Nesta – Written evidence (INQ0076)
Nesta is an innovation foundation. For us, innovation means turning bold ideas into reality. It also means changing lives for the better. We work in areas where there are big challenges facing society, from the frontiers of personalised healthcare to stretched public services and a fast-changing jobs market.
Nesta is based in the UK and supported by a financial endowment. We work with partners around the globe to bring bold ideas to life to change the world for good.
We welcome the government’s mission to ensure that people can enjoy at least five extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest. Mainstream healthcare has made significant progress over the past half-century in delivering excellent clinical treatment for acute and infectious disease. So much so, this clinical success has contributed to a new strategic challenge: people are now living longer, often with multiple long-term conditions. The existing health system, focused primarily on pharmaceuticals, medical instruments and clinical procedures, has proven ill-suited to many contemporary challenges, including the fact that although life span has increased over recent decades, health span has not kept pace.
Nesta has been working on issues relating to health and ageing for the last ten years, through research and practical work. We think there is an innovation imperative to adapt well to an ageing population. It is a significant challenge, and an important one. We need models of living and working that are fit for the future: a future where entering the second half of our lives is not the beginning of the end, but the start of something new.
Five years ago in our five hours a day report we set out what we think is needed:
We incubated the Centre for Ageing Better, part of the network of What Works Centres with a focus on creating a society where everyone enjoys a good later life. We have also been supporting some of the most promising ageing innovations, such as new neighbourhood networks and peer support, to scale across the UK.
We welcome the inquiry’s broad approach and believe that whilst there has been progress, we have far further to go. The rest of this note outlines some of our relevant work, experience and learning, and we would welcome opportunities to share further as part of this inquiry.
People powered health
Nesta’s health work grew out of our interest in the idea that public services should work in collaboration with citizens. People are more likely to be healthier when they are more in control of their health and care.
In the future, the best public services will be people powered – designed to be more open, where each interaction creates connections, deliberately works to enable creative and active citizenship, and brings together professionals and local people to change communities and lives. We see that many solutions lie outside the formal statutory sector - in effective behaviours and social contexts that are preventative and help to ameliorate clinical symptoms. In other words, communities that create health, rather than undermine it. We also think technology can be an important enabler. If co-designed and applied appropriately, digital technologies are well placed to connect individuals with their communities, peer groups and care teams; help individuals monitor long-term conditions and to support those around the individual who may be involved in their care.
That is why we’re committed to using people power, smarter use of new technology and new methods to stimulate innovation in the health and care system. We back and champion great examples of people powered solutions across the country that shift power, value relationships, combine the best approaches of working with citizens, public servants and civil society to lead to better outcomes.
Making connections: the power of relationships
Evidence consistently shows the power of relationships, social connection and kindness to improve our wellbeing and help us live healthier, happier lives. We need more opportunities for older people to feel connected to others and actively engaged, with support to develop and maintain their own sense of purpose, build confidence and take action.
We think reciprocal, intergenerational and neighbourhood-based approaches have a fundamental role to play. Amid growing disconnection and loneliness amongst both older and younger people within society, we all need to explore new ways of creating greater connection, community and cohesion.
Through our Accelerating Ideas work, in partnership with the National Lottery Community Fund, we have been supporting eight ageing innovations to scale across the UK. For example, The Cares Family, who bring together older people with deep roots in an area but few connections, and young people who may have many connections but no deep roots. An evaluation showed that as a result of taking part, 76% of older neighbours feel less isolated and 81% feel less lonely, while 98% of young people said they felt closer to the community.
We are also celebrating 10 years of GoodGym this week, another innovation we are supporting to scale, which makes social connections between older and younger people possible, with incredible stories of people entering retirement and finding renewed purpose after bereavement, to people in later life no longer able to leave their homes sharing wisdom with younger runners visiting them.
High-impact volunteering is another effective way of using the knowledge and skills of older people, as well as supporting them to improve their health and well-being, feel more in control of their health needs and better connected with their community. Through our Second Half Fund , in partnership with the Office for Civil Society, we are supporting innovations that mobilise the time and talents of people over 50 alongside public services, to create more age inclusive opportunities. For example VIY involves retired volunteers teaching young people trades, Grandmentors support care leavers and the Eden project explores how we can support grandparents as they take on more childcare responsibilities.
Technology as an enabler
Through our programmes we have actively encouraged and accelerated the development of many digital tools and technologies that are championing the use of data and digital technologies for ageing.
Technology can be used to better connect people in new ways that are not possible offline. An example of this is the winner of Nesta’s Smart Ageing Prize, KOMP, a platform which allows family and friends to share photos, messages, and make video calls with the aim of making the time between physical meetings feel a little shorter. KOMP was developed with and for people over age 75 with little to no technological competence. That is why KOMP has a high contrast screen, no touchscreen, a loud audio connection and only one button.
The Healthier Lives Data Fund, a programme run in partnership with the Scottish Government, is supporting six start-ups using health and care data innovatively to give control back to individuals. This includes supporting people to live healthier lives at home by ensuring long term conditions are effectively monitored and controlled. One innovation we are backing, Pharmatics, is focused on preventing exacerbations for people with COPD, including recording key pieces of data about how the individual is feeling and combining this with clinical records and medication data to predict the likelihood of an exacerbation in the next 24 hours. Using this information, it is expected that the individual will have more freedom to plan around their condition, can avoid unnecessary visits to the health service and will have a better quality of life overall.
Technology can also be used to support the people requiring support and those around them, such as family members and carers. Through our ShareLab work we have supported Equal Care Co-Op, a platform co-operative co-owned by people receiving and offering care and support. We want to see new operating models like this being used more widely to support healthy ageing.
We are also working with the Department of Culture, Media & Sport on Tech to Connect, an England-wide challenge which is looking to find ways that tech can tackle social isolation and loneliness.
We believe that the development of these products will continue and will become more reliable as advancements in technology progress. We envisage a future where information from all an individual’s apps is collated and combined with health and care data to help us to build a fuller picture of the individual, ensuring that the right support and services are available and spotting the signs of deterioration earlier. Combining all of this information in one place will help to give control back to the individual, helping them to access services available and better monitor their own health and wellbeing.
Addressing the social, behavioural and environmental influences on health – ‘The Nightingale’
We particularly welcome the inquiry’s focus on the gap in experience between the richest and poorest in society. For too long the UK has promised to tackle health inequalities and improve health but hasn’t followed through with sufficient investment or action. This means we know a lot about what causes good and bad health, and can measure many of the inequalities, but we still know woefully little about what to do about them.
We believe it is time for a radical shift in investment - not just to new solutions, but also to new research to build our collective understanding of how to create and sustain the best conditions for good health throughout the life course. We propose a new centre of innovation and research excellence to turn this ambition into reality, drawing expertise from across public health and behavioural and social sciences, with the best practices from human-centred design, citizen science and asset-based community development. We suggest calling it ‘The Nightingale’, in honour of Florence Nightingale’s vital contribution to public health research and practice.
Annex - Our most relevant work
● Accelerating Ideas - A 5 year partnership (to 2021) with the National Community Lottery Fund supporting eight highly promising ageing innovations to increase their reach and impact across the UK:
● GoodGym is powered by a growing community of runners who work to reduce isolation among older people and bring communities together
● Shared Lives Plus involves a Shared Lives carer sharing their home and family life with an adult in need of care or support
● Hand in Hand (Stroke Association) run stroke groups that are self-funded community groups, run and supported by people affected by stroke; providing essential long-term peer support. Three quarters of strokes happen in people over the age of 65.
● The Cares Family is a group of community networks of young professionals and older neighbours, who support and socialise with each other
● The National Volunteering Programme of Carers UK enables people with experience of caring to provide valued support to help others better manage their caring role, an increasing number of whom are older
● First Call Support at Home (british Red Cross offers emotional and practical support for those being discharged from, or awaiting, hospital treatment
● Integrated Breathe Easy (British Lung Foundation) provide peer support, information, innovative engaging activities, self care that boost lung health for people living with respiratory conditions, their families and carers, the majority of who are older people
● GoodSAM is an app that connects those in need with those who have the skills to provide critical help in the minutes before an ambulance arrives. GoodSAM focuses on cardiac related emergencies which are most common in older people
● The Second Half Fund supports the growth of innovations that mobilise the time and talents of people in the second half of their lives to help others, alongside public services
○ Aesop is a falls prevention dance programme for older people
○ Eden Project develops programmes for grandparents and their grandchildren to learn together
○ Grandmentors is an innovative project using the power of intergenerational mentoring to support care leavers who may be in challenging life circumstances. These mentors are volunteers aged 50 and over who use their wisdom, their energy and their life experience to help support young care leavers
○ VIY involves retired volunteers teaching young people trades
○ BuddyHub is a new tech‐enabled befriending service that targets older adults considered to be at high risk of loneliness and social isolation
○ Compassionate Neighbours are volunteers who offer time, friendship and emotional support to people who live near them who have a chronic or terminal illness and are experiencing loneliness or social isolation.
○ The Reader - Older people volunteer as Reader Leaders to lead shared reading sessions. It is a simple yet powerful non-medical intervention that improves wellbeing, reduces social isolation and builds community resilience and connectedness.
● The Healthier Lives Data Fund is a partnership between Nesta and the Scottish Government to support innovative digital technologies that make data available and useful to citizens, helping them lead healthier and more independent lives. A number of these innovations have a direct
○ Nquiringminds use technology to improve sharing care between formal carers and friends, family and volunteer
○ CogniCare is a digital companion for dementia carers available as an app and on Amazon Alexa
○ Pharmatics uses AI to transform self-management of long-term conditions
● The Nightingale In this paper we propose a new centre of innovation and research excellence to equip us with the knowledge we need to improve the social, behavioural and environmental determinants of health
● The Smart Ageing Prize identified products and services that use innovative digital technologies to support older people to participate fully in social life. The winners included:
○ KOMP a one-button computer designed to make communication between all generations simple. It was developed with and for seniors (75+) with little to no technological competence.
○ PlaceCal is a partnership of community organisations, charities, social housing providers, government services, health providers, and citizens, working together to improve the quality, quantity and accessibility of community data to make smarter and better-connected neighborhoods that work for everyone.
○ Refresh by How Do I? is a mobile app and content creation platform designed to build confidence and support those with memory loss to live, work and socialise more independently, using step-by-step videos accessed at the touch of a mobile device
● Five Hours a Day - we make the case for a systematic look at how we live in an ageing society, to create models of living and working fit for the future
● Realising the value - an NHS England funded programme we led with a consortium of organisations including The Health Foundation and Voluntary Voices, we recommended putting people and communities at the heart of health and wellbeing through approaches like personal budgets, community navigators and social prescribing
● Centre for Social Action Innovation Fund - The Centre for Social Action Innovation Fund was a £14 million fund, with the Cabinet Office, to support the growth of innovations that mobilise people’s energy and talents to help each other, working alongside public services. Innovations backed included:
○ Rebuilding Connections by Social Finance - Social Finance is working with Age UK and communities in Worcestershire to deliver a social impact bond programme that reduces loneliness and improves well-being in older age.
○ The Green Gym -The Green Gym combines keeping fit with improving the environment, transforming volunteers' health and wellbeing while improving local areas.
○ Integrated Care Pathway, by Age UK - The ‘integrated care pathway’ is a pioneering new way of delivering support for older people with long term conditions embedding voluntary sector professionals alongside older people and clinicians, led by Age UK.
○ Good Neighbours Scheme by Bedfordshire Rural Communities Charity - Good Neighbour schemes are very localised support networks, harnessing and facilitating street-based, grassroots social action and building social capital within communities.
● Rooted - A practical guide providing clear, step-by-step practical advice and resources to support social entrepreneurship in later life
● Preparing for Ageing - A report that describes the challenge of an ageing society, the role of innovation in meeting it, and where innovation needs to be better harnessed
● People Helping People - A report that explores how peer support can help people focus on their assets and abilities, rejecting the standard illness model in favour of a focus on self-efficacy and hope
● People Powered Health - A programme that supported the design and delivery of innovative services for people living with long term health conditions
● The Ageing Well Challenge Prize looked for ideas to improve the lives of older people by reducing social isolation or increasing mobility. Specifically, we sought approaches that would encourage lots more people to give their time, resources and skills to address this challenge
○ Radio Club – a weekly live radio show where up to 15 older people are the weekly contributors. The ‘call-in’ format has been developed to support older members of the community by allowing them to socialise live on air from the comfort of their home – chatting and sharing stories. As members, they talk about anything and everything, giving them a chance to chat, while creating great content for the listeners.
○ NANA – A comfort food and community café run by older ladies from the local area. For older ladies it’s a chance to get out of the house, meet new people, and put their skills to good use, and for everyone else it’s a place to enjoy proper hearty home cooked food at a reasonable price.
○ The After Work Club – A network to engage, inspire and connect men, to help redefine their retirement. They are building a task force of retired men who use their skills to make positive changes in the wider community and by doing so reclaim a sense of personal value and purpose, reduce their risk of social isolation and equip themselves to face the challenges of ageing.
○ Stonewall Housing, One Small Step – aims to make it easier for volunteers in London to help isolated, older LGBT people with small day-to-day tasks such as changing a light bulb or walking the dog.
○ Age UK Exeter, Tools Company – Part of Men in Sheds, Tools Company enables men to repair broken and old garden and trade tools to send to local UK charities and to Africa for business start-up schemes. Using donated tools and volunteer buddies they give older men with complex needs a chance to reconnect with meaningful, practical activity.