Innovate UK - Healthy Resilient Cities: Building a Business Case for Adaption

Lead Research Organisation: University of Bristol
Department Name: Civil Engineering

Abstract

The project is planned around 6 work main packages - see Gantt in Appendix B:
WPs1+2: Team meeting and interviews to identify stakeholders, data and scope. Development of city-systems analysis approach, integration of team's existing models with online systems mapping platform. City-systems workshop to map relationships, identify data required, and confirm project scope. Qtr 1 report setting out progress to date. Lead: db+a/UoBristol. 3 months. [DB:85/MY:27/AH:5/BHP:10/GCAP:6/UWE:2]
WP3: Source and re-format relevant data sets, GIS mapping and extraction of targeted data enquiries revealing vulnerabilities to populate economic valuation work. Lead: db+a/BCC. 3 months. [DB:20/AH:5/BHP:5/BCC:10] WP4: Development of economic valuation models, including quantification of potential climate impacts within envelopes of confidence. Value testing of model outputs through a series of interviews with relevant senior level stakeholders (e.g. risk managers). Finessing of data extraction and economic valuation re-modelling following feedback. Lead: UoBath/db+a. 3 months. [DB:20/AH:25/BHP:5/BCC:5]
WP5: Second large interactive systems analysis workshop and follow up interviews with relevant local decision- makers and national/international influencers to capture impact of evidence on decision-makers (e.g. risk committees) to identify second stage actions and tipping points including sketching out changes in resource commitment. Final report and strategic recommendations for end users, documentation of process methods and reflection on the process of developing the prototype. Review through Advisory Panel workshop. Lead: db+a/UoBristol. 3 months with lead in for invitations. [DB:40/MY:20/AH:4/BHP:5/GCAP:4/UWE:1]
WP6: Large market assessment workshop aimed at local authorities, clinical commissioning groups, and health and wellbeing boards. Lead: db+a. Time: overlapping with WP5. [DB:35/MY:5/AH:5/BHP:5/GCAP:4]
This a large consortium with collaborating sub-contractors, advisors, and a wide range of stakeholders taking part in the market assessment, requiring considerable liaison, coordination and management by db+a. We do not have rival technologies as much as potential competing consultancies. Our approach offers a better outcome given the industry-leading quality of the consortium and the unusual level of interest from and access to the wider market.

Planned Impact

The primary direct beneficiary of this feasibility study is the Bristol Health Partners consortium, whilst other direct beneficiaries include the stakeholders involved in - or affected by - the activities of the Health Partnership. The potential indirect beneficiaries include all those organisations that use the diagnostic tools to be developed by the proposed study. The University of Bath is responsible for the application of the adaptation cost-benefit analysis tool proposed in the study. In the first instance, these are envisaged to be other health partnerships though the generic components of the tools will allow straightforward application to all organisations who identify climate change risks as potentially significant to their activities.
Bristol Health Partners will be engaged by being included as a partner in the study. Thus, personnel from the Partnership will be involved in the development of the tools from the outset. The personnel will therefore be consulted at each decision point in the research such that all aspects regarding their usability and usefulness as diagnostic tools in the management of climate risks are optimised. We plan that telecommunications (e-mail, phone, Skype, etc.) will facilitate day-to-day contact between the academic partners and the Partnership, in additional to the formal workshops and meetings planned for the course of the study. This process will begin in Month 1 and continue over the twelve months of the study. In the formulation of this prospective study it has been established that the Partnership will not only work with the other project plans to specify the climate risks of most significance to their activities, but also to supply the tool developers with sufficient data to appropriately populate the tools and facilitate their operation.
The stakeholders associated with the Partnership will have an input into the design of the tools via the planned workshops as well as in subsequent bilateral contact, as requested or required. Via these communication routes they will help to maximise the efficacy of the tools. The up-take of these tools beyond the period of the feasibility study will be a function of their perceived usefulness in relation to their cost. Their up-take and use will be promoted and tracked by the co-ordinating partner.
The Researcher from Bath University, (Dr Alistair Hunt), will be responsible for the application of the adaptation cost-benefit analysis tool and will therefore be directly involved in communications with potential beneficiaries over the course of the study. Dr Hunt has been involved in a number of activities with the UK Climate Impacts Programme and Defra, including the development of guidelines for costing climate change impacts, which have required extensive stakeholder engagement through a series of participatory workshops. The impact activities to be undertaken by Bath University will be supported by the personnel costs requested for Dr Hunt, together with the associated travel and subsistence costs. Dr Mike Yearworth (University of Bristol) is an expert in Problem Structuring Methods (PSMs) and a skilled facilitator of group model building workshops. He has carried out extensive research in developing systems modelling methodology and has applied this research primarily in the energy, waste and transport domains. Recent outputs from this work are indicated in Dr Yearworth's CV. He will lead the key stakeholder participation engagements in the project.
 
Description The economic valuation suggests that Bristol could experience very significant impacts from climate change over the next 25 years (e.g. £2.9bn from flooding, £800m from overheating). Using this evidence as an indicator of potential scale of risk, we have been successful in securing meetings and presentations with Executive Directors, who in turn have expressed a firm interest in this work and have agreed to: a) promote modest immediate change at organisational level and b) to promote this work through the Bristol Health Partners Executive Board at city level.
There is a strong need to present this work through Bristol Health Partners. Acute Trusts are normally under pressure and are under particular pressure at the moment. They operate to 1-5 year planning horizons and can't see further than that in their existing governance structures. Furthermore, it is recognised that these costs impact not just on one organisation, but across the city as a whole. One of the first questions from Executive level at the individual trust was around the scale of impact on each individual organisation. As the costs are aggregated there is an initial piece of work to be done on 'attribution' to understand the scale of input needed from each partner. This needs to come from Bristol Health Partners.
In addition to ongoing conversations at Exec Director level, the augmented market research work, not least the final conference, have all been giving us a much better idea of how best communicate these findings and even how to navigate the process of decision-making. The economic evidence is a vital estimate of the scale of risk, but financial metrics are not the only metrics used for decision making and in order to stimulate action, decision-makers need not just the threat, but also an idea of where to move to avoid it.
There are multiple recommendations over and above the attribution of scale of impact across the partner organisations, not least 1) a more detailed analysis of available data, 2) the possible need for new data, 3) the integration of this information via the emerging Sustainability and Transformation Plans; and 4) proper use of existing laws (e.g. Social Value Act, Civil Contingency Act).
There is also a need to connect with each decision-makers values, over and above just their concerns around finance and law.
The specific outcomes so far are:
1) Based on the evidence we provided, the Executive Director for Strategy and Transformation at the University Hospitals Bristol NHS Foundation Trust has agreed to form an expanded Sustainability Forum that includes representatives from risk, finance, operations and estates in order to start examining more closely this issue at a strategic, cross-departmental level.
2) She has also agreed to be the lead Executive representing this work when we present to the Bristol Health Partners Executive Board at the end of October.
3) db+a have been invited to give keynote speeches at conferences for Public Health England, Joseph Rowntree Foundation (July 2016) and at the NHS's National Performance Advisory Groups for Sustainability Leads (Sept 2016) and Resilience (Feb 2017).
4) The Department of Health working closely with Public Health England and the NHS Sustainable Development Unit (SDU) have expressed strong support for this project and we are working with them to promote the findings of the case study. The Head of the SDU gave a keynote at our final conference.
5) db+a are in discussions around a formal partnership arrangement with engineering firm, Buro Happold, and are exploring opportunities with significant 'mid-level' accountancy firms
Exploitation Route Other than what has been set out above (i.e. awaiting response from Bristol Health Partners, exploring partnerships and legal frameworks) the key action is to return to the social housing sector, which was out of action last year due to welfare reform, and test the level of interest there, as well as following up with all the contacts within the health sector we have now made. We will be looking for opportunities to speak at relevant events all with the aim of securing meetings with Executive Directors with whom we can present the findings of these case studies.
Sectors Environment,Healthcare
 
Description We set out to: a) quantify the potential costs of climate change to Bristol's health sector, then b) to use that evidence to raise climate change significantly up the agendas of the Bristol Health Partners' member organisations. Following the production of the economic evidence (end Q3), we immediately achieved 'buy-in' from the Executive Director for Strategy and Transformation at University Hospitals Bristol NHS Foundation Trust in early Q4, who has now agreed core strategic action internally within her organisation, and to table the need for action at city level via Bristol Health Partners' Executive Board. We have also achieved considerable support from national agencies: the NHS Sustainable Development Unit; Joseph Rowntree Foundation; Public Health England; the Adaptation Sub-Committee; Department for Health; NHS Supply Chain. We were given keynote speaking slots at a joint Joseph Rowntree Foundation/Public Health England conference in Leeds in July, and at the National Performance Advisory Group's NHS Sustainability Leads Network meeting in London in September. The gaps are predominantly in the latter stage exploration of end user response and market research. Deliverables are multiple: reports from interviews; systems maps of stakeholders and decision processes; multiple presentations; data report; systems modelling report; economic valuation report; project report with strategic recommendations.
First Year Of Impact 2016
Sector Environment,Healthcare
Impact Types Policy & public services
 
Description Final Stakeholder Event 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The impact of this feasibility study, as reported in this event, is that we have raised climate change from it being a marginal issue only dealt with by relatively junior officers through regulation and compliance (e.g. emergency preparedness, ISO standards, energy savings) to a significant potential issue that is responded to strategically with sponsorship from Executive Director level. The market potential is significant; as far as we are aware there is no one else offering this kind of service. With this information, we could help trigger a sea change in activity in this area, significantly expanding the market for products and services in this space. The societal potential is vast if predictions around climate change impacts are accurate. We would like it to enable full and robust response to the threat of climate change impacts from organisations, which are currently constrained by short-term governance structures.
Year(s) Of Engagement Activity 2016