Centre for Ageing Better – Further supplementary written evidence (INQ0099)

Letter from Anna Dixon, Chief Executive, following her evidence session on Tuesday, 3 March 2020

Thank you for inviting me to give oral evidence to the Committee in March. I hope the Committee found my remarks useful. I wanted to provide a further and more specific note on the actions that are needed by UKRI to achieve the greatest value from the Healthy Ageing Grand Challenge Fund. Given the release of additional funds to respond to Covid-19, it is particularly timely for the Committee to consider how funding associated with the Healthy Ageing Grand Challenge is being evaluated.

I would also like to make the Committee aware that the Centre for Ageing Better was commissioned to provide some advice on how to conduct an effective evaluation on interventions that aim to improve people’s health in later life in order to support the design of UKRI’s evaluation of the Industrial Strategy Challenge Fund on healthy ageing. This was provided to UKRI in December 2019.

Achieving social impact

There is a need for both the Covid-19 response funding and Healthy Ageing Challenge Fund to have a well-designed and adequately resourced evaluation to ensure the best value is achieved for the funding. There are three main types of evaluation that should inform the approach taken

•         Process – tracking progress and learning throughout the life of the programme

• Impact – summative reflections on whether the desired outcomes have been reached (including any unintended consequences). This category includes a number of different types of impact including for example, what has changed from the perspective of the public/end users (defined as social impact).

•         Economic impact – exploring the outcomes from a financial perspective.

Social impact relates specifically to the outcomes for individuals, communities or population-wide. This could be something quite specific – such as an improvement to a clinical condition – or a more general impact on a person’s wellbeing. The impact on carers, practitioners, family and friends can also be considered.

Without the measurement of social impact, an intervention could, for example, be classified as ‘successful’ due to the profit it is making or number of people it is reaching. However, it would not be possible to know whether it is having a positive or negative impact on end users. Consequently, public funding could be stimulating a market for products and services which don’t in fact result in a longer healthier life. Both of these elements are equally crucial for the Challenge Fund. As financial and operational data will be collected through UKRI-wide evaluation and monitoring structures, it is essential that the Healthy Ageing Challenge Fund focuses on social impact.

We would therefore suggest the Committee request that UKRI rapidly review the evidence for any of the interventions/ services they are proposing to fund and where evidence of any effect is lacking put in place appropriate evaluation.

Mainstreaming

The biggest opportunity of the fund will come in investing in the scaling of technology, products or services that has already proved both its economic and social impact to bring these to a larger market. Without a clearer framework and strategic leadership, there is a danger that the difficulties that have been endemic in innovation relating to healthy ageing and older consumers will persist. These difficulties have seen the repeated funding of projects that do not get to scale and a proliferation of products seeking to solve the same problems without success.

There has been a tendency for funding to be spent on the development of digital applications because there is a clear and easy route to bring these to market. Too often not enough is done to establish whether they are meeting a consumer need and they fail to integrate with the wider services that people need to gain benefit from the app. For example, the development of falls monitoring products that reinvent the same technology without addressing integration with services that can respond to and support someone who has fallen/ is at risk of a fall. The lack of service integration has continued to be a barrier to success and widespread adoption.

Covering the Industrial Strategy Challenge Fund framework and attracting the right businesses

To attract a diverse and wider range of businesses to healthy ageing innovation, there is an opportunity for future spending rounds to be more focused and directed towards specific areas of the framework. In doing so, the Healthy Ageing Challenge Fund can take a more explicit market-shaping role to fill gaps and accelerate innovation in areas that are currently lacking.

The ISCF framework, suggested by the Centre for Ageing Better, focuses on seven themes where we think there are the greatest opportunities to tackle market failures and stimulate innovation in pursuit of longer, healthier lives for all:

1. Sustaining physical activity

2. Maintaining health at work

3. Designing for age-friendly homes

4. Managing common complaints of ageing

5. Living well with cognitive impairment

6. Supporting social connections

7. Creating healthy and active places

There is a risk that if funding is responsive to existing suppliers that the market reverts to where it has been historically that is with a focus on high need individuals and more clinical products, selling to a niche market. The opportunity lies in mainstream products and inclusive markets across a wide range of areas set out in the Framework. We would advocate that UKRI should review projects funded so far and commission market analysis to inform where the gaps are and what should be the direction and focus of future spend in order to achieve the greatest value from remaining funds.

What is needed to make this happen?

To make this a reality we suggest that the Committee encourage the Government and UKRI to do the following:

•         Require that funding applications include evidence of social impacts and when this is lacking ensure a clear evaluation plan is in place with the appropriate skills and resources to deliver.

•         Establish a common evaluation framework which sets minimum requirements and standardised measures through the contracting process to enable a central evaluator to synthesise and compare outcomes between projects and products.

•         Increase resources for evaluation and appoint a central evaluator to develop a common evaluation framework, support and quality assure the evaluation proposals of bidders/ awardees, and synthesis the findings across the Fund. This more complex evaluation will involve mixed-methods research and therefore needs to be adequately resourced.

•         Undertake a market analysis to understand where there is a need for government to take a more active market shaping role, and direct future funding to these areas.

21 May 2020

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