Jon Siddall, Director of Funding, Guy's and St Thomas' Charity
Aug 07, 2018
Last year we launched two long-term programmes of work – on childhood obesity and multiple long-term conditions. Our ambition, back then and today, was to make a step change impact on these two issues locally, and to share what we learn with other places facing similar challenges.
These are complex health issues. They are impacted by many factors and solutions often sit across a wide spread of people and organisations. So we started by taking time to understand what these issues look like in our communities and beyond. We looked at what is already happening – locally and elsewhere – to tackle them and the approaches we might want to take through our ten-year programmes. We worked with partners to co-design a set of projects for each programme as part of our ‘development phase’. We wanted to understand the issue better, and to test our assumptions on where to focus our efforts. This work had a profound impact on the way we designed our programmes – both of which we started to deliver earlier this year.
For a detailed read on what we’re learning about these complex health issues, I recommend taking a look at our recently published reports Bite Size and From One to Many. Both have made a mark on thinking around these issues on a national scale, including helping to inform the Government’s recently published child obesity strategy. Rather than repeat the content of these reports, I’ve focused here on three things that stood out as we met, worked and learned from others during the development of our programmes.
Firstly, we’ve learnt the importance of staying focused and flexible. This means remaining focused on our unique role as an independent foundation, and flexible in our approach to understanding and identifying routes to impact.
For example, in approaching the development of our childhood obesity programme, we asked ourselves where we could focus our effort to create the greatest change. This led us deep into the data to understand where this issue occurs. Our analysis showed a worrying variation in childhood obesity levels across our boroughs, with the highest rates concentrated in the most disadvantaged areas. As a result, we’ve shifted our efforts to focus on closing the childhood obesity deprivation gap. Meanwhile, exploring people’s lived experience told us we needed to be flexible in our approach to tackling this issue, working across the different environments where families spend time – from homes to schools and high streets – to target opportunities for action that align with people’s existing habits and routines.
Secondly, we’ve learnt our value is often in taking the time to identify things that exist and help join the dots to accelerate impact.
For our multiple long-term conditions programme, we’re finding this means connecting local assets and resources to address the underlying health and social context factors to that accelerate people’s journey from one to many conditions. This is important across all our work on multiple conditions, but particularly with our in specific neighbourhoods like Walworth or North Lambeth.
In our childhood obesity programme, we’re finding that helping to connect those who can have the greatest impact on the issue – including schools, businesses and housing owners – is generating multiple routes to impact. At a neighbourhood scale, we’re finding local spaces – such as the East Street market in Southwark – can act as vibrant hubs for joint activity across different environments.
Thirdly, we’ve learnt the importance of helping to create the space for creativity.
Our programmes deliberately target issues that are complex in nature and require a long-term approach. In our experience, although there is energy within local communities and organisations to tackle these sorts of issues, more immediate pressures – along with the complexity of the issues – displaces the desire to do something about it.
Given this context, we’re finding that relatively modest investments into creating the space to bring people together helps to realise the energy and move to action.
This really becomes powerful when we support and engage in local co-production. For example, our work with Citizens' UK brought together residents and professionals in Southwark to explore the evidence on childhood obesity and their own experience. As a result, the idea of providing a space for families to cook healthy meals together that they can then take home, was born. It was developed and led by local need, whilst also drawing on approaches from inside and outside the boroughs.
Similarly, in our multiple long-term conditions programme, we’re helping to create the space for local health and care professionals to come together and accelerate the development of Local Care Networks. These new structures are set to join up health and care for everyone, and to help support people in our communities to manage their long-term conditions better.
Over the last year, we’ve come a long way developing our understanding of the issues we want to tackle. We’ve developed a clear sense of our ambition, identified what to focus on and explored how to approach these issues. But the journey has only just begun. Over the next ten years we’ll be focusing on building partnerships across both these programmes – and future ones – to build a picture of how to tackle complex health issues in urban environments.
We’re always on the lookout for exciting ideas to help us on this journey. If you have one you’d like to share, start a conversation with us today.
20 September, 2019
Our Policy and Partnerships Manager, Rowena Estwick, shares how we're working to understand the opportunities and barriers to equitable health in urban areas, comparing our boroughs to neighbourhoods elsewhere in the world.
04 June, 2019
We asked some of the international experts speaking on at our joint event with the King's Fund what actions must happen today to make sure that future health in cities is equitable and thriving.