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Overcoming London’s Barriers
Conference
Thursday, 21 June 2018
#mendbarriers
SUPPORTED BY
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Professor Tony Travers | @LSE_London
Director, LSE London
#mendbarriers
Political and administrative
borders in London
Tony Travers
London school of Economics & Political Science
London’s borders
• London’s outer border with the South East and East regions
• London borough boundaries
• Ward boundaries
• Some councils from time
to time create
‘neighbourhoods’
London/SE border
Croydon/Bromley border
Croydon ward boundary
Why borders matter
• Different jurisdictions
• Interpretation of law
• By-laws
• Different policies
• Planning, housing, heritage, tall buildings
• Different political control
• Even if by same party
• Desirable infrastructure at centre of borough; unliked infrastructure
at the edge
London as an island
Source: Jess Wilson
Boroughs as islands
A borough boundary: inner to outer London
Camden [inner London] Barnet [outer London]
NB: tarmac
line
Lincoln’s Inn Fields, WC2 Bourne Street, SW1
Small, real world, impacts
Bigger impacts
- Cleveland Street, W1: servicing located on boundary street
Major effects
- Nine Elms: ex-industrial land on border now available for redevelopment
London Plan Opportunity Areas
- mostly on boundaries: often because of past industrial activity there
Service level impacts
• Refuse collection/recycling rules vary significantly from borough to
borough
• Patterns of social care and delivery methods can vary
• Policy approaches to housing, development and tall buildings
profoundly affected
• London has a very different political system to the counties and
unitary authorities which surround it
Net affordable housing delivery as % of total, 2014-15
- significant variation from borough to borough
Mechanisms and policies to reduce
boundary/service level effects
• London Councils
• Co-ordinates LB approaches to London-wide policy
• Represents LBs’ joint views
• The Mayor/Greater London Authority
• London Plan as framework for development; grant allocation
• Metropolitan services, eg, transport, police, fire
• Joint committees/partnerships
• Bi-lateral co-operation
• Political parties
• Central departments
Possible reform
• Fewer boroughs?
• More co-ordination power for the Mayor?
• More co-ordination power for central government and its agencies?
• More voluntary partnerships
Most importantly:
• Greater awareness of the impacts of boundaries
• On services
• On development
• On planning
• On design and streetscape etc etc…
Political and administrative
borders in London
Tony Travers
London school of Economics & Political Science
Overcoming London’s Barriers
Breakout sessions
#mendbarriers
SUPPORTED BY
Workshop: More London
Tools and data: Tower B+C (this room)
Place perceptions: Tower A
Overcoming London’s Barriers
Tools and data for overcoming barriers
#mendbarriers
SUPPORTED BY
Dr Paulo Anciaes | @StreetMobility
Research Associate, UCL Transport Studies
#mendbarriers
Tools and data for understanding barriers
Overcoming London’s Barriers
London 21/06/2018
Paulo Rui Anciaes
Centre for Transport Studies
University College London
- Economic valuation -
Additional funding (2017)Original funders (2014-2016)
This project has received funding from the European
Union’s Horizon 2020 research and innovation
programme under grant agreement No.636573.
Background: UCL Street Mobility project
Toolkit available from
http://www.ucl.ac.uk/street-mobility/toolkit
How much would you
pay to have this
instead?
How bad is this?
(from 0 to 100)
© URB-I (urb-i.com), using Google Maps images
Preferences for road designs and traffic conditions
vs. walking time vs. money
Preferences
for crossing facilities
vs. walking time
Case studies
A23 Streatham High RoadA4 Great West Road (Osterley)
Severance
index
UNDERPASSSTAGGERED PELICAN
CHANGE TO
STRAIGHT PELICAN
NOW
REDUCE
ONE LANE
REDUCE TRAFFIC
DENSITY
REDUCE TRAFFIC
SPEEDOPTIONS
84% 7% 23%
53% 49% 77% 6%
ACTUAL SPEED 30MPH ACTUAL SPEED 20MPHACTUAL SPEED 30MPH
ACTUAL SPEED 30MPH
Traffic density: High
Traffic density: HighTraffic density: MediumTraffic density: High
Monetary value
of interventions
(per trip)
UNDERPASSSTAGGERED PELICAN
CHANGE TO
STRAIGHT PELICAN
NOW
REDUCE
ONE LANE
REDUCE TRAFFIC
DENSITY
REDUCE TRAFFIC
SPEED
OPTIONS
ACTUAL SPEED 30MPH ACTUAL SPEED 20MPHACTUAL SPEED 30MPH
ACTUAL SPEED 30MPH
Traffic density: High
Traffic density: HighTraffic density: MediumTraffic density: High
£0.04 £0.95£0.88 £0.47£1.26
Simulation tool: inputs
Simulation tool: inputs
Simulation tool: outputs
Disaggregation by age, gender, and trip purpose
Ed Parham | @Ed_Parham @Space_Syntax
Director, Space Syntax
#mendbarriers
Integrated Urban Models
Ed Parham
How do urban systems combine to create severance?
How can this be measured?
What does this mean for every day life?
Who is affected by this?
How can we overcome this at different scales?
Space Syntax Limited © 2018
Integrated Urban Modelling
Make better urban design and policy
decisions by measuring how systems
interact to affect daily patterns of use
Integrated Urban Modelling Why, What and How?
Road network
Public Transport Network
Pedestrian Routes
Land use
Population
Census Data
User focused outcomes:
How many jobs can I get to
in half an hour?
Can I walk to a decent
school or doctor?
Am I close to shops, cafes,
parks etc?
Space Syntax Limited © 2018
Integrated Urban Modelling
Option A Option B Option C
Make better urban design and policy
decisions by measuring how systems
interact to affect daily patterns of use
Integrated Urban Modelling Why, What and How?
User focused outcomes:
How many jobs can I get to
in half an hour?
Can I walk to a decent
school or doctor?
Am I close to shops, cafes,
parks etc?
Car dependence
Car Dependence
Car is equal to Public Transport
Car is 1.0 x better
Car is 1.0 - 2.5 x better
Car is 2.5 - 5.0 x better
Car is 5.0+ x better
Space Syntax Limited © 2018
Integrated Urban Modelling
Number of GP practices within
15 minutes of walking
12% of households do not have
access to a GP practice within 15
minutes walk
Access to services
Space Syntax Limited © 2018
Integrated Urban Modelling
Access to services Quality and Capacity
Space Syntax Limited © 2018
Integrated Urban Modelling
Number of GP practices within 15
minutes of walking
< 75%
≥ 75%
Overall satisfaction percentage
missing data
0.63 – 5
5 – 10
10 – 15
Number of GPs per 1,000 registered
patients
Number of GP practices within 15
minutes of walking
< 75%
≥ 75%
Overall satisfaction percentage
missing data
0.63 – 5
5 – 10
10 – 15
Number of GPs per 1,000 registered
patients
Access to services Deprivation
Space Syntax Limited © 2018
Integrated Urban Modelling
Social Isolation Score
Car dependence vs Social isolation
Car Dependence
Car is equal to Public Transport
Car is 1.0 x better
Car is 1.0 - 2.5 x better
Car is 2.5 - 5.0 x better
Car is 5.0+ x better
Space Syntax Limited © 2018
Integrated Urban Modelling
Align pedestrian infrastructure with desire lines
Movement patterns Strategic design Modelled impact
Space Syntax Limited © 2018
Integrated Urban Modelling
Align pedestrian infrastructure with desire lines
Movement patterns Modelled impact Design
Space Syntax Limited © 2018
Integrated Urban Modelling
Align pedestrian infrastructure with desire lines
Movement patterns Modelled impact Outcome
Space Syntax Limited © 2018
Integrated Urban Modelling
www.spacesyntax.com
www.spacesyntax.com/openmapping
Jawad Sardar| @sardarj90
Director, Sum Global
#mendbarriers
Traditional Data Collection
• Clicker counters
• Traffic Count Devices
• Business and customer
surveys
• Census/ONS
• Mobile phone data
• Transaction Data
• WIFI Networks
• Social Media data
• Open Data (ONS)
• Google
Big Data
Movement
• Origin and
Destination
• Transport modes
• Dwell times
• Transits
• Mobility patterns
Big Data Insights
Behaviour/Sentiments
• Interaction with
spaces
• Views of users
• Perceptions
• Competition
Economic
• Transaction volumes
and breakdown of
types of
transactions
• Business Hours
• Property market
analysis
• Project delivered by Habidatum, Vodafone India, Citilogik, KPIT
Accessibility: Pune, India
Hammersmith & Fulham
Stratford Town Centre
www.sum-
global.com
Moderated discussion
• Tell us your name/organization
• Keep your question brief!
#mendbarriers
Refreshment break
Return to breakout sessions by 15:15
Overcoming London’s Barriers
Public health implications and approaches
#mendbarriers
SUPPORTED BY
Paul Goulden | @PaulGoulden @Age_UK
Chief Executive, Age UK London
#mendbarriers
Overcoming barriers for
older people
Paul Goulden, CEO, Age UK London
Loneliness
• Rising population
• Increased health issues but . . .
• Living better for longer?
What causes loneliness?
• Income
• Frailty
• Managing long term conditions
• Mental as well as physical
• Fear
• Of the unknown
• Of change
• Of “worst case scenario”
Health and social care impact
• Crisis management, not planned journey
• Unscheduled admissions
• Once you’re “in the system” . . .
• Cost and staffing pressures
• Downward spiral and revolving door
How do we address these fears?
• Do you know your neighbour?
• Digital inclusion
• Intergenerational opportunities
• Strong communities – physical and personal
• Getting transport right!
Oliver Davey | @umovewemove
Design Engineer, Urban Movement
#mendbarriers
THE BARRIER
THE CONTEXT
• The oldest population in London and the second
highest with a severe physical disability
• Junctions with the 2nd, 4th and 5th worst collision
records on the Boroughs road network
• The largest influx of children between 2010 and 2015
of any London Borough
• Lower spend per person per month than comparable
Metropolitan Centres such as Kingston and Bromley
• Air quality hot spot
• Crime hot spot
• 3,300 new homes will be built, straddling the Ring Road,
as part of the Romford Housing Zone
• The people that will live in these new homes have yet to
decide how they will travel
• To maintain existing journey times on the Ring Road we
want to give these new people viable alternatives to the
private car
THE FUTURE
THE PROPOSALS
• First Phase addresses the western side of the Ring
Road, through the Housing Zone
• Focus on reducing the barrier affect of the Ring Road
and encouraging positive development
• Replacement of existing subway networks with at-
grade crossings
• ‘Healthy Oases’ with new landscaping, public art,
informal play, SuDS, seating and lighting
• Free-flow, steady-state roundabout design
• £7.13M budget
Yvonne Doyle | @doyle_yg
Director for London, Public Health England
#mendbarriers
Overcoming London’s barriers
Public Health implications and approaches
YvonneDoyleCB
Director forLondon
21st June 2018
The strategic aims of London government regarding devolution
Investment in skills and innovation towards a
high tech economy
Home building across all types of tenure
A safe capital city where business investors
have confidence
Faster reform of health and social care
services, leading to improvements
in health and reduction of pressures on
public services
Self financing growth and reform model
London is required to deliver internationally competitive growth and
to outpace other global cities, adding £6.4bn to the capital’s economy by 2030
Since 2013 London’s health and caresystemhas been on ajourney
From system turnover to joint (Commission) focus on London to partnership
The public health journey since2013
• With ambitions and powers
• Engagement across London
• Governance led by the city’s Mayor…
• ….And increasingly, others wanting to join
Significant health challenges to address
And these are driven by inequalities in wider determinants of health
83
London devolution pilot commitments
Utilisation of capital and
estates
NCL ONEL HaringeyHackney LewishamLondon
System finances: payment
mechanisms and provider
support
Explore adaptation to provider
regulation and inspection
Workforce and skills
Transformation of health and
care services
Public health: developing
healthy and inclusive
environments
Employment and health
Early sub-regional pilots in London – initial ambitions
include integration on service, estate handling and prevention of
ill health
Lewisham integration:
Developing a whole system model
which fully integrates physical and
mental health and social care,
tailored and delivered to the whole
population.
Barking &
Dagenham, Havering
and Redbridge sub-
regional health and
care integration:
Aims to develop an
Accountable Care
Organisation with full
budget accountability.
Haringey prevention: aims to embed best
practice and test the limits of existing
powers to promote prevention. It seeks to
find the most effective ways of using
planning and licensing powers to create
healthy environments. The pilot will also
identify new ways of supporting more
people into sustainable employment.
Hackney integration: particular focus on
achieving parity between mental and
physical health services. Exploring a single
delivery organisation taking responsibility for
Hackney’s whole population, with combined
financial resources and a capitated budget.
North Central
London estates:
Aims to develop the
estate needed for
new models of care.
This will optimise
existing assets and
reinvest capital in
health and care
services which
support wider
benefits for local
communities.
Success and challenge: Health success
The partnerships outlined in these slides have achieved a huge amount since
2013 in London and are recognised as leading on prevention
The Mayor leads on the wider dimensions of health and is a major champion
on inequalities
Some population trends have improved and we expect this to continue
London is increasingly viewed internationally as getting serious about
population health
Some exciting developments have occurred – led by multiple sectors. This is
likely to continue
1. A ‘do once for London’ approach with clear governance is more likely to have impact. London
health and care public sectors are working in this way with maturing partnerships.
2. Funding for prevention is meagre compared with treatment and care funding albeit return on
investment is very high compared with many clinical treatments. Nevertheless those working on
prevention have shown resilience and imagination in taking a range of work forward.
3. Some big challenges that require a system wide approach remain. These include:
o Child and adolescent obesity levels (but progress at earlier ages)
o Elements of mental ill health including the need for access to services
o Poor lifestyles (eg low physical activity levels, smoking in deprived communities)
o Early disability in adults especially those experiencing long term deprivation
Work in progress
Work in progress
1. Devolution is one of several approaches being used in the public sector in London to
accelerate progress on preventing ill health, modernising out of hospital
infrastructure, and integrating the service offers for those who have complex needs
requiring many care inputs.
2. Devolution has offered permission to innovate with the wider environment (for
example around schools, in high streets of deprived communities) to design health
considerations into place shaping
3. The financial cost of this work is minimised by ‘sweating assets’ for instance
complementary offers from partners, and seeking new sources of funding.
4. Prevention gaps identified for further consideration
o Londoners feeling enabled to look after themselves
o Digital solutions to the population
o Engagement of the population (including children) in regular ways in the future of their
health, their city
Thank you
Moderated discussion
• Tell us your name/organization
• Keep your question brief!
#mendbarriers
Remain in/return to this room for closing session
#mendbarriers
Dave Hill | @DaveHill
London Commentator, OnLondon
#mendbarriers
Next steps
• Networking drinks!
• Field trips to Croydon, Lewisham, and Finsbury Park
• Senior roundtables
• …and new FoL projects starting this autumn
Stay in touch
@futureofldn
Future of London
futureoflondon.org.uk/subscribe

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Future of London 2018 Conference (afternoon breakouts main room)

  • 1. Overcoming London’s Barriers Conference Thursday, 21 June 2018 #mendbarriers SUPPORTED BY Photos will be taken at this event For information about how we use photos or to tell us that you don’t want to be photographed, please talk to a member of staff.
  • 2. Professor Tony Travers | @LSE_London Director, LSE London #mendbarriers
  • 3. Political and administrative borders in London Tony Travers London school of Economics & Political Science
  • 4. London’s borders • London’s outer border with the South East and East regions • London borough boundaries • Ward boundaries • Some councils from time to time create ‘neighbourhoods’ London/SE border Croydon/Bromley border Croydon ward boundary
  • 5. Why borders matter • Different jurisdictions • Interpretation of law • By-laws • Different policies • Planning, housing, heritage, tall buildings • Different political control • Even if by same party • Desirable infrastructure at centre of borough; unliked infrastructure at the edge
  • 6. London as an island Source: Jess Wilson
  • 8.
  • 9. A borough boundary: inner to outer London Camden [inner London] Barnet [outer London] NB: tarmac line
  • 10. Lincoln’s Inn Fields, WC2 Bourne Street, SW1 Small, real world, impacts
  • 11. Bigger impacts - Cleveland Street, W1: servicing located on boundary street
  • 12. Major effects - Nine Elms: ex-industrial land on border now available for redevelopment
  • 13. London Plan Opportunity Areas - mostly on boundaries: often because of past industrial activity there
  • 14. Service level impacts • Refuse collection/recycling rules vary significantly from borough to borough • Patterns of social care and delivery methods can vary • Policy approaches to housing, development and tall buildings profoundly affected • London has a very different political system to the counties and unitary authorities which surround it
  • 15. Net affordable housing delivery as % of total, 2014-15 - significant variation from borough to borough
  • 16. Mechanisms and policies to reduce boundary/service level effects • London Councils • Co-ordinates LB approaches to London-wide policy • Represents LBs’ joint views • The Mayor/Greater London Authority • London Plan as framework for development; grant allocation • Metropolitan services, eg, transport, police, fire • Joint committees/partnerships • Bi-lateral co-operation • Political parties • Central departments
  • 17. Possible reform • Fewer boroughs? • More co-ordination power for the Mayor? • More co-ordination power for central government and its agencies? • More voluntary partnerships Most importantly: • Greater awareness of the impacts of boundaries • On services • On development • On planning • On design and streetscape etc etc…
  • 18. Political and administrative borders in London Tony Travers London school of Economics & Political Science
  • 19. Overcoming London’s Barriers Breakout sessions #mendbarriers SUPPORTED BY Workshop: More London Tools and data: Tower B+C (this room) Place perceptions: Tower A
  • 20. Overcoming London’s Barriers Tools and data for overcoming barriers #mendbarriers SUPPORTED BY
  • 21. Dr Paulo Anciaes | @StreetMobility Research Associate, UCL Transport Studies #mendbarriers
  • 22. Tools and data for understanding barriers Overcoming London’s Barriers London 21/06/2018 Paulo Rui Anciaes Centre for Transport Studies University College London - Economic valuation - Additional funding (2017)Original funders (2014-2016) This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No.636573.
  • 23. Background: UCL Street Mobility project Toolkit available from http://www.ucl.ac.uk/street-mobility/toolkit
  • 24. How much would you pay to have this instead? How bad is this? (from 0 to 100) © URB-I (urb-i.com), using Google Maps images
  • 25. Preferences for road designs and traffic conditions vs. walking time vs. money
  • 27. Case studies A23 Streatham High RoadA4 Great West Road (Osterley)
  • 28. Severance index UNDERPASSSTAGGERED PELICAN CHANGE TO STRAIGHT PELICAN NOW REDUCE ONE LANE REDUCE TRAFFIC DENSITY REDUCE TRAFFIC SPEEDOPTIONS 84% 7% 23% 53% 49% 77% 6% ACTUAL SPEED 30MPH ACTUAL SPEED 20MPHACTUAL SPEED 30MPH ACTUAL SPEED 30MPH Traffic density: High Traffic density: HighTraffic density: MediumTraffic density: High
  • 29. Monetary value of interventions (per trip) UNDERPASSSTAGGERED PELICAN CHANGE TO STRAIGHT PELICAN NOW REDUCE ONE LANE REDUCE TRAFFIC DENSITY REDUCE TRAFFIC SPEED OPTIONS ACTUAL SPEED 30MPH ACTUAL SPEED 20MPHACTUAL SPEED 30MPH ACTUAL SPEED 30MPH Traffic density: High Traffic density: HighTraffic density: MediumTraffic density: High £0.04 £0.95£0.88 £0.47£1.26
  • 32. Simulation tool: outputs Disaggregation by age, gender, and trip purpose
  • 33. Ed Parham | @Ed_Parham @Space_Syntax Director, Space Syntax #mendbarriers
  • 35. How do urban systems combine to create severance? How can this be measured? What does this mean for every day life? Who is affected by this? How can we overcome this at different scales?
  • 36. Space Syntax Limited © 2018 Integrated Urban Modelling Make better urban design and policy decisions by measuring how systems interact to affect daily patterns of use Integrated Urban Modelling Why, What and How? Road network Public Transport Network Pedestrian Routes Land use Population Census Data User focused outcomes: How many jobs can I get to in half an hour? Can I walk to a decent school or doctor? Am I close to shops, cafes, parks etc?
  • 37. Space Syntax Limited © 2018 Integrated Urban Modelling Option A Option B Option C Make better urban design and policy decisions by measuring how systems interact to affect daily patterns of use Integrated Urban Modelling Why, What and How? User focused outcomes: How many jobs can I get to in half an hour? Can I walk to a decent school or doctor? Am I close to shops, cafes, parks etc?
  • 38. Car dependence Car Dependence Car is equal to Public Transport Car is 1.0 x better Car is 1.0 - 2.5 x better Car is 2.5 - 5.0 x better Car is 5.0+ x better Space Syntax Limited © 2018 Integrated Urban Modelling
  • 39. Number of GP practices within 15 minutes of walking 12% of households do not have access to a GP practice within 15 minutes walk Access to services Space Syntax Limited © 2018 Integrated Urban Modelling
  • 40. Access to services Quality and Capacity Space Syntax Limited © 2018 Integrated Urban Modelling Number of GP practices within 15 minutes of walking < 75% ≥ 75% Overall satisfaction percentage missing data 0.63 – 5 5 – 10 10 – 15 Number of GPs per 1,000 registered patients
  • 41. Number of GP practices within 15 minutes of walking < 75% ≥ 75% Overall satisfaction percentage missing data 0.63 – 5 5 – 10 10 – 15 Number of GPs per 1,000 registered patients Access to services Deprivation Space Syntax Limited © 2018 Integrated Urban Modelling
  • 42. Social Isolation Score Car dependence vs Social isolation Car Dependence Car is equal to Public Transport Car is 1.0 x better Car is 1.0 - 2.5 x better Car is 2.5 - 5.0 x better Car is 5.0+ x better Space Syntax Limited © 2018 Integrated Urban Modelling
  • 43. Align pedestrian infrastructure with desire lines Movement patterns Strategic design Modelled impact Space Syntax Limited © 2018 Integrated Urban Modelling
  • 44. Align pedestrian infrastructure with desire lines Movement patterns Modelled impact Design Space Syntax Limited © 2018 Integrated Urban Modelling
  • 45. Align pedestrian infrastructure with desire lines Movement patterns Modelled impact Outcome Space Syntax Limited © 2018 Integrated Urban Modelling
  • 47. Jawad Sardar| @sardarj90 Director, Sum Global #mendbarriers
  • 48. Traditional Data Collection • Clicker counters • Traffic Count Devices • Business and customer surveys • Census/ONS
  • 49. • Mobile phone data • Transaction Data • WIFI Networks • Social Media data • Open Data (ONS) • Google Big Data
  • 50. Movement • Origin and Destination • Transport modes • Dwell times • Transits • Mobility patterns Big Data Insights Behaviour/Sentiments • Interaction with spaces • Views of users • Perceptions • Competition Economic • Transaction volumes and breakdown of types of transactions • Business Hours • Property market analysis
  • 51. • Project delivered by Habidatum, Vodafone India, Citilogik, KPIT Accessibility: Pune, India
  • 55. Moderated discussion • Tell us your name/organization • Keep your question brief! #mendbarriers
  • 56. Refreshment break Return to breakout sessions by 15:15
  • 57. Overcoming London’s Barriers Public health implications and approaches #mendbarriers SUPPORTED BY
  • 58. Paul Goulden | @PaulGoulden @Age_UK Chief Executive, Age UK London #mendbarriers
  • 59. Overcoming barriers for older people Paul Goulden, CEO, Age UK London
  • 60. Loneliness • Rising population • Increased health issues but . . . • Living better for longer?
  • 61. What causes loneliness? • Income • Frailty • Managing long term conditions • Mental as well as physical • Fear • Of the unknown • Of change • Of “worst case scenario”
  • 62. Health and social care impact • Crisis management, not planned journey • Unscheduled admissions • Once you’re “in the system” . . . • Cost and staffing pressures • Downward spiral and revolving door
  • 63. How do we address these fears? • Do you know your neighbour? • Digital inclusion • Intergenerational opportunities • Strong communities – physical and personal • Getting transport right!
  • 64. Oliver Davey | @umovewemove Design Engineer, Urban Movement #mendbarriers
  • 66.
  • 67. THE CONTEXT • The oldest population in London and the second highest with a severe physical disability • Junctions with the 2nd, 4th and 5th worst collision records on the Boroughs road network • The largest influx of children between 2010 and 2015 of any London Borough • Lower spend per person per month than comparable Metropolitan Centres such as Kingston and Bromley • Air quality hot spot • Crime hot spot
  • 68. • 3,300 new homes will be built, straddling the Ring Road, as part of the Romford Housing Zone • The people that will live in these new homes have yet to decide how they will travel • To maintain existing journey times on the Ring Road we want to give these new people viable alternatives to the private car THE FUTURE
  • 69.
  • 70. THE PROPOSALS • First Phase addresses the western side of the Ring Road, through the Housing Zone • Focus on reducing the barrier affect of the Ring Road and encouraging positive development • Replacement of existing subway networks with at- grade crossings • ‘Healthy Oases’ with new landscaping, public art, informal play, SuDS, seating and lighting • Free-flow, steady-state roundabout design • £7.13M budget
  • 71.
  • 72.
  • 73.
  • 74.
  • 75. Yvonne Doyle | @doyle_yg Director for London, Public Health England #mendbarriers
  • 76. Overcoming London’s barriers Public Health implications and approaches YvonneDoyleCB Director forLondon 21st June 2018
  • 77. The strategic aims of London government regarding devolution Investment in skills and innovation towards a high tech economy Home building across all types of tenure A safe capital city where business investors have confidence Faster reform of health and social care services, leading to improvements in health and reduction of pressures on public services Self financing growth and reform model London is required to deliver internationally competitive growth and to outpace other global cities, adding £6.4bn to the capital’s economy by 2030
  • 78. Since 2013 London’s health and caresystemhas been on ajourney
  • 79. From system turnover to joint (Commission) focus on London to partnership The public health journey since2013 • With ambitions and powers • Engagement across London • Governance led by the city’s Mayor… • ….And increasingly, others wanting to join
  • 80. Significant health challenges to address And these are driven by inequalities in wider determinants of health
  • 81. 83 London devolution pilot commitments Utilisation of capital and estates NCL ONEL HaringeyHackney LewishamLondon System finances: payment mechanisms and provider support Explore adaptation to provider regulation and inspection Workforce and skills Transformation of health and care services Public health: developing healthy and inclusive environments Employment and health
  • 82. Early sub-regional pilots in London – initial ambitions include integration on service, estate handling and prevention of ill health Lewisham integration: Developing a whole system model which fully integrates physical and mental health and social care, tailored and delivered to the whole population. Barking & Dagenham, Havering and Redbridge sub- regional health and care integration: Aims to develop an Accountable Care Organisation with full budget accountability. Haringey prevention: aims to embed best practice and test the limits of existing powers to promote prevention. It seeks to find the most effective ways of using planning and licensing powers to create healthy environments. The pilot will also identify new ways of supporting more people into sustainable employment. Hackney integration: particular focus on achieving parity between mental and physical health services. Exploring a single delivery organisation taking responsibility for Hackney’s whole population, with combined financial resources and a capitated budget. North Central London estates: Aims to develop the estate needed for new models of care. This will optimise existing assets and reinvest capital in health and care services which support wider benefits for local communities.
  • 83. Success and challenge: Health success The partnerships outlined in these slides have achieved a huge amount since 2013 in London and are recognised as leading on prevention The Mayor leads on the wider dimensions of health and is a major champion on inequalities Some population trends have improved and we expect this to continue London is increasingly viewed internationally as getting serious about population health Some exciting developments have occurred – led by multiple sectors. This is likely to continue
  • 84. 1. A ‘do once for London’ approach with clear governance is more likely to have impact. London health and care public sectors are working in this way with maturing partnerships. 2. Funding for prevention is meagre compared with treatment and care funding albeit return on investment is very high compared with many clinical treatments. Nevertheless those working on prevention have shown resilience and imagination in taking a range of work forward. 3. Some big challenges that require a system wide approach remain. These include: o Child and adolescent obesity levels (but progress at earlier ages) o Elements of mental ill health including the need for access to services o Poor lifestyles (eg low physical activity levels, smoking in deprived communities) o Early disability in adults especially those experiencing long term deprivation Work in progress
  • 85. Work in progress 1. Devolution is one of several approaches being used in the public sector in London to accelerate progress on preventing ill health, modernising out of hospital infrastructure, and integrating the service offers for those who have complex needs requiring many care inputs. 2. Devolution has offered permission to innovate with the wider environment (for example around schools, in high streets of deprived communities) to design health considerations into place shaping 3. The financial cost of this work is minimised by ‘sweating assets’ for instance complementary offers from partners, and seeking new sources of funding. 4. Prevention gaps identified for further consideration o Londoners feeling enabled to look after themselves o Digital solutions to the population o Engagement of the population (including children) in regular ways in the future of their health, their city
  • 87. Moderated discussion • Tell us your name/organization • Keep your question brief! #mendbarriers
  • 88. Remain in/return to this room for closing session #mendbarriers
  • 89. Dave Hill | @DaveHill London Commentator, OnLondon #mendbarriers
  • 90. Next steps • Networking drinks! • Field trips to Croydon, Lewisham, and Finsbury Park • Senior roundtables • …and new FoL projects starting this autumn
  • 91. Stay in touch @futureofldn Future of London futureoflondon.org.uk/subscribe

Editor's Notes

  1. Talk about some work we’ve been doing to make models of cities, and to use these models to build further tools that focus on health on top of. 3 key things – look at cities across scales – across systems – and to consider people These all have technical impacts (outcomes)/about format These are all aimed at making more walkable cities and encouraging active transport Has health benefits, but we also think cities that are better for health outcoems are better for a whole range of other outcomes too.
  2. IUMS Interaction between systems Can see how work in combination and each individually Can see what it means for day to day life
  3. Look at future growth of city and measure impacts Example of Jeddah – access to centres (employment, pt, social infrastructure)
  4. Display outputs however most useful – could be maps, could be graph – here profiling centres within 15 mins of every household And this makes the city easier for everyone to use, but to link this to healthy streets - BMJ article talks about links between obesity and public transport use, if you can plan a city so that it is easier to use public transport than private car its going to help this.
  5. Car dependency Just from physical systems – correlates with census data on commute to work Because have each system – streets, land use, density, public transport – can look at impact of changing each system Different way of working – Exeter example – frailty, obesity etc
  6. Impact on access to services Split by mode
  7. Add quality and capacity
  8. Question then of who lives where Where are highest risk populations Include census data Overlap access with deprivation
  9. Example again in MK Where is more car dependent Where are there likely to be older, more lonely people? If you cant change physical conditions, can you deliver services differently, or tailor policy to specific areas? License taxis etc?
  10. Smaller scale public realm improvements Align pedestrian infrastructure to patterns of movement Strategic design Model impact
  11. Smaller scale public realm improvements Align pedestrian infrastructure to patterns of movement Strategic design Model impact
  12. Smaller scale public realm improvements Align pedestrian infrastructure to patterns of movement Strategic design Model impact
  13. Helping the UK population eat a healthy diet is important given that diet is now one of the top causes of morbidity and mortality [Global Burden of Disease 2017] and one in five 5 year olds are overweight or obese and that this trend is not changed by the time children leave primary school when one in three are overweight or obese. And more adults (60%0 are now overweight or obese than of a healthy body mass index (BMI)