The UK currently spends 70% of its entire health and social care budget on long term ("chronic") health conditions. These include diabetes, dementia, obesity, depression, COPD, arthritis, hypertension and asthma. We need to be better at: -- Understanding the cause of these illnesses -- Helping a person to avoid developing them -- Creating new treatments -- Helping the patient self-manage their conditions All these require working with a patient over months or years, outside of a traditional hospital environment. In a very real way, we need healthcare to go where the patient goes; the single place that most people spend most of their time is their home. Consequently, SPHERE project is seeking to develop non-intrusive home-based technologies for measuring health related behaviours at home over long periods of time. The requirements for these technologies are: -- They should require little or no action from the patient, since our daily lives are busy; being ill is distressing and time-consuming; and when the benefit may take months or years to achieve, there is often not much day to day motivation to be bothered with measurements or devices. -- They should work reliably in the home; a home is not a hospital or a laboratory - it is smaller, full of furniture, pets and people, often not brightly-lit and often challenging to get wireless network coverage everywhere. This poses lots of problems for researchers. -- They should be acceptable; bringing healthcare home with us doesn't mean we want to turn our homes into hospital and it definitely doesn't mean we want people spying on us! Since 2013 this has been the SPHERE vision and we have worked with scientists, doctors, engineers and more than 200 members of the public to achieve the project's initial goal of creating a cheap sensor system that can be installed in a home. More than 30 people have had the experience of living with the sensors over periods from days to months and, by the end 2017 we expect more than 200 people will have had SPHERE sensors in their own home, in many cases for months. Although the first-generation system was only completed in late 2016 and at the time of writing is still under test in the first "pilot" homes, the system is already moving into real patient applications - we are applying for ethical permission from the NHS to use SPHERE for patients recovering from surgery. Later in 2017 we will be applying for ethical permission to use SPHERE with a group of dementia patients. The initial testing of the sensor system has gone well but, especially as we start to think about large scale use of the SPHERE system across potentially hundreds or thousands of people, the team have learnt a lot from the early pilots and have some priorities for significant improvements: 1. The SPHERE video system needs to be better at evaluating the quality of someone's movement, such as getting out of a chair, even when the view of the person is blocked by items of furniture. Evaluating quality of movement is important in physical and mental health conditions. 2. The SPHERE wristband lasts for over a month on a single charge, however we want to remove as far as possible the need to charge it at all, because the more ill someone is, the less likely they are to do this. 3. Digital data gathered from sensors needs to be turned into understanding for doctors; this is especially difficult in a home environment because every home and every household is different. These are major research issues and will be the focus of the technology parts of the SPHERE programme, while the clinical parts move forward with patient populations. The NHS itself has recently said: "if the UK fails to get serious about prevention then recent progress in healthy life expectancies will stall, health inequalities will widen, and our ability to fund beneficial new treatments will be crowded-out by the need to spend billions of pounds on wholly avoidable illness."

Across the world, growing population sizes and increasing urbanisation cause transportation networks to reach their capacity limits. In addition, the environmental impact of the transport sector, contributing an estimated 33% of carbon dioxide emissions in the UK for 2018, needs to decrease. Thus, environmental considerations and transportation needs necessitate an increase in trips completed by active, low-emission transport, such as walking. Walking is healthy, sustainable and plays a crucial role in how urban places of work, leisure and living are accessed and used. According to the National Travel Survey 2017 for England over 80% of trips under one mile are completed on foot and considering that over 70% of trips between one and five miles long are completed by car, the potential for an increase in walking is substantial. Getting more people to walk requires better infrastructure or policy interventions, such as clean air schemes, parking fees, or incentives for walking. Currently, planners and policy makers have to make do with data from surveys or localised pedestrian counts to inform their work. However, to decide which policies or infrastructure investments will work best in promoting walking, it is necessary to consider how pedestrian traffic varies over time across the entire street network of cities. For example, making walking more attractive in one part of a city centre may influence the footfall in other, potentially unexpected locations and possibly only at certain times, such as outside of rush-hour. Despite the evident use for such information, pedestrian traffic is currently not mapped over time for cities. This project aims to change this and develop a theoretical framework for robustly constructing time-dependent pedestrian traffic maps at the scale of cities. To future-proof the methodology, it will use pedestrian counts observed at distinct locations. These can be recorded via different, privacy-preserving technologies and do not rely on the voluntary participation of individuals or private sector service providers, as is the case for data obtained from personal devices, such as mobile phones. Crucially, to ensure the traffic maps are robust to sensor failures and the occurrence of events or unscheduled disruptions, the theoretical framework will incorporate several predictive methods, each of which contributes different desirable properties, such as accurately capturing regular patterns based on historic data, efficiently interpolating between count locations and the capability to predict traffic dynamics from initial values without further data input. To directly inform the deployment of measurement devices, suitable data collection protocols will be established. Outputs of this project will be useful beyond traffic monitoring. The ability of the methodology to forecast changes in pedestrian traffic caused by construction projects will be demonstrated and the relevance of pedestrian maps for assessing pedestrian exposure to poor air quality and for evaluating the success of businesses relying on passing trade will be shown. This project will develop our understanding of city-wide pedestrian traffic and will therefore be directly useful for monitoring, across large spatial scales, long-term transport developments, short-term effects of disruptions or planned alterations and it will help the economy by informing the positioning and running of businesses that rely on passing trade, for example.

Serious illness and bereavement affect us all, but our experiences of them are not equal. People living in the poorest areas of the UK are less likely to get the care and support they need if they become seriously ill or a loved one dies. They are also more likely to be socially isolated and lonely - which can be made even worse by serious illness or bereavement. This project is based in Weston-super-Mare, a deprived coastal town in North Somerset. Nine of its neighbourhoods are among the poorest 10% in the country. The population is growing, getting older and living with more frailty and long-term, complex health conditions. There are also high levels of mental health and addiction problems. The project team will create a strong group with a shared aim ('a consortium') that unites health and social care workers, people providing community assets (collective resources which are available to individuals and communities, e.g. arts organisations, charities and community groups), academics, and people with lived experience to work together to reduce health inequities in Weston-super-Mare and the North Somerset region. Our consortium will focus on inequities related to end-of-life care, bereavement support, social isolation and loneliness. During the 9 months of the project, we will hold 3 consortium meetings and work together to: 1. create a directory of community assets and interview key people to understand how health and social care and community assets can best work together 2. design and evaluate creative and cultural activities to be held over Dying Matters Awareness Week (DMAW, May 2023), with members of the public employed as co-researchers 3. hold creative workshops with local groups (people with drug and alcohol addiction problems, young people, and older men) to facilitate conversations about grief and illness, raise awareness of local support, and help inform our DMAW events 4. review existing evaluation data from arts/creative organisations working in Weston-super-Mare over the last 5 years (2017-2022) to identify what activities have best engaged and benefitted the community, and draw on this in designing DMAW events 5. map available health and social care data and determine how it can be used to help understand, measure and reduce inequities 6. hold a final consortium meeting to: review all our work; consider how we can apply our findings in other deprived coastal towns; and agree research questions and methods for a future joint funding application The project will benefit: 1) the Integrated Care System (ICS), strengthening their relationships with community organisations and the public in Weston-super-Mare and providing information (community asset directory, map of datasets) to enable equitable end-of-life care and bereavement support; 2) community organisations, by bringing recognition and funding (via linking with the ICS) and helping them reach more people (via linking with the consortium and awareness raising at events); 3) creative and cultural organisations, by enabling them to engage and empower local community members in an evidence-based way, providing training to artists and increasing links with the ICS and community organisations; 4) members of the public, who will learn about the care and support available to them via the ICS and community assets and benefit from opportunities to express their experiences and socialise in creative workshops, attend free events, participate as co-researchers and at consortium meetings; 5) academic researchers, by modelling new multidisciplinary, collaborative ways of creating research and building evidence about how community assets can help reduce health inequities; 6) policy makers, by making recommendations for how ICSs can best harness community assets. We will engage with these groups via consortium meetings, blogs, the project website, journal articles, reports, presentations at community/ICS events and a policy brief.

As European Green Capital 2015 and one of the Rockefeller 100 Resilient Cities, Bristol has challenged itself to transform by 2065 into a place where citizens 'flourish' by working together to create wellbeing, and achieve this equitably and sustainably. The Bristol Urban Area can legitimately claim to be in the vanguard of such urban transformation, and yet its development pathway remains characterised by paradox, and the need to deal with some stark realities and to challenge a 'business-as-usual' mind-set if progress towards aspirational goals is to be sustained. This proposal addresses a fundamental issue: what is stopping Bristol from bridging the gap between its current situation and the desired future as encapsulated in the City's various visions and aspirations? We have forged a partnership focused on the contiguous City of Bristol and South Gloucestershire urban area. We have secured the full backing of the two local authorities, Bristol Green Capital Partnership and Bristol Health Partners, the LEP, the local business community, citizen groups, and academics from across both Universities, with tangible commitments of support. Dissolving siloes through partnership, and a genuine interdisciplinary and cross-sectoral collaboration, is core to our approach, and hence both Universities have committed to share equally the financial resources with external partners in a three-way split. It is a key strength of this project that we are able to leverage extensively on internationally leading research assets, including: 'Bristol is Open', the FP7-funded Systems Thinking for Efficient Energy Planning (STEEP), the Horizon 2020 REPLICATE project, ongoing work at the £3.5m EPSRC/ESRC International Centre for Infrastructure Futures (ICIF) and co-produced and co-designed research such as the AHRC/ESRC Connected Communities and Digital Economy funded projects including REACT Hub, Tangible Memories and Productive Margins. We also have access to a wealth of highly valuable data sources including the 2015 State of Bristol Report, Bristol's Quality of Life Survey, and the Avon Longitudinal Study of Parents & Children that has followed the health of 14,500 local families since the 1990s. We intend to build on the ICIF cognitive modelling approach which identifies the importance of challenging established mental models since these entrench a 'business-as-usual' mind-set. At the heart is co-creation and co-production, and an acknowledgement that citizen behaviour and action are essential to the delivery of desired societal outcomes such as wellbeing, equality, health, learning, and carbon neutrality. The work programme synthesises existing domain-specific diagnostic methodologies and tools to create a novel Integrated Diagnostics Framework. We believe strongly that unless an integrating framework is developed to bring together multiple viewpoints, the diagnosis of urban challenges will remain fragmented and understandings will potentially conflict. We will apply this framework in this pilot project to diagnosis complex problems across four 'Challenge Themes': Mobility & Accessibility, Health & Happiness, Equality & Inclusion and the 'Carbon Neutral' city. We have appointed 'Theme Leaders' who are all 'end users' of the diagnostics, ensuring that the process of investigation is cross-sectoral, interdisciplinary, participatory and grounded in real-world context and application. The legacy of the project will be threefold: firstly innovation in the diagnostic framework and methods needed to address urban challenges; secondly its application to the Bristol urban area and the resulting diagnostics synthesise across the four Challenge Themes; and finally the formation of an embryonic cadre of cross-sector city leaders with the capability to apply integrated diagnostics and challenge the prevailing 'business as usual' approaches.

The EMERGENCE network aims to create a sustainable eco-system of researchers, businesses, end-users, health and social care commissioners and practitioners, policy makers and regulatory bodies in order to build knowledge and capability needed to enable healthcare robots to support people living with frailty in the community. By adopting a person-centred approach to developing healthcare robotics technology we seek to improve the quality of life and independence of older people at risk of, and living with frailty, whilst helping to contain spiralling care costs. Individuals with frailty have different needs but, commonly, assistance is needed in activities related to mobility, self-care and domestic life, social activities and relationships. Healthcare can be enhanced by supporting people to better self-manage the conditions resulting from frailty, and improving information and data flow between individuals and healthcare practitioners, enabling more timely interventions. Providing cost-effective and high-quality support for an aging population is a high priority issue for the government. The lack of adequate social care provisions in the community and funding cuts have added to the pressures on an already overstretched healthcare system. The gaps in ability to deliver the requisite quality of care, in the face of a shrinking care workforce, have been particularly exposed during the ongoing Covid-19 crisis. Healthcare robots are increasingly recognised as solutions in helping people improve independent living, by having the ability to offer physical assistance as well as supporting complex self-management and healthcare tasks when integrated with patient data. The EMERGENCE network will foster and facilitate innovative research and development of healthcare robotic solutions so that they can be realised as pragmatic and sustainable solutions providing personalised, affordable and inclusive health and social care in the community. We will work with our clinical partners and user groups to translate the current health and social care challenges in assessing, reducing and managing frailty into a set of clear and actionable requirements that will inspire novel research and enable engineers to develop appropriate healthcare robotics solutions. We will also establish best practice guidelines for informing the design and development of healthcare robotics solutions, addressing assessment, reduction and self-management of frailty and end-user interactions for people with age-related sensory, physical and cognitive impairments. This will help the UK develop cross-cutting research capabilities in ethical design, evaluation and production of healthcare robots. To enable the design and evaluation of healthcare robotic solutions we will utilize the consortium's living lab test beds. These include the Assisted Living Studio in the Bristol Robotics Lab covering the South West, the National Robotarium in Edinburgh together with the Health Innovation South East Scotland's Midlothian test bed, the Advanced Wellbeing Research Centre and HomeLab in Sheffield, and the Robot House at the University of Hertfordshire covering the South East. Up to 10 funded feasibility studies will drive co-designed, high quality research that will lead to technologies capable of transforming community health and care. The network will also establish safety and regulatory requirements to ensure that healthcare robotic solutions can be easily deployed and integrated as part of community-based frailty care packages. In addition, we will identify gaps in the skills set of carers and therapists that might prevent them from using robotic solutions effectively and inform the development of training content to address these gaps. This will foster the regulatory, political and commercial environments and the workforce skills needed to make the UK a global leader in the use of robotics to support the government's ageing society grand challenge.