Select Committee on Science and Technology Written Evidence

Memorandum by Professor Peter Lansley


  Peter Lansley is Professor of Construction Management at the University of Reading. He has been closely involved with the development of the EPSRC EQUAL (Extending Quality Life) Initiative. He has chaired some of its awards panels and frequently acts as spokesperson for the Initiative. He is Director of the EQUAL Research Network which is concerned with promoting the contribution to improving the independence and quality of life of older people of design and engineering orientated interdisciplinary research.

  The memorandum reviews some the features of the EQUAL Initiative and the organisation of research at national level and it offers some proposals for the future. It is informed by the experiences of the Network and the views of its members and supporters which include professionals, practitioners and older and disabled people as well as researchers. However this not an official account of the EQUAL Initiative. Rather it represents the perspective of those who have been closely involved with ensuring that it has had a clear focus on meeting the needs of older people.


  Recent research provides valuable support for the case that better design and application of both conventional and innovative technology can make a major contribution to improving the independence and quality of life of older people. The creation of more comfortable environments and of aids to living and recovery are valid areas for research.

  Such research has been supported by a number of charities, some of which have a long-term commitment to improving living conditions for older and disabled people (for example, the Joseph Rowntree Foundation programme of work centred on Lifetime Homes, the work of the Thomas Pocklington Trust focused on visual impairment, and that of the RNIB in many areas including the design of the home). It has also received significant support from EPSRC, principally through its EQUAL Inititative. The success of these programmes gives a clear indication of both the positive outcomes which can be achieved and useful guidance on how to organise research to achieve maximum impact.

  Given the range and magnitude of the issues faced by older and disabled people who may benefit from research there has been insufficient investment. However, since the research base is small and capacity for research is limited there is a need to consider how best to develop the research base and more generally how to organise ageing research, especially in the light of disappointing progress over the last three years.


  EPSRC launched its EQUAL Initiative in 1997. This was focused on enhancing the independence and quality of life of older and disabled people through a programme of design, engineering and physical science orientated interdisciplinary research involving social, medical and health scientists as well as design, engineering and technology scientists. The programme required collaboration with intermediate organisations, such as housing providers, health and social services organisations, transport companies, and charities, and the direct involvement of older and disabled people in the individual projects constituting the programme. EQUAL has supported 39 projects ranging from very small one year feasibility studies with a value of £30,000, to large three year consortia projects with an award value of £650,000.

  Most projects have considered how the environments of older and disabled people, and in some cases their carers, can be designed or modified to enhance well-being, independence and quality of life, but others have considered the enhancement of approaches to rehabilitation following illness or accident so as to enable the rapid return to home and, as far as possible, to normal daily routines. Although there has been a particular interest in the home environment including the devices and products used in the home, there has also been concern for care settings, public access buildings, urban environments and transport systems. Some projects have considered general aspects of ageing and disability whilst others have focused on specific aspects of physical impairment, sensory impairment (particularly vision and hearing), and cognitive impairment (especially dementia and stroke).

  All projects have entailed the development of a detailed understanding of the way in which users interact with their environments, and their priorities and preferences. This has been a very necessary precursor to the gathering of data and creation of conceptual and operational models to enhance design information, improved design methodologies, better assistive technologies and innovative rehabilitation systems.


  Those projects concerned with the home fall into two main categories. Building on the widespread success of community alarms and related systems, several projects have focused on the development of the smart home, advanced intelligent sensor systems, telecare and telemedicine. Other projects have been concerned with developing design guidance for new homes and yet others with the challenge of adapting existing homes so that older people can remain in them despite considerable infirmity. These have blended the perspectives of sociology, health care, design, technology and economics to provide important and compelling accounts of the options for policy makers, housing, health and social services organisations and for older people themselves. This work is able to make a sound economic as well as a quality of life case for the substitution of adaptations and assistive technology for traditional forms of care services. In some situations the savings could be considerable. A large proportion of the projects in all fields have a strong business or economic dimension reflecting their concern to meet the needs of government, other organisations and society to identify cost-effective approaches to enhancing independence and quality of life.

  Projects concerned with infrastructure, transport systems and non-domestic buildings form two groups. Firstly, there have been those concerned with improving accessibility to buildings, transport systems and more generally the urban environment through better design and, secondly, projects concerned with developing navigation tools for people with specific impairments. Here again the integration of a range of disciplinary perspectives and exploitation of new technology have generated new practices, often with the potential to couple significantly improved independence with major cost savings.

  The projects concerned with sensory and cognitive impairment have generated unique information about the needs of specific groups of people which is invaluable to designers, who previously have had little design guidance, and for health workers for example, Occupational Therapists, who have to match the needs of individuals with recommendations about how their homes might be adapted. Research with dementia patients is leading to systems which can afford them a greater degree of independence and confidence for longer whilst also supporting their carers. New technology has a role to play here but so too do new approaches to the design of care facilities. The work with stroke patients will contribute to improved recovery times and will enable some rehabilitation therapies to be home rather than hospital-based.

  Inclusive design projects consider a wide range of conditions from normal ageing to ageing with multiple impairments. These are producing design data sets, advice, methodologies and technologies for design which are immensely attractive in terms of both innovative design processes and the resulting environments and products. Here there is much evidence to support the business and economic case for inclusive design especially when considering older people as consumers of products and services.


  Just over half of the projects supported by the EPSRC EQUAL Initiative have been completed. The reminder will do so in the next two years. Many of their findings have been adopted by practitioners and policy makers, often within two years of project completion, and sometimes before they have been completed. Because the projects have involved collaboration with service providers and the involvement of older and disabled people, developments arising from the projects have been rapidly evaluated and refined. This has facilitated the further articulation of outcomes, especially where projects have produced state of the art and best practice guides, tool kits for professionals, demonstration systems, and devices and systems ready for application. Some of the outcomes have been of particular value to those who commission buildings, infrastructure and products, and to architects and designers who have to ensure that their designs are more inclusive of the needs of older and disabled people, and more generally the ageing population.

  The research outcomes have also influenced, for example, the development of British Standards and building regulations, and the policies, practices and general outlook of key individuals within government organisations, such as the Housing Corporation, the Department for Transport, and the Disability Rights Commission, even where they have called into question current policies and recommendations in relation to older people. At a more general level the findings have influenced expectations about how the built environment and everyday consumer products could and should be designed to accommodate the needs of older and disabled people. Similar comments apply to the findings arising from the rehabilitation projects. In particular these have raised expectations of what might be achieved through engineering and technology orientated research.

  In addition the EQUAL Initiative has stimulated an enthusiasm amongst scientists from quite different fields for working closely together, and has highlighted the need to find further ways of working across scientific boundaries. For example, there is a need to understand in much more detail the implications of the biology of ageing, for instance, the variation in human biological functions, especially between ethnic groups. This is required not just to help designers accommodate particular impairments but also to aid health practitioners in the community to detect the onset of disabling conditions and to take appropriate action to arrest the rate of decline.

  To summarise, the EQUAL Initiative has been particularly effective at identifying and supporting projects which, within a short space of time, have produced significant outputs for improving the quality of life of older and disabled people. Some of these outputs have already produced direct benefits. Others, through informing, for example, official standards and regulations, design procedures, and professional practice, will have a long term and systemic effect on the design and management of the built environment and consumer products, and on approaches to rehabilitation following illness or accident. Whilst modest, the approach taken by EPSRC to building research capacity and facilitating ageing research should be commended.


  The EQUAL Initiative has run in parallel with other similar ageing related research programmes supported by large and small charities, housing and other organisations. Because some of these organisations are in a good position to ensure the application of their work, and many do so very successfully, they can create important expectations and standards of all research. A recent example is work carried out by RNIB Cymru and JMU Access Partnership on the design of housing to meet the needs of people with sight loss which is being incorporated into the requirements of grant funded Registered Social Landlords when they are building or adapting homes.

  However, much of this other work is carried out in isolation and is rather ad hoc. For example, many organisations are presently involved with the development and application of home-based technologies in recognition of a major challenge for the quality of life of older people being that of supporting people in their own homes, especially people with dementia. There is a great deal of work needed here in bringing together these efforts if the aim is to develop cost-effective integrated services with good distribution networks, skilled installation personnel, and managers who are aware of the capabilities, cost effectiveness and limitation of new technologies.


  In 1997 although there was a surprising number of university based research designers and engineers with some experience of ageing-related research, often gained through small-scale projects with charities or undertaken out of personal interest, there were very few experienced researchers in the areas to be covered by EQUAL. However, the Initiative was successful in attracting those with experience, as well as many newcomers from a broad range of disciplines within the physical, social, health and medical sciences. Probably because so many were new to the area, they were prepared for and relatively untroubled by many of the challenges of interdisciplinary user-orientated work. So, they quickly established new research methodologies which were to contribute to a new style of applied science. These new approaches deserve greater recognition for their effectiveness in the skilled business of involving users as active participants in the research process.

September 2004

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