Covering more than 9% of the total land area England’s ten National Parks comprise some of the highest quality landscapes and wildlife habitats in the country, forming part of our national identity and contributing to our economy and society. They are of huge importance to the people who live and work within them, as well as those who live outside and who benefit from a wide range of services such as clean water as well as the attractions that bring 90 million park visitors each year. Tourism, recreation, farming and forestry are the largest contributors to National Park economies, but other sectors are significant and together provide around 50% of total National Park employment, which grew by 2.7% in 2012.

John Dyke, Chair of National Parks England, describes the economic and other benefits of National Parks:

“English National Parks contribute between £4.1-£6.3bn to the economy through economic activity within their boundaries. That’s equivalent to the UK aerospace industry. This report really shows the great value of National Parks to the economy and National Park Authorities’ role in supporting rural communities and businesses. It also reminds us of the other benefits National Parks provide – clean water, stunning landscapes, wildlife habitats, a place to relax or to be active to name but a few. These are hard to put a figure on but immensely important to us all as are the economic benefits that flow from them.”

Contributing to national prosperity and well-being

The Vision for English National Parks in 2030, published by the Government and the English National Parks Authorities Association (now National Parks England) in 2010, stated that National Parks “will be recognised as fundamental to our prosperity and well-being”.

The report presents examples of how National Park Authorities are already responding to the priority for growth, from hydro-power schemes in the Yorkshire Dales and new cattle market facilities in Exmoor to improvements to water quality in the South Downs and work with young offenders in the Norfolk Broads.

The latest economic and socio-economic data relating to the National Parks are also presented, in order to assess the contribution of National Parks to economic prosperity and well-being, and to identify future opportunities for National Park Authorities to further support sustainable rural economies in partnership with local communities, businesses and local government partners.

Public spending on National Parks via the National Park Grant is less than £1 per person per year. National Park Authorities increase the value of this spending by bringing in around 50p per person in funding from other sources. The report argues that, with sufficient core funding and the support of partners, the National Park Authorities will be able to continue to help National Park economies to grow in a sustainable way and contribute to national prosperity and well-being.

The report identifies fifteen key opportunities for National Park Authorities and partners to address the challenges facing National Parks and realise the economic opportunities:

1. Developing and applying the brand
2. Supporting stronger and more sustainable farming and forestry
3. Promoting sustainable tourism
4. Working more closely with businesses
5. Further developing positive development management and community led planning approaches
6. Progressing economic development by closer working with Local Enterprise Partnerships and Local Authorities
7. Developing appropriate infrastructure to support economic growth
8. Creating pathways to employment
9. Promoting a low carbon approach and developing renewable energy
10. Delivering and rewarding the providers of ecosystem services
11. Further partnership working to deliver National Park purposes
12. Leveraging further funding and exploring other income-generating opportunities
13. Delivering European and national environment, heritage and regeneration programmes at local level
14. Raising the profile of National Parks as contributors to economic growth
15. Developing the evidence base relating to the economy and economic growth

Further resources

• Valuing England’s National Parks: full report, summary and infographic available to download

A short film, Natural Park, Natural Assets accompanies the report:

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• News round-up: fish discards, agroforestry, endangered species, Environment Agency, Natural England
• Securing the value of nature in English national parks
• Sustainable Development in England’s National Parks

Increasing life expectancy is putting our health and social care systems under more pressure than ever before as more people need continuous care and support, with the right systems and resource in place to enable it. Many people are living longer but with complex conditions – like diabetes, asthma or heart disease – that need constant care and attention. Children born with complex conditions are now living to adulthood, while those with learning disabilities and other groups have lifelong needs.

In the first ever system-wide ‘shared commitment’, twelve national lead organisations in health and care have come together to build a system of integrated care that can provide care and support built around the needs of the individual, their carers and family and that gets the most out of every penny spent. By helping to prevent illnesses, properly manage complex conditions, avoid falls and other accidents, an integrated approach can offer better care for the individual with less pressure on the system.

The ultimate aim is to improve the outcomes and experiences of individuals and communities through personalised care and support, an increased focus on primary and community care, and population-based public health.

Defining integrated care

With over 175 different definitions of “integration” in the published literature, a common language and a shared understanding of the term “integrated care and support” is essential.

National Voices, a national coalition of health and care charities, developed an agreed definition or ‘narrative’ of integrated care to provide a guide to the sort of things that integrated care will achieve, such as better planning, more personal involvement of the person using services, and free access to good information. The headline definition aims to describe something that an individual person would recognise as integrated care and support:

“I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.”
Narrative of integrated care, National Voices

A more detailed understanding of this headline definition describes an individual’s experience of person-centred, coordinated care and support using a series of generic “I” statements, such as ”I tell my story once”.

Committing to integrated care and support

Integrated Care and Support: Our Shared Commitment sets out how local areas can use existing structures like Health and Wellbeing Boards to bring together local authorities, the NHS, social care providers, education, housing services, public health and others to make further steps towards integration.

The plans, which will be delivered by national leaders and local areas working closely together, include:

• An ambition to make joined-up and coordinated health and care the norm
• The first ever agreed definition of what people say good integrated care and support looks and feels like, developed by National Voices
• New ‘pioneer’ areas around the country to be announced in September 2013
• New measures of people’s experience of joined-up care and support by the end of this year

Partners involved in this initiative include the Association of Directors of Adult Social Services (ADASS), the Association of Directors of Children’s Services, the Care Quality Commission, Department of Health, Local Government Association, Monitor, NHS England, NHS Improving Quality, Health Education England, the National Institute for Health and Care Excellence, Public Health England, the Social Care Institute for Excellence and Think Local Act Personal in association with National Voices.

Putting people first

The commitment recognises that national and local organisations need to take urgent and sustained action to make integrated care and support happen.

The focus is on person-centred coordinated care and support as key to improving outcomes for individuals who use health and social care services, in the context of recent reforms to the health and care system, which have enabled local communities to increase focus on commissioning and ensure the kind of care and support that best meets their needs, with local practitioners at the fore.

Launching the commitment Care and Support Minister Norman Lamb explained:

“People don’t want health care or social care, they just want the best care. This is a vital step in creating a truly joined-up system that puts people first. Unless we change the way we work, the NHS and care system is heading for a crisis. This national commitment to working together is an important moment in ensuring we have a system which is fit for the future.”

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• Consulting on a new sustainable development strategy for health and social care
• Adapting to tomorrow’s climate in health and social care

Figures from the first Community Life Survey show an increase of 9% in regular volunteering, reversing a steady decline since 2005. The proportion of people volunteering at least once a year also increased, from 65% in 2010-11 to 71% in 2012.

The survey also found high, and in many cases increasing, levels of belonging and community spirit:

• 55% reported a very strong sense of belonging to Britain, an increase from 51% in 2010
• 79% of people reported they belong strongly to their neighbourhood
• 84% are satisfied with their local area as a place to live
• 87% of people report that their local area is one where people from different backgrounds get along well together
• 48% want to be more involved in local decisions, a significant increase from 2010
• 19% took part in some form of civic consultation about local services or problems in the last year
• 53% agree that they borrow things and exchange favours with their neighbours

Other findings from the survey showed consistent levels of charitable giving and trust:

• 74% made donations to charity in the four weeks prior to the interview, up from 72% in 2010
• 42% think most people can be trusted

The full findings are available to download and through an online dashboard:

Encouraging involvement in local communities

Ministers see the figures as a vindication of the Big Society agenda to support people to get more involved in their communities. Minister for Civil Society Nick Hurd said:

“These figures show a very positive picture of how well Britain has responded to tough times. We should take pride that so many people have helped reverse the decline in volunteering.

“”London 2012 showed what we can achieve through volunteering and we are determined to build on the inspiration of the games.””

The government has backed a number of other initiatives to engage a new generation in volunteering and civic engagement, including:

• Social Investment: Big Society Capital: The first social investment institution of its kind in the world – launched with up to £600m to build the social investment market. Over £55m of investments already committed for projects to support local communities. The UK is leading the world on Social Impact Bonds. There are now thirteen operational SIBs.
• Community Organisers: Over 700 organisers and volunteers have been trained to give communities the help they need to take control and tackle their own problems.
• Social Action Fund – new volunteering opportunities: Through the Social Action Fund the Government has supported 40 charities with over £20m over the past two years so that they can recruit more volunteers. So far, over 100,000 volunteers have been recruited with half million expected by Autumn 2013.
• National Citizen Service: Supporting teenagers to gain new skills and give over 700,000 volunteering hours to the community. NCS will triple in size to offer one in six the chance to take part by 2014. The service has supported over 34,000 participant, and 93% would recommend NCS to a friend.
• Join in: Inspired by the London 2012 Games, 300,000 people were able to participate in over 6,000 events across the UK thanks to Join In – the new Olympic volunteering legacy programme set up to keep the spirit of the Games makers alive.

As the statistics were published the Prime Minister launched a new drive to recruit one million volunteers to support people with dementia, in conjunction with the Alzheimer’s Society, and welcomed the progress on volunteering:

“We all want a bigger, stronger society where people do their bit and that’s why I am pleased that the Community Life Survey shows we are making progress. The figures show that millions more people are volunteering and that the British people remain incredibly generous with charitable giving.

“We want to build on this success and make it easier for people who want to get involved. That’s why I am proud to be launching the effort today to get one million new volunteers trained to support people with dementia.””

Further reading

• Community Life Survey: full findings, excel tables and survey outputs
• Promoting social action: encouraging and enabling people to play a more active part in society: detail and news of the Government’s policy on social action

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• London’s quality of life improving
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The London Sustainable Development Commission’s 2012 London Quality of Life Indicators Report finds that overall quality of life for Londoners is getting better despite the recession and record population growth over the past 10 years.

The report’s indicator set encompasses 33 headline indicators across the environmental, social and economic spheres – from energy use, air pollution and traffic volumes to life expectancy, happiness and employment levels. The majority of the indicators have improved in the past three years.

Falling traffic, waste and emissions

Despite London’s population increasing by more than 850,000 people in the last decade, traffic volumes dropped by seven per cent between 2003 – 2010, with 1.5 billion fewer vehicle journeys between 2009-2012, and total household waste fell from 3.4 million tonnes in 2006-7 to 3 million tonnes in 2010-11. CO2 levels have fallen by almost one tonne per capita since 2009.

Improving education and stabilising employment

The proportion of pupils obtaining at least 5 GCSE passes at A*-C or equivalent has increased by 29% since 2004.

Employment levels have stabilised at around 69 per cent during the last three years and there is evidence that the employment rate for London has been increasing since mid 2009. While one-year and three-year business survival rates are down, 60% of London businesses started in 2007 were still trading three years later. London has a 19 per cent market share in the green jobs sector in the UK and 0.7 per cent of global market share. Jobs in the green economy rose slightly between 2008-09 and 2009-10.

In 2012, 22.9 per cent of firms in London reported introducing product innovations, a rise from 20 per cent in 2009. In the same year, 13.2 per cent of London firms reported introducing process innovations, also a rise since 2009 when levels were at nine per cent.

Increasing life expectancy

Life expectancy has also improved for both men and women with males’ life expectancy increasing to 79 years from 77.4 and females up to 83.3 years form 82. Both figures compared 2008-10 with 2004-06 data.

Room for improvement

Not all areas of life have improved during the past decade. The cost of childcare has risen whilst its availability has decreased. Between 2009-2011 the number of childcare places for under eights per 100 children has declined by just over four per cent and London has the highest childcare costs of all regions in the UK. The affordability of housing continues to be a problem – affordability has more than halved in the capital since 1997 and London homes were also 37 per cent less affordable than the national average.

Working to be the best big city in the world

London is the only major world city to produce such a comprehensive report examining all aspects of life across the three main themes of environment, economy and social progress. The LSDC produced the first Quality of Life Indicators Report in 2004 and subsequent reports were produced in 2005 and 2009. The report provides baseline data that will inform the Commission’s future work programme and advice to the Mayor, contributing to his aspiration for London to be the best big city in the world:

“The London Sustainable Development Commission supports this aspiration and believes that as part of being ‘best’ we should work to make London the benchmark for sustainable cities by 2020. To improve our chances of achieving this we need first to know what this would mean in economic, environmental and social terms; where we currently stand; and then measure progress against these issues.”

Mayor of London Boris Johnson welcomed the report:

“This snapshot of London life underlines that despite the economic difficulties of the last few years, the capital continues to thrive and can justifiably lay claim to be the best big city in the world to live, work and do business in.

“London is a great place to invest – air quality is improving, we’re one of the greenest capital cities and we have a well educated and highly-skilled workforce.”

LSDC Commissioner Dr Paul Toyne who has lead on the report for the Commission said:

“As a Londoner and London resident, sustaining the best possible quality of life is something I am passionate about. Improving it without losing the unique and vibrant identity of this city is key.

“The challenge remains to transform London into a more sustainable city. One that will safeguard us against the potential environmental, social and economic disruption that will affect our health, well-being, community spirit and economic viability.

“Despite the general evidence pointing to overall quality of life improvements there are large variations borough by borough. For London to really progress we need to ensure the quality of life improves for all Londoners, regardless of gender, background and where they live – the goal must be for an inclusive approach offering opportunities for all.”

Further reading

• London’s Quality of Life Indicators 2012 Report: summary report, full report and data available to download
• Past reports

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• An index for a better life
• Healthy lives, healthy people: improving public health outcomes
• New contract for rural economies, communities and quality of life

What’s good for the environment is good for us sets out the evidence base that integrating pro-environmental understanding, values, and behaviours into our daily lives also has distinct benefits for our own wellbeing.

The Waste Watch approach

Waste Watch’s aim is to help people to waste less and live more, underpinned by a belief that improving our environment is a positive message that goes hand in hand with improving our wellbeing and happiness in life. Through its programmes Waste Watch works to show communities, schools, organisations and government how.

The report demonstrates how people can reduce waste whilst living more fulfilling lives that improve our health, wellbeing and happiness. The approach is about bringing people together to share more, to learn new skills, and to build stronger communities that actively care for each other and the planet.

Waste Watch sets out to learn and innovate from best practice and knowledge in order to develop, trial and monitor next practice programmes.

Five ways to wellbeing

The report methodology uses the New Economic Foundation’s Five Ways to Wellbeing – developed for the 2008 Foresight Project on Mental Capital and Well-being – as its framework. For each of the “five ways”, related activities are suggested:

• Connect: Connecting with the people around you, no matter where you may be, family friends at home, at school, at work or in your local community. Building these relationships are important for enriching your life.
• Be Active: Find a physical activity that you enjoy and you can build into your life, take time to get outside and go for a run or a walk, garden or get dancing.
• Take Notice: Take time to be aware of the world around you, reflect on what you see, hear, taste. Be curious and observe the changing seasons and think about what really matters to you.
• Keep Learning: Don’t be afraid to try something new, it’s never too late to take up a new hobby or learn a new skill, play an instrument or take up a language. This can not only increase your confidence but can be great fun.
• Give: Giving can be as good as, or often better than receiving. Thank a friend, smile, volunteer in your community, and help a stranger. Your wellbeing is linked to those around you so supporting here can be rewarding.

Encouraging others

This report is intended to provide an introduction to this work, highlight key results, and provide an insight to the practical application of monitoring wellbeing. Waste Watch is calling on other organisations to simultaneously monitor and celebrate both the environmental and social outcomes their work can enable.

The report offers recommendations to support organisations looking at measuring wellbeing and practical insights for building a monitoring and evaluation framework. These include not only practical insights such as trialing any monitoring and evaluation first on a smaller scale, but also recommendations on the importance of capturing qualitative responses to enrich the data and explore unexpected outcomes.

Further reading

• What’s good for the environment is good for us: more information and summary report available to download

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• Natural Environment White Paper, one year on
• Our changing diet in difficult times: report launch

New public health guidance from the National Institute for Health and Clinical Excellence (NICE) examines how – and why – to increase the level of walking and cycling in the UK, detailing the multiple, overlapping benefits that increases in exercise can yield in many different areas of public policy.

The new guidance complements previous NICE guidance in this area, covering the changes needed in the national physical infrastructure, national fiscal measures and injury-reduction strategies.

Accessible health benefits

NICE recommends targeting walking and cycling as an efficient way of accessing the health benefits of exercise because they are already, respectively, the first and fourth most common recreational activities undertaken by UK adults and are thus already familiar to most people. Walking and cycling are also free or cheap forms of exercise that are widely available.

Small increases in physical activity are strongly positively linked with a wide range of health benefits, the most prominent being reduced risks of coronary heart disease, strokes, cancer, obesity and type 2 diabetes. In addition, exercise has been shown to provide well-being benefits for individuals. Despite this, a small minority of the population achieves regular exercise.

‘Only six per cent of men and four per cent of women achieved at least thirty minutes of moderate or vigorous activity on at least five days…’

The case for increased exercise levels as a major source for improving public health has been incorporated into new national physical activity guidelines issued by the Chief Medical Officers of England, Scotland, Wales and Northern Ireland in 2011.

Social and environmental benefits

Increasing walking and cycling rates offers a wide range of other social and environmental benefits and can create virtuous cycles of outcomes.
Perhaps the most obvious are reductions in car use and corresponding environmental gains. These gains can be split broadly between reductions in carbon emissions which help to deliver on climate change mitigation, and air pollution reductions that significantly improve localised air quality, particularly in urban areas where human populations are more highly concentrated. This air quality improvement then feeds back into further health benefits for populations who spend a much of their lives in those environments. And this may be a significant gain; the report notes that air pollution probably reduces UK average life expectancy by 7-8 months and causes 50,000 premature deaths per year.

‘‘Unless otherwise stated, the recommendations will benefit everyone”

Economic gains

The publication points out that there is no conflict between the health benefits of the policy and its economic outcome, indeed there seem to be some clear economic gains from reductions in road traffic. For example the DfT estimates the cost of road congestion to be over £10billion per year. There is also evidence that improvements in the walking environment leads to increases in economic activity and resulting increases in commercial rents and local property prices.

At the same time as providing clear gains in the spheres of health and environment, and offering some potential economic gains, the guidance argues that increased levels of walking and cycling can also improve the social quality of public spaces by increasing the numbers of people using them. This not only makes streets safer but increases the feeling of safety, another virtuous cycle of increased use, especially for vulnerable groups. The report also highlights some of the smaller gains such as a reduction in noise to be had from quieter roads.

‘‘Bicycles are used for around 2 % of journeys in Britain – compared to about 26 % in the Netherlands… Yet of all trips made in Great Britain in 2009, 20% covered less than one mile…”

Ten detailed recommendations are set out, taking a detailed route through various elements of implementation. Recommendation 2 (“ensuring all relevant policies and plans consider walking and cycling”), for example, includes a list of 20 agencies or stakeholder groups who need to be considered when pushing through a plan to increase walking and cycling and 15 issues that they will need to take into consideration or that may be effected by the issue. All this is augmented by substantial appendixes providing information on cost effectiveness and gaps in the research picture.

Fighting the “inactivity pandemic”

Countless bodies have come out on the side of active travel as the healthy way to go, not least the medical journal, The Lancet, which last year pointed to the global ‘inactivity pandemic’. NICE’s latest authoritative and comprehensive examination of the importance of activity in preventing ill health gives us all the evidence we need to start the activity revolution.

Implications for health, transport, planning, neighbourhood design and air quality

NICE was formed to standardise health policy in the UK and its solidly empirical approach wields considerable power. The NHS in England and Wales is legally obliged to provide funding for medicines and treatments recommended by NICE’s technology appraisal board.

NICE guidelines are based primarily on evaluations of efficacy and cost-effectiveness in various circumstances, in three areas;

1. The use of health technologies within the NHS (such as the use of new and existing medicines, treatments and procedures)
2. Clinical practice (guidance on the appropriate treatment and care of people with specific diseases and conditions)
3. Guidance for public sector workers on Health promotion and ill-health avoidance.

This publication on walking and cycling falls into the third category above and speaks directly to public health professionals. However its comprehensive nature and the stature of NICE guidance means that this publication has value for those working in transport, planning, neighbourhood design and air quality as well as those with a focus on the health co-benefits to be gained from behaviour that benefits the environment.

Further reading

• Walking and Cycling, local measures to promote walking and cycling as forms of travel and recreation (NICE Public Health Guidance 41)

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• Adapting to tomorrow’s climate in health and social care

The Better Life Index offers an interactive and visual comparison of well-being across countries. The aim is to involve citizens in the debate on wellbeing, and to empower them to become more informed and engaged in the policy-making process that shapes all our lives.

The tool allows users to compare well-being across countries, based on 11 topics the OECD has identified as essential, in the areas of material living conditions and quality of life. The topics can be individually weighted according to the priorities of the users and results compared by country, gender and across social and economic status.

Your Better Life Index currently profiles the 34 OECD member countries as well as key partners Brazil and Russia, and will eventually include other key OECD partner countries (China, India, Indonesia and South Africa), representing the world’s major economies.

More than economic statistics

Since it was founded in 1961, the OECD has sought to help governments design better policies for better lives for their citizens, providing a forum in which leaders and policy makers can work together to share experiences and seek solutions to common problems. The OECD also produces a range of internationally comparable statistics used to help understand what drives economic, social and environmental change.

GDP has always been the main factor by which the OECD has measured and understood economic and social progress. More recently, recognising that GDP has failed to capture many of the factors that influence people’s lives, the OECD has become involved in the debate on well-being.

The wellbeing debate addresses the question of whether wealth is all that matters, or if we must also consider other issues like the balance between work and the rest of our lives.

“There is more to life than the cold numbers of GDP and economic statistics”

Essential indicators

The index is based on 11 topics the OECD has identified as essential, in the areas of material living conditions (housing, income, jobs) and quality of life (community, education, environment, governance, health, life satisfaction, safety and work-life balance).

Each topic is built on one to three specific indicators. For example, the jobs topic is based on four separate measures: the employment rate, personal earnings, the long-term unemployment rate and job security.

The current indicators reflecting current material living conditions and quality of life will in future be complemented by indicators describing sustainability of well-being over time, informed by the priorities of users. The data will be updated over time.

The data mostly come from official sources such as the OECD or National Accounts, United Nations Statistics, National Statistics Offices. A couple of indicators are based on data from the Gallup World Poll a division of the Gallup Organization that regularly conducts public opinion polls in more than 140 countries around the world. More than 80% of the indicators in Your Better Life Index have been already published by the OECD.

Further information

• Better Life Index: available online

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• Measuring national well-being: first results, exploratory articles, interactive tool and map

The Doha declaration on climate, health and wellbeing highlights the effects of climate change on both current and future health, the cost to health of carbon, and the immense health and economic ‘co-benefits’ of meaningful climate action.

The signatories – over 80 health medical organisations, including the UK’s Royal College of Physicians and Royal College of General Practitioners, alongside over 1,200 individuals – are seeking the protection and promotion of health as a central priority of global and national policy responses to climate change, calling for:

• The health impacts of climate change to be taken into account domestically and globally
• Investment in climate mitigation and adaptation to be significantly increased on a rapid timescale
• The health sector and the community to be engaged and informed on climate action

Calling for action

Speaking at the launch of the declaration Dr Cecil Wilson, President of the World Medical Association, set out its importance:

‘The declaration is an important statement from leading health organisations around the world and builds on last year’s successful climate change health summit. The statement illustrates why we are extremely worried about the slow progress at the international climate change negotiations and it highlights the health benefits of tackling climate change.

‘The world’s leaders still do not appear to recognise the impact on health as a result of climate change. If these health implications continue to be overlooked, the world population will be exposed to serious consequences. It is time for the world’s leaders to show leadership and to act now before it is too late.’

Health as a driver for mitigation and adaptation

The declaration asserts that the impact of climate change on health is one of the most significant measures of harm associated with our warming planet, and argues that protecting health is one of the most important motivations for climate action.

Climate change is affecting human health in multiple ways: both direct – through severe weather events, food and water insecurity and infectious diseases – and indirect – through economic instability, migration and as a driver of conflict. Direct health impacts like vector-borne diseases, heatwaves, drought or flooding, are relatively widely recognised, but severe weather events can also cause food insecurity, leading to increased migration and even civil conflict.

The declaration argues that urgent and sustained emissions reductions as well as effective adaptation are needed to counter the risks to health from climate change, which will particularly affect children, women and poorer people and those in developing nations.

Climate action for health benefits

The declaration offers a positive message that climate action has the potential to deliver many benefits to health worldwide:

“Reducing fossil fuel consumption simultaneously improves air quality and improves public health. Shifting to cleaner, safer, low carbon energy systems will save millions of lives each year. Moving to more active lifestyles and expansion of and access to public transport systems can improve health through increased physical activity and reduced air pollution. Improving insulation in homes and buildings can protect people from extreme temperatures and reduce energy consumption. All of these changes will provide significant economic savings.

“Climate action that recognises these benefits can improve the health of individuals and communities, support resilient and sustainable development, and improve global equity.”

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Building the UK’s resilience to climate change is an economic, social and environmental challenge that cuts across every sector of society. To help meet this challenge Defra is developing the National Adaptation Programme (NAP).

NAP will address the risks from climate change set out in the first UK Climate Change Risk Assessment.

From our archive
» UK Climate Change Risk Assessment: The UK Climate Change Risk Assessment (CCRA), published on 25 January 2012, builds on the 2009 UK Climate Projections to develop our understanding of climate risk and provide detailed analysis of the practical implications of climate change across all sectors of the economy and society.

The first NAP is due to be published in 2013, with subsequent reviews every five years, and will focus on helping UK businesses, local authorities and civil society to become more resilient to climate change impacts, working towards a “Climate Ready UK”:

“A society which makes timely, far-sighted and well-informed decisions to address the risks and opportunities posed by a changing climate.”

NAP will reflect new and current or ongoing policies within Government which are being proofed against climate risks, but equally Defra wants to encourage awareness and action beyond central government players. Working alongside businesses, local authorities and civil society, Defra hopes to stimulate innovative policymaking and to empower a wide variety of non-government organisations to take responsibility for finding the best solutions for their sector.

Social vulnerability and community resilience

Health and wellbeing is one of five core themes in the National Adaptation Programme, and includes building community resilience and addressing social vulnerability:

“Climate change could have significant implications for the health and wellbeing of the UK population. There are implications for public health, the continuity of health and social care services both within the NHS and beyond, the resilience of local emergency services and the impact on the most socially vulnerable. Although there may be some extremely welcome benefits, these are projected to be outweighed overall by a range of negative effects.”

Proposed aims for this theme are to create:

“A health service, public health and social care system resilient and adapted to a changing climate”

And:

“Local resilience structures and capability take account of, and are resilient to, a changing climate”

Defra is already working in partnership with local authorities and civil society groups to support projects championing resilience to climate change impacts for the most vulnerable in society by strengthening capacity, capability, tools and guidance.

Mapping the needs of BME communities in Manchester

MC-UK is leading a project to map the needs of BME (Black and Minority Ethnic) communities impacted by changing climate across Greater Manchester, focusing on two particularly vulnerable communities: older people and the refugee and asylum community.

In its first phase the project will map the needs of BME older people and refugees and asylum communities to understand concerns, difficulties and solutions relating to the impact of changing climate on them and their families and friends in their countries of heritage.

The project will subsequently work to build capacity, raise awareness and empower the communities to address climate change impacts, through a creative toolkit and practical workshops. A final report will gather feedback from the project to offer recommendations for future action.

Building social resilience to heat and flooding in Islington

The Climate Resilience Islington South Project (CRISP) will explore the level of social resilience against climate impacts and principally heat and flooding, alongside education elements addressing vulnerability to air pollution and sun exposure. The project will investigate and ‘market-test’ a number of solutions around the optimisation of social capital, community resilience and enhancing the responsiveness of the statutory and voluntary sectors. The findings of the project will inform a new Community Climate Resilience Toolkit and Islington’s local extreme weather risk and resilience plan, as well as being replicable across urban local authorities.

The project will focus on areas identified as strongly subject to the urban heat island effect, with little green space, large concentrations of properties whose residents could be at particular risk of excess heat and a number of areas prone to flooding. Such areas also have considerable concentrations of tenants, both social and private, without the means to improve the resilience of their properties, and experience significant deprivation, poor physical and mental health, and generally increased risk.

The most significant challenges are to help people realise that they are vulnerable, to inform residents and service providers that heat waves constitute genuine health risks, and to improve understanding of the behavioural aspects of heat exposure. Whilst focussing primarily on behaviour adaptation and service preparedness the project will also identify buildings and estates that are the least climate-resilient and seek to identify fabric measures for future implementation.

Mapping vulnerability in Leeds

Leeds City Council is working to directly build climate resilience within vulnerable groups by developing a spatial tool allowing partners to map the most vulnerable residents of Leeds, overlaid by their relative exposure to severe weather events. The project aims to combine the most appropriate data sets, including work done in other cities and by the Environment Agency, with detailed data about the whereabouts of vulnerable people to develop a GIS tool.

The tool will help keep front line workers up to date with the severe weather risks of their clients and to assist in both longer term planning for severe weather events as well as the short term response when these events occur. Initially based in Leeds, the project will aim to develop a tool with practical applications for other Local Authorities.

Building resilience for people with mental health and substance misuse problems

Equinox is an organisation providing support and care for people with mental health and substance misuse problems who are often overlooked by mainstream services and marginalised by society.

Equinox will be working through peer led consultation with people who have experience of alcohol and drug problems and/or with mental ill health to gauge how to build resilience to climate change issues. The findings will inform the production guidance leaflets, appropriate to service users who are often outside the main target audience for such support.

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» Equinox works with mental health and substance misuse service users for climate harm reduction »: Catherine Max describes Equinox’s innovative climate harm reduction project to help mental health and substance misuse service users take action on the environment and develop resilience to climate change, contributing to the National Adaptation Programme.

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Equinox provides support and care for people with mental health and substance misuse problems who are often overlooked by mainstream services and marginalised by society. Equinox works across London and the South East with a range of housing, outreach and day services, all of which aim to assist their users in engaging with the communities around them and finding effective strategies to deal with the challenges they face in their lives.

Defra support to help vulnerable groups affected by climate change

One of only two charities nationally to be awarded a grant by Defra to improve knowledge of how “vulnerable groups” will be affected by climate change and how best to respond to its impacts, Equinox will focus on extreme weather events such as heatwaves, severe cold snaps and flooding, and associated risks specific to Equinox service users.

Defra’s grant recognises the commitment and prior achievements of Equinox in engaging with climate change as an issue where we all have responsibilities and can all make a difference.  Led by service users acting as peer mentors, the new project will raise awareness of climate change among people with drug, alcohol and mental health needs and consult on practical tools to help them adapt.  It will also give Equinox a platform to influence national policy and local government, especially emergency planning.

Service User Involvement Manager, Earl Pennycooke, describes how Equinox service users are central to the project:

“The Defra award to Equinox represents a first for people with mental ill health, drug dependence and alcohol dependence.  Service users from Equinox and other organisations are coming together to discover how extreme weather conditions affect these under-represented groups. We are proud that Equinox service users are leading this pioneering project – from focus groups through to final designed information leaflets.”

Chief Executive Bill Puddicombe explains how the project aims to reach groups often missed by existing advice and support:

“Our experience is that local authorities issue helpful guidance leaflets for voluntary organisations to distribute to the vulnerable, for example, about keeping warm in winter or cool in heatwaves. This is commendable but this vital information is not always relevant to our service user groups, as it tends to be aimed at the elderly.”

How Equinox got started with climate harm reduction work

Around the same time Equinox began to develop its Service User Involvement (SUI) Strategy in 2008 (Breaking Down Barriers, published 2009), the organisation started to think about its sustainability policy and also got involved in the Big Response initiative exploring the role of civil society organisations with respect to climate change.

Sharon Bye, former operations director at Equinox, describes Equinox’s involvement in The Big Response project to explore how climate change could affect its work

This was the perfect opportunity to model emerging SUI principles, and a working group of service users, staff, directors and trustees came together to think and act upon what climate change means to Equinox.  It soon became clear that everyone, whatever their role, wanted to relate the Big Response to what is important to Equinox.  This meant Equinox as a sustainable “business” in the long-term, the efficiency and resilience of everyday operations, and the place of Equinox in the wider community, as well as the wellbeing of service users.  In one of a series of workshops, facilitated by the Big Response team and involving people from across the whole organisation, the term “climate harm reduction” was coined to link the commitment to tackling climate change with the “harm reduction” risk management concept familiar to people in the sector.

Beyond mitigation and adaptation to resilience and recovery

Early on in its thinking about sustainability, Equinox had committed to a number of short and longer term actions to reduce carbon emissions which would also benefit the organisation in other ways, including smarter energy use, promoting walking and cycling, and food growing at some services.  For example, Equinox has vegetable gardens at Equinox Aspinden Wood, a care home in Bermondsey for people who have long term problems with alcohol, mental health and homelessness, and Equinox Southampton Way, self contained accommodation for men with enduring mental health problems, in Peckham. 

Equinox recognised the “win wins” in this kind of behaviour change, as being more active is good for physical and mental health, and contributing to the community engenders a sense of purpose which can in turn aid recovery.  Energy efficiency is also good for our pockets.  These things are important to Equinox as a charity, to staff and to service users alike.

With the Big Response, Equinox turned its attention to actions to adapt to climate change, including thinking differently about how to keep services open whatever the weather, and the kinds of messages for service users to share.  It was this which drove home the fact that information and support is not currently well suited to Equinox service users.  Issues identified included the importance for people on medications like methadone to keep hydrated during heatwaves; the possibility that extreme weather could cause or increase side effects for people taking medication; the increased risk of food poisoning due to scavenged food spoiling more quickly; and service users on benefits being less able to afford bottled water when fresh water is not available.  The Defra grant allows Equinox to test and expand this list with a wider group of stakeholders – and to do something about it.

Life experience and life skills:  climate harm reduction and “personalisation” in social care

The grant from Defra is part of the National Adaptation Plan (NAP), which includes a section on health and wellbeing, and the Climate Ready implementation programme.

Equinox’s information leaflets, with practical suggestions to help manage the risks identified, will be shared with the NAP team, with local authorities and the NHS, and groups like the London Climate Change Partnership so that they can be promoted more widely.

Equinox itself will feed its learning into service user support planning, for example, coping with severe weather as an essential “life skill”.

Last but not least, the project will demonstrate the know-how and creativity of our service users, who say they consider themselves “forgotten people”.  Equinox hopes this will help combat stigma in general and give people with drug, alcohol and mental health problems the confidence to work alongside commissioners and decision-makers on a global challenge which affects us all.  This aspiration is central to the Personalisation Strategy, co-produced by staff and service users, which includes objectives for Equinox to make the most of the skills of its service users, ensure they have a real say over the resources of the organisation, and encourage and support service users to influence the world around them.

Further reading

• National Adaptation Plan: addressing the risks set out in the first UK Climate Change Risk Assessment
• SCIE resources on personalisation in social care: thinking about social care by taking the person and their individual circumstances as the starting point, rather than the service
• London’s Changing Climate – In Sickness and In Health: London Climate Change Partnership tool to aid health and social care commissioners and providers as they begin to design and shape their services in the new delivery landscape.
• Vulnerable People and Climate Change: NCVO project building on the Big Response and involving VCS organisations working with older people in London, disabled people and those with mental health needs in London, black and minority ethnic communities in Greater Manchester, and people on low incomes in Hull & East Riding and Portsmouth.

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• The National Adaptation Programme: building climate change resilience among vulnerable groups
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