking openly and differently about them. Many organisations and initiatives are or have been focused on this subject, including: the Centre for Ageing Better (CfAB)[3], the National Innovation Centre for Ageing[4], Industrial Strategy Challenge Fund[5]; the 100 year life project run by Design Council, CfAB and the Social Care Institute for Excellence[6] and many others too. With multiple agencies involved in research, setting policy and in delivery, organisations need to be ready to work together and recognise where approaches have not worked or could work better. An important and positive piece of work could be for government to bring all these organisations together to get the best use of resources and combine learning and effort.

Design Council has been working to deliver on these priorities. We have been working with the team driving the healthy ageing grand challenge to help them explore how design can support their thinking and, including a workshop on designing for low dexterity and that funds dedicated to the ISCF meet the right targets.

Below we describe two of our programmes, along with case studies which set out how they have succeeded.

Design in the Public Sector

Design Council’s Design in the Public Sector programme[7] supports public sector leaders to explore key challenges affecting their local communities and identify innovative opportunities to deliver positive and sustainable change. The programme supports councils and their partners to further explore the needs and wants of their residents and place them at the heart of the decisions they make and public services they design. The programme also develops key skills and capabilities to embed new ways of working across the sector.

During the programme the teams build their skills and capabilities, create new insights and evidence, and shape new opportunities that have the potential to deliver alternative and improved outcomes. Although the programme does not focus solely on ageing, it is one of the areas where we’ve seen a real appetite and drive from local authorities to try more innovative approaches to often longstanding, complex issues. Some case studies of age-related challenges:

West Suffolk Housing, 2017

In 2015, West Suffolk Council’s housing service, Suffolk County Council’s Adult Social Services, West Suffolk Clinical Commissioning Group and the area’s largest housing association, Havebury Housing Partnership, worked together on a challenge focused on tackling an increasingly complicated services issue around supporting older people to maintain their independence. They all recognised the increasing needs arising from the area’s older population and were keen to come together to better understand each service’s pressures, targets and objectives for this group of users.

An ageing population creates challenges for service providers across the UK. Preventing unplanned hospital admissions and ambulance callouts for older people is increasingly a priority as the need for financial efficiency intensifies. Older people living in sheltered housing receive day-to-day support from their housing provider, social services and others, yet this doesn’t appear to have substantially reduced hospital admissions.

A positive impact of the project to date has been the relationship building between individuals working within different organisations, the shared learning and problem solving. Information sharing is now taking place regarding alternative support to acute interventions, such as hospital admissions via A&E, or long-term residential care.

A local registered provider of affordable housing, Havebury Housing Partnership, agreed to work with the team on the project. Havebury commenced the collection of data on admissions to hospital or ambulance call outs from mid October 2015 for their 10 sheltered housing establishments in West Suffolk, and continue to do so as it provides useful insight into levels of activity and highlights potential areas where additional support/advice could be provided to specific units

Valuable links have already been made between Havebury and the newly developed Early Intervention Service (a team including therapists, nurses, social workers and carers). The team can respond to individuals in a crisis situation, providing the necessary assessment and support and, importantly, avoiding a potential attendance or admission to hospital.

Feedback from Havebury to date is that the reporting procedure and its format allows them to see clearly who the frequent users are and provides the opportunity to consider alternative interventions/services that could potentially avoid crisis situations and so reducing ambulance call outs and hospital admissions. The Independent Living Advisers have found that having the data in one place has meant they are able to use it as a reference point and identify patterns – all highly beneficial when talking to family and medical professionals.

Mendip District Council

In 2015, Mendip District Council took part in Design Council’s Design in the Public Sector programme: their challenge focused on housing vulnerable adults.

In Somerset, like elsewhere in the UK, public bodies have had to reduce budgets while maintaining service levels, often while coping with increasing service demand. With an increasing number of adults with complex issues in the area, Mendip District Council knows there is a need to collectively address support for these adults in order to stop their problems spiralling out of control – with corresponding cost implications. The team aimed:

• To develop a coordinated approach across support organisations, sectors and agencies to address the housing needs of vulnerable adults
• Develop an overall brand identity which would allow it to easily communicate the actions taking place to wider partners and organisations the actions taking place
• To better understand the blockages in the system and the drivers for the people within it.

The Mendip team set out to bring together leaders and decision-makers in local organisations to develop a truly collective, coordinated approach. It also carried out targeted work with service users to gain insight into the way they perceive their treatment by the system, their aspirations and the tensions between service delivery and user expectation. They mapped out the current systems, identifying strengths and weaknesses, and collectively agreed opportunities for change. From this, a series of prototypes were agreed to begin to change the system.

A board is now in place that meets monthly and reviews actions coming out from a series of prototypes, projects and programmes all aimed at improving the lives of the service users. The board has now been branded as the Positive Lives board, and all work related to this area now sits under the Positive Lives brand.

There are currently nine work streams running that cover areas including: realigning accommodation from large hostels to smaller household-sized units; trauma informed practice; family hosting and the pattern changing. Many of these have been developed as a consequence of ethnographical research and the messages that came back from clients through this.

The branding of the approach and the coordination of all the partners has enabled additional funds to be levered into the system because of the raised profile of the work. These funds have been used to implement new approaches to support, run prototypes and support transitional arrangements for those affected by a £880,000 cut in housing support for vulnerable people in Somerset.

While the project continues, the Mendip team has already seen results and is on the right course to having an increased positive impact for adults with complex needs and behaviours. The system had had hundreds of thousands of pounds taken out of it. What the Design in the Public Sector work did was show the need to – rather than replace the money – try different ways of working.

Transform Ageing 2016-2019

Transform Ageing[8] is a pioneering programme taking a community and design led approach to improve people’s experience of ageing. Bringing together people in later life, social entrepreneurs and public sector leaders, Transform Ageing examines challenges ageing communities in Devon, Torbay, Cornwall and Somerset experience and aims to support social entrepreneurs to develop and deliver innovative products or service solutions to meet these needs. Over the last three years the programme has demonstrated that combining social entrepreneurship and community action with world class design practice will result in positive change that responds to the challenges of our ageing society.

With funding from the National Lottery, Transform Ageing is being delivered in the south-west of England through a partnership made up of Design Council, UnLtd, South West Academic Health Science Network and the Centre for Ageing Better. Delivery of the programme has been supported locally by Community Council for Somerset, Devon Communities Together, Torbay Community Development Trust and Volunteer Cornwall

Social Entrepreneurs Supported

•         CareCalls helps those who are frail, have learning or physical disabilities and those with complex medical needs. It also helps those who are just a bit forgetful. CareCalls works by delivering reminders and check-ins via landline or mobile. They can deliver as many phone calls as are needed 24 hours a day 7 days a week. When a call is answered they play a message reminding the listener to do important tasks, such as taking medication. If they don’t answer the phone at any time, other people can be informed.

•         LookBack uses VR to virtually transport people to places and experiences of significance to stimulate memories. Using technology, LookBack brings the benefits of reminiscence to more people in an immersive, accessible, and engaging way. The platform is being tested in the NHS and this approach has shown to be beneficial in helping manage the psychological impact of dementia which can include anxiety, loneliness and stress.

•         Personal Alarm Watch brings more freedom to those wearing it at home and outdoors with access to a 24/7 care team at the press of a button. For 36 years, people in later life had to put up with the traditional pendant alarm. They have worked closely with people in later life to identify the underlying problems with traditional pendant alarms – they find the red button stigmatising and because they only work at home, there’s hesitation in going outdoors. Their aim is to help them keep their independence, so they developed The Personal Alarm Watch; a discreet watch that works anywhere in the country. At a simple press of a button, people in later life have access to 24/7 care team and can speak to them directly through the watch. Through Transform Ageing, they worked closely with hundreds of people to design and launch the best alarm.

•         NEDCare began as a small community project determined to tackle a chronic lack of social care for rural communities living in north-east Dartmoor. They are now a regulated home-care agency and we employ their own team. Because they knew how costly and long-winded a process it is to set up a regulated agency, supported by Transform Ageing they developed a quick and cost-effective solution; a Carer Introduction Service. With this, they match people in need of care to local, self-employed carers. On the Caring Connections Project, we they are also working with three project partners, supporting them to establish their own Carer Introduction Services.

Conclusion

The programmes, ideas and outcomes highlighted here demonstrate that design for people in later life needs to be inclusive and start with the people who face challenges around their ageing. That means people managing their own ageing, not having policies or processes forced upon them. If we widen participation in this thinking, we can contribute to making ageing better for everyone, not just those who are now in retirement or approaching it. Everyone has a stake in this endeavour, and we urge the Committee and the government to consider think carefully on how they encourage inclusive conversations and innovation, to provoke new ideas, new thinking and build communities which allow us all to thrive as we age.

Submitted by: Sarah Weir OBE, Chief Executive

20 September 2019