Spire Healthcare were at the start of a journey to radically transform and modernise the way the organisation operates. With an ambition to streamline services and become more patient centric, there was a need to ‘get everyone to the starting line’ – that is, open to change, excited about transforming the business and willing to contribute to Spire’s future.
According to the UK government’s obesity strategy, nearly a third of children aged two to fifteen are overweight or obese. The drivers leading to child obesity include social, environmental and economic factors meaning that a preventative approach to obesity cannot be solved by the formal health sector alone. Healthy London Partnership commissioned Uscreates to explore how innovative and place-based commissioning models could lever in partners from outside the formal health service, activate local communities and create sustainable interventions across three of the most deprived areas of London (Seven Sisters, Isle of Dogs and Haggerston).
What was needed
Through our research, we identified the need to create community-led, sustainable, healthy living initiatives in the three neighbourhoods to tackle childhood obesity. Additional nurturing and a different cultural mindset were required to incubate social ventures and at the same time ensure the ventures that emerged had the right support to evolve in a way that attracts investment. Taking a design-led approach provided an innovative way to rapidly test new models of community interventions whilst simultaneously engaging the local community and ensuring local buy-in.
What we did
Key insights from our research that informed the development of our three community initiatives included:
- We found that time-poor parents were more influenced by convenience than health in their food choices and needed to develop their confidence in making healthy choices.
This led to Make Kit: an affordable and confidence-building healthy-eating recipe pack.
- We found that young people went to fast food outlets on the way home from school because there was nowhere else nearby where they could get low-cost, hot and tasty food.
This led to the creation of Snack Stop, an after-school tuck shop selling healthy snacks and hot Caribbean and other locally popular food from a local restaurant owner.
- In the Isle of Dogs, we found that parents often wanted to live more healthily for the benefit of their kids, but they didn’t know how or didn’t have the confidence to do this.
This led to Active Local Links, a parent led information network, which provided parents with information and support to get involved in healthy activities in their local area.
Uscreates adopted an agile design approach with two key phases – to better understand the local community and their assets and needs, and to deliver design solutions for each of the three communities:
1. Ethnography with local people and community based co-design
2. Prototyping with social incubation
Our approach differed from both the traditional commissioning model and service design process in that:
- The research phase gathered insight but was also used as an opportunity to build relationships and trust within the community.
- The interventions were community-asset based and tapped into local resources and capabilities.
- We incorporated social incubation into how we delivered the three initiatives and made them sustainable.
- Our approach used the theory of behavioural economics to understand how to change local community behaviours to healthy eating.
Two of the three initiatives have been running independently since Uscreates’ support finished, which is a significant achievement given that one in three social enterprises usually succeed. Make Kit has even won a Healthcare Transformation Award 2017. Additionally, the interventions have generated significantly improved health habits (as reported by our evaluation partners). For instance, as a result of Make Kit, 83% of survey respondents reported to have more confidence in cooking healthy meals, 83% reported being highly likely to refer a friend or family member to the kits and 50% reported being inspired to get more involved in their community.
A number of important learnings have emerged as a result of this work:
- The project has shown that it is possible to deliver health outcomes outside the formal health system.
- A place and asset-based approach enabled the projects to pull in different types of partnership outside the traditional commissioning approaches; and, through incubation support, the ventures are exploring ways of securing financial sustainability through independent funding.
- Initiating health programmes through social ventures creates added social value beyond solely addressing obesity. Value was also created through the design and agile methods used to develop these initiatives, activating and engaging local communities around an issue.
- An agile, collaborative and design-led approach allowed this project to progress from insight to idea to implementation in a relatively short space of time. The project harnessed energy and action from the local community and partners (e.g raising £16k through crowdfunding), and allowed the interventions to be shaped by local characteristics, and become embedded and sustained in the community.