Navigating health – improving collaboration between health and the built environment

Earlier this year we held a webinar – Tackling the health crisis together – that highlighted the potential for the built environment sector to contribute to tackling health inequalities in our cities. Together, participants explored how we can navigate the health sector to deliver positive impact in our communities.

As part of our Healthy neighbourhoods programme, this seminar sought to provide inspiration for tangible tactics to work with and understand the health sector, overcoming issues of language, timescale, budgets and different working cultures to collaborate effectively with health colleagues.

Contributors included:

  • Mark Harrod, NHS Programme Director, Barking Riverside Health & Wellbeing Hub
  • Sarah McCready, Head of Placemaking and Communications, Barking Riverside
  • Smriti Singh, Director – Healthcare Transformation, Arcadis
  • John Thorne, Partnership Manager – Parks for Health, LBs Camden and Islington
  • Ed Williams, Director, London Communications Agency

The move towards integrated care systems

Smriti opened the seminar by walking us through the most recent structural changes to the UK health sector and what that means for those looking to collaborate on health.

Globally we face strategic challenges that are exacerbating health inequalities, such as ageing and lifestyle, rising costs of healthcare, and financial constraints. However, only 10% of what makes a healthy population is access to health care. The rest is shaped by socio-economic factors.

The introduction of integrated care systems (ICS) looks to build partnerships between providers of health and other types of care, while working with citizens to improve population health and reduce inequalities. Mark highlighted that the introduction of the ICS will be the first time we see addressing health inequalities made explicit through the health system, marking a “significant shift” away from traditional treatments towards helping people lead healthy lives.

Smriti explained that while ICS is still being worked out, the move towards integration in England is a step in the right direction. For those looking to work with health colleagues in the NHS or other healthcare providers, it is important to know who holds the budgets.

Firstly, you need to know who you need to speak to: a Clinical Commissioning Group: an NHS provider, or an independent provider? Furthermore, if you are considering making a strategic shift in addressing health inequalities, it is important to consider how it is (a) going to support integration, and (b) support us to live in a post-Covid world where lifestyles and systems have changed dramatically.

A new approach to health at Barking Riverside

Mark and Sarah shared the fantastic work being done at Barking Riverside – the largest housing development site in east London. In an area where 30.8% of residents are economically deprived and physically inactive, social and health outcomes have been at the heart of every aspect of planning and development of the area.

In 2016 Barking Riverside became London’s only Healthy New Town, a programme which applies capital investment to explore if health outcomes and inequalities can be improved and reduced via:

  • New models of care
  • Community activation
  • Built environment enhancements

Mark posed a thought-provoking question to the group: “how do we use Barking Riverside to increase the wellbeing of the existing community and work with the community to do that?”

Barking Riverside shared that they have already been working with new models of care that are community-led. A new health hub is being created which will serve primarily as a community space where ‘health happens’ – with residents having access to a multitude of social, civic and health services in one place. In creating a new system of health care in the area, the community play a key role in creating a healthier place for all.

“Relationships are critical. Find a trusted guide and they will lead you to where you want to go”

Barking Riverside

Mark and Kate admitted that after years of working with the healthcare system, sometimes it’s still hard to know exactly where all the decision-making lies. But, as Sarah told us, “you will find the pathway if you find the right people.” The transformation of health in Barking Riverside is progressing through strong partnerships that span across the NHS, local authorities, communities and the built environment and key to the project’s successful partnership working has been shared vision, prioritising people and working with equally passionate people and partners.

Navigating the health sector

Following the presentations, a workshop session looked towards solutions to the practical barriers the built environment and health sector face in working together. Our discussion tables explored different themes and solutions – here are some nuggets of wisdom from the day:

  • Working across different timescales and boundaries: be aware of decision-making processes and timescales and the pressure of work on others
  • Putting communities at the heart of change: define what communities mean to you and your work – are they residents? Communities of interest? Identify who you need to work with and build a relationship with them, communicating with language they can engage with
  • Shared budgets: Covid created a lot of opportunity for new sources of funding. Consider using smaller pots of money for street-based activation of health programmes. And don’t forget to top up the Section 106 contributions!
  • Overcoming communication barriers: working with new teams and organisations sees different ways of working come together (or sometimes, clash) – create a shared culture to communicate effectively and link up teams that may not usually work together

Attendees will, once again, have been reminded of how complex London’s health landscape really is. Our partners at London Communications Agency (LCA) – represented at the session by Ed Williams, who leads on their NHS estates and service change work– have kindly shared this graphic which seeks to map the shifting array of organisations involved in planning, regulating and delivering healthcare services in the capital. We hope you will find this interesting and if you have any comments, do feel free to share these with LCA’s Research Manager Stefanos Koryzis.

The outcomes of this seminar and previous events from the Healthy neighbourhoods programme will inform the programme’s final report. The report will feature best practice case studies that showcase examples of collaboration to achieve positive outcomes for health, and provide practical recommendations for how the built environment sector can be a good partner their health colleagues. Find out more here.