The threads of power and place run through everything we are exploring in UK 2040 Options. Understanding how power and place interact, and how they impact people and communities, is critical to understanding how we might make the UK a fairer place to live. This is part of a series of guest essays that explores these themes.

England is a deeply unequal country. Health, wealth, and opportunities to thrive differ greatly depending on where we live and work.

The relationship between health and place can be considered in terms of the interplay between who lives in a place, what the place is like and the wider public policy context. Often, individual circumstances interact with the place where people live to exacerbate or reinforce inequalities in health outcomes.

In this piece, I highlight the worrying statistics that show the level of health inequality in England and why policymakers must consider a hyperlocal approach. I also outline the policy options that local and central government have available to help tackle place-based health inequalities.

The UK has wide place-based health inequalities: and they are growing

The UK ranks among the highest in terms of regional economic inequalities among OECD countries. The north of England bears the brunt of these inequalities, with lower economic productivity as well as lower life expectancy than the south of England. Nationally, coastal communities grapple with a higher burden of ill-health and substance misuse.

Our analysis of the most recent data shows that on average, males living in the most deprived areas of England are expected to live 9.7 fewer years than males in the least deprived areas. Females living in the most deprived areas can expect to live 8 fewer years than females in the least deprived areas.

These gaps are even bigger when we consider healthy life expectancy, an estimate of lifetime spent in very good or good health. Males living in the most deprived areas have a healthy life expectancy that is 18.2 years lower than males living in the least deprived areas. Females living in the most deprived areas have a healthy life expectancy that is 18.8 years lower than females living in the least deprived areas.

Worryingly, there is a downward trend in life expectancy for those living in the most deprived areas meaning that the gaps between the most deprived and least deprived areas have been growing over time.

“Despair” is not uniformly spread throughout England

In 2015, a phenomenon coined ‘deaths of despair’ emerged in the US, highlighting an increase in deaths caused by drug and alcohol misuse as well as suicide. The underlying cause of these deaths in the US is long-term economic disadvantage: low levels of education, income inequality and poverty, as well as a breakdown of community and social structures, including insecure and low-paid jobs, income inequality, housing evictions and workplace automation.

In a study that my team at the University of Manchester recently conducted, we used the latest available data from England to see whether there was a similar trend. It showed us that between 2019-21, 46,200 lives were lost to deaths of despair (equivalent to 42 each day) with an average rate for England of 34 lives lost per 100,000 people.

But below this average hid significant regional disparities, mapping on to what we know about place-based inequality. The North East had the highest burden, averaging 55 deaths of despair per 100,000 people, but in stark contrast, London’s rate was very low, with around 25 per 100,000. Despair therefore seems to not be uniformly spread throughout England: of the 20 local authorities with the highest rates of deaths of despair, 16 were in the north – but none of the 20 areas with the lowest rates were. These are stark and unacceptable differences.

To understand what might be driving these gaps, we identified a number of area-level factors that were associated with the elevated risk of deaths of despair. These included high unemployment rates, higher proportions of White British ethnicity, solitary living, higher rates of economic inactivity, employment in elementary occupations, and whether the community was urban (compared to rural). This also emphasised that deaths of despair are not inevitable – but rather a tragic consequence of inequitable resource distribution.

Deprivation interacts with place, amplifying its impact

While deprivation and the lack of resources available to people and places are key drivers of health inequalities, there is evidence that region-level deprivation interacts with and amplifies the effect of small area deprivation. We can see deeper health inequalities at a hyperlocal level: this is a phenomenon that we have called ‘deprivation amplification’.

We see this throughout England. Persistent inequalities, evolving over recent decades, have led to the creation of ‘left-behind’ communities. While the use of the phrase left-behind has generated some controversy, it reflects that a set of neighbourhoods and communities have higher levels of need and have largely been forgotten by national policy. There are 225 left-behind neighbourhoods, which are mostly found in post-industrial areas in the north of England and the Midlands.

Again, this has an impact on health outcomes: in left-behind neighbourhoods, men live 3.7 years fewer than average and women 3 years fewer. Both men and women in these neighbourhoods can expect to live 7.5 fewer years in good health than their counterparts in the rest of England, and there is a higher prevalence of 15 of the most common health conditions, even when compared to other deprived areas. This has an economic impact: individuals are twice as likely to claim incapacity benefits due to mental health-related conditions when compared to England as a whole.

This deprivation amplification was particularly acute during the Covid-19 pandemic. Across England, the most deprived areas had the highest rates of Covid-19. But when deprived areas in the north were compared to areas that were equally deprived in other parts of England, we found that northern areas had significantly higher rates of mortality. We found that deprivation alone could not explain these very stark differences. And again, people living in left-behind neighbourhoods in the early stages of the pandemic were 46% more likely to die from Covid-19 than from those in the rest of England.

Options for a more equal England

Interpreting the complex interrelationships between health and place relies heavily on the availability of high-quality data and the definition ‘place’. However, the way that we currently measure the health of a place is based on geographic definitions that are not always meaningful when it comes to supporting decision-making about how to improve health.

For example, Liverpool has the fifth-lowest life expectancy for males if we consider local authority averages. Yet of the 62 middle super output areas (MSOAs) that make up Liverpool, 10 of them have above the national average male life expectancy. Conversely, not all MSOAs within the local authorities that have the best health outcomes experience the best health. For example, based on census data, 12% of areas within Richmond on Thames (the local authority with the highest life expectancy) reported below average levels of very good or good health.

Therefore, if we base funding decisions solely on local authority averages, we mask really important variation that tells us about the health of communities and where services might be needed.
We need to tackle the hyperlocal differences in health outcomes, as well as the between regions and between local authority differences. But the way policymakers currently think about place-based health inequalities is insufficient, as decisions are based on their understanding on averages of disparate areas. And the way that most people conceptualise ‘place’ is very often different to how geographical boundaries are drawn. For example, most people have no idea which MSOA they live in: instead, we tend to define where we live through key landmarks.

We can see this insufficient consideration of place play out in the previous UK Government’s Levelling Up agenda. Our research has previously raised concerns around whether funding is allocated equitably. Around £125 million was allocated to England in the first round of the Community Renewal Fund (one of the first flagship ‘levelling up’ funding pots). However, when a ‘fair share’ funding allocation was created (based on the UK Government’s own formula) and compared to the actual allocation of funding, large place-based inequalities emerged. The North East received £13.4 million less than expected based on its resilience score. At the other end of the scale, the South East received £3 million more from than expected. Overall, analysis showed no significant correlation between need and actual Community Renewal Fund allocations.

The implication of our work is therefore clear: preventive policies must be geographically tailored. There is no one-size-fits-all solution to fixing regional inequalities, and knowing where the hotspots of poor health really are will mean that policymakers can target funding in a much more nuanced way.

We have set out a series of policy options below. Devolving greater decision-making powers and funding to local and regional governments offers one avenue for delivering bespoke solutions. Greater powers are needed for Metro Mayors to direct financial, health, and community resources towards the areas hit hardest by unfair health inequalities. This is underway in Greater Manchester and the West Midlands, with their ‘trailblazer deal’, but this new data highlights the urgent need to accelerate the devolution of place-based powers.

However, the national policy context – prioritising equitable access to economic opportunities, the labour market, and housing – remains paramount in reducing health inequalities by tackling the social determinants of health. This has been shown to be successful in the past in the UK at reducing inequalities in life expectancy, infant mortality and mortality at age 65. Tackling these socio-economic factors requires interdepartmental collaboration, cross-party working and a long-term commitment to levelling up. The responsibility falls across Government to ensure health is embedded in all decisions aimed at reducing inequalities.

Options

What Westminster can do

• A national strategy developed to reduce health inequalities through targeting multiple neighbourhood, community and healthcare factors. However, this needs to be allocated based on need, so that more deprived and left-behind communities receive their fair share.
• The impact on health, and health inequalities, should be taken into account when making all government decisions, regardless of which government department is making the policy.
• An increase in NHS funding in more deprived local areas (including left behind neighbourhoods) to reduce healthcare inequalities.
• Long-term ring-fenced funding put in place for targeted health inequalities programmes, and focussed at the hyper-local neighbourhood level.

What mayoral/combined authorities and local authorities can do

• Local governments should have increased freedom over their spending to ensure it is used in the best way to tackle health inequalities. In particular, following on from the Health Foundation work, local authorities should utilise hyperlocal data to identify the areas with the highest burdens of disease and use this to target services within their jurisdiction.
• Consistent and long-term financial support should be ring-fenced for communities to engage in neighbourhood-based health initiatives. For example, a Community Wealth Fund, which, if implemented, could offer a means of improving social infrastructure and empowering communities by placing neighbourhoods at the heart of decision-making.
• Programmes developed to increase community engagement to better understand and identify the issues and barriers faced by individuals, and thereby improve the quality of local services.
• Set up community consultation processes in left-behind neighbourhoods to identify the issues facing local communities.

What local government and communities can do

• Fund health initiatives that increase the level of control local people have over their life circumstances, such as the community piggy bank.
• Put community engagement which builds social cohesion, networks and infrastructure at the heart of health delivery.
• Help communities to take ownership of community assets facilitated by sufficient help and support from national and local government.
• Support and incentivise residents to make the most of community assets and maintain their participation through schemes such as lower transport costs.
• Existing services should be redesigned to respond to specific challenges within an area.

If we get this right, there is much to be gained. Not only will it improve the lives of millions of people living throughout England, it will also bring significant savings to the taxpayer. If the health outcomes in local authorities that contain left behind neighbourhoods were brought up to the same level as in the rest of the country, an extra £29.8 billion every year could be put into the country’s economy.

Fixing health inequalities must be a moral urgency for this new UK Government.

Dr Luke Munford is a Senior Lecturer in Health Economics at the University of Manchester and deputy theme lead for Economic Sustainability within the NIHR Applied Research Collaboration in Greater Manchester (ARC GM). He is a quantitative researcher who uses existing data to understand the causes and consequences of health inequalities, with a strong emphasis on place, including focussing on the interactions between people and place. He is also academic co-director of Health Equity North. Health Equity North is a virtual institute focused on place-based solutions to public health problems and health inequalities, bringing together world-leading academic expertise from leading universities and hospitals across the North of England.

The threads of power and place run through everything we are exploring in UK 2040 Options. Understanding how power and place interact, and how they impact people and communities, is critical to understanding how we might make the UK a fairer place to live. This is part of a series of guest essays that explore how we might use new models of power and place to do just that.

Too many adults in the UK are stuck in a persistent cycle of unemployment, insecure housing and poor health. To break this invidious cycle, we need to think about public services – and invest in people’s skills – in a very different way.

Today, 4.3 million children in the UK live in poverty. In England alone more than 83,000 are looked after by the state, around 100,000 will leave school this year without qualifications and 20% are persistently absent from school. As a society we are facing intergenerational cycles of devastating outcomes cycles which can and must be broken to create a better society for the 2040 generation.

For the most part, the problem is not that the state is failing to reach the individuals behind these statistics. In fact, many of those in the most challenging circumstances have been through multiple public service interventions, at great cost and with good intentions, but without lasting success.

The problem is that we are not reaching the worst affected people early enough, and even when we do, the model for delivering services is fundamentally flawed.

A new paradigm for public services

In the UK, the traditional public services model is to standardise a particular process or intervention and deliver it in the same way, to anyone who needs it, as efficiently (and cheaply) as possible. This model focuses on immediate needs or problems to be fixed, and deals with them individually, in isolation – this is known as the ‘deficit model’.

This works very well for single issues with a ‘one-size-fits-all’ solution, such as mass vaccination or pension payments. However, it demonstrably fails to effectively address our society’s so-called ‘wicked problems’ – complex social problems without clear solutions, including multifaceted challenges such as family breakdown, long-term health conditions and homelessness.

This standardised deficit model has three key drawbacks. Firstly, by only focussing on ‘needs’ or ‘weaknesses’ (real or perceived) it can reinforce rather than break down the psychological barriers many people face when pursuing education and employment. Secondly, by focusing on isolated issues rather than trying to understand an individual’s situation more holistically, we often end up treating the symptoms rather than the underlying cause. And thirdly, it prohibits the personalisation needed to effectively address multifaceted challenges with complex interactions and instead takes a one-size-fits-all approach, treating everyone the same instead of treating them as individuals.

Fortunately, over the last decade, a new model of public services has started to emerge. This new paradigm recognises that what it takes to achieve positive outcomes is going to be different for everyone. It recognises that different places have different assets and priorities. It recognises that building on people’s strengths rather than focusing on weaknesses provides a better basis for sustained change. And it recognises that relationships are fundamental for thriving lives and communities.

At Bridges Outcomes Partnerships (BOP), we believe there are 12 essential ingredients when designing delivery to deal with these wicked problems.

Collaborative design

From programmes designed by a central department, often in isolation from other departments and implemented in a top-down way, to projects that:

1. Bring community organisations together around a shared vision of success
2. Co-create with real experts – frontline teams and participants themselves
3. Join up with other local services via cross-government co-payment funds
4. Operate as dynamic, actively managed partnerships by changing the nature of the contractual relationship between governments and delivery organisations.

Flexible delivery

From fixed-specification contracts that are delivered to rigid budgets for groups of people with identical needs to flexible, personalised services that:

5. Tailor to peoples’ strengths by giving front-line teams the freedom to shape their services around individuals
6. Invest properly in delivery teams by taking a more flexible approach to resourcing costs
7. Embrace continuous improvement and allowing the service to be redesigned and ‘relaunched’ regularly
8. Tackle systemic barriers to progress.

Clear accountability

From arms-length contracts with limited visibility on progress, success and key learnings to supportive partnerships which:

9. Are transparent on progress by sharing regular updates against objective, clearly defined milestones
10. Are accountable to those who access services
11. Consider the longer-term impact of the service by finding light-touch ways to link into or compare with other government data
12. Access and share learnings to benefit future services by investing in more sophisticated evaluations that tease out relative benefits of project features.

Since 2012, BOP has deployed these lessons through ‘outcomes partnerships’. These bring together multiple stakeholders to achieve meaningful change for people facing wicked problems, while helping create environments where delivery teams have more flexibility to personalise their delivery. By switching the focus to the desired goals rather than a specific delivery model, it allows for more personalised, localised programmes. The model also breaks down silos between systems to create more holistic – and therefore more effective – delivery of public services.

For example, in Kirklees, West Yorkshire, the local council recognised that its existing top-down, deficit-based model – using rigid service specifications focused on short-term needs – was consistently failing to achieve lasting change in people’s lives. So, together with the council, we created the Kirklees Better Outcomes Partnership (KBOP). Its strengths-based, outcomes-focused approach to tackling persistent homelessness, drawing on community assets, has been much more successful.

Of the 6,379 people KBOP supported since September 2019, 73% of people have been able to keep their accommodation while 49% have entered education or employment compared to 43% of people sustaining accommodation and only 15% entering education or employment in the initial year. These outcomes demonstrate ongoing innovation in delivery and are outcomes with long-term impact:

13. 13. KBOP has reduced the need for repeat support by over 70%
    14. has been able to support more than twice as many people than predicted
    15. at an average cost-per-participant which is 39% lower to the commissioner than under the previous service.

Moving to a holistic, strengths-based approach to delivery through outcomes partnerships has not only transformed lives, it has resulted in much better value for taxpayers’ money.

Breaking the cycle: skills and education

This emerging model has important implications for our approach to skills and education – an essential foundation of fulfilling, stable lives. Our work supporting adults who are homeless or at risk of homelessness demonstrates how this more personalised, strengths-based approach has helped practitioners approach skills in a different way and help people achieve sustained, positive changes in their lives.

Take the Greater Manchester Better Outcomes Partnership (GMBOP), a collaboration between mission-led organisations commissioned by Greater Manchester Combined Authority. This project supports young people at risk of homelessness. A lack of educational attainment was one of the biggest barriers to accessing stable employment and therefore housing. Many young people with highly transferable practical, creative and interpersonal skills are held back from jobs and apprenticeships because they don’t have a grade 4 GCSE in Maths or English.

By helping young people get qualified, GMBOP’s link workers have a huge impact, enabling them to access and sustain employment and accommodation. But first, they need to overcome the barriers that have stopped them in the past and lay the foundations for transformational change. This means taking a relational approach to improve resilience and confidence. And conceiving of skills in a wider sense to embrace essential soft skills such as communication, building relationships, setting goals and practical skills such as budgeting. Taking the time to develop foundational skills and focus on long-term outcomes helps these young people break their cycle of dependence on public services.

It follows then, that if we really want to tackle these problems we need to start early and prevent young people from getting trapped in these negative cycles in the first place.

That’s the key idea behind AllChild (formerly West London Zone), an outcomes-focused organisation that supports children and young people with an average of four risk factors across emotional, social and academic areas. None of these risk factors are, in isolation, bad enough to trigger statutory thresholds for children’s services. But taken together, they put the young person at high risk of negative outcomes, such as mental health challenges, being excluded from school, and/or falling into the ‘not in education, employment or training’ category.

AllChild’s two-year Impact Programme puts the child at the centre and personalises support around them, working with schools, early help, social care and local voluntary organisations to provide the tailored, holistic support they need. And it works. AllChild has supported more than 4,500 children across over 50 schools in West London. Three-quarters are no longer assessed as at risk in terms of their emotional and mental wellbeing, while two-thirds improved their grades.

A crucial factor in AllChild’s success is that it is deeply place-based. Extensive community co-design ensures interventions and services work in the local context, capitalising on local strengths. Indeed, building on its success in West London, this year AllChild has launched a new model in Wigan, Greater Manchester.

We need to change the system

These strengths-based, outcomes-focused programmes are hugely promising. But they remain the exception rather than the norm and there are systemic barriers to them realising their full potential. Most services designed to tackle ‘wicked’ problems are delivered with rigid service specifications that don’t allow for the personalisation possible under outcomes contracts – procurement processes and limited resources tend towards inflexibility, short-term budget cycles lead to short-term decisions and funding pressures result in prioritisation of crisis cases rather than prevention.

While this is understandable, it’s a false economy. Independent analysis (which has yet to be published) has found that outcomes partnerships such as AllChild deliver average total savings and wider economic benefits of £81,000 per child. This includes money saved by the state through the avoidance of negative outcomes, such as requiring child protection, and increased value from improved educational attainment and reduced exclusion. We must escape this ‘firefighting’ funding trap.

AllChild offers one potential solution. Partly because of its focus on place, it has been able to develop an innovative co-payment funding model. This brings together central and local government, local schools, local businesses and philanthropists to jointly pay for the positive outcomes the programme achieves, recognising that improving outcomes for children has benefits for the whole community. The model will soon be launched in Wigan – and can and should be replicated nationally.

Another crucial challenge is to target the right support, at the right time, to those most at risk of spiralling into negative outcomes.

In delivery, we see time and again the common factors trapping people in cycles of negative outcomes. And we see the enormous value of early intervention and prevention.

Where it’s been possible to securely link data sources, for example through Ways to Wellness, an asset-based social prescribing service, we have seen dramatic improvements in collective ability to understand what works and for whom leading to much improved outcomes for participants and cost savings to the NHS. With the advent of big data and AI, we have an opportunity to much more effectively target and tailor support for those who need it most.

The voluntary, community or social enterprise sector working on the frontline has a vital role to play in identifying those in need of help. Critically, the front line is the source of innovation and can also build the evidence base around how best to help people develop the skills they need to break negative cycles and improve their lives. We at Bridges Outcomes Partnerships would love to join forces with others who see the potential impact of truly holistic, place-based data and learning partnerships to get the right support to the right people at the right time. Given the likely state of the public finances over the next five years, improved targeting and investment in early intervention is clearly essential.

Solving these problems won’t be easy. Embracing this new approach to public services – more preventative, holistic and localised services and a strengths-based approach focused on improving individual outcomes – requires a change in mindset from commissioners and policy-makers. Breaking the cycle requires boldness and innovation. And if we get it right, the potential prize is huge.

The threads of power and place run through everything we are exploring in UK 2040 Options. Understanding how power and place interact, and how they impact people and communities, is critical to understanding how we might make the UK a fairer place to live. This is the first in a series of essays that will explore ideas about how we might use power and place to do just that.

What will life be like in the UK when today’s children reach adulthood? The question Nesta has posed through UK 2040 Options is the same one that is being discussed with growing pessimism at school gates and dinner tables across the country. It is no surprise: hope is in short supply and trust is at a record low.

However, there is reason for optimism. As trust in traditional institutions has fallen into sharp decline, new models of public-led activism, innovation and ownership are on the rise, catalysed by technology. Yet, despite this, the way we design solutions to our biggest public problems has barely changed for centuries, with decisions made by a small number of people in an even smaller number of institutions. This creates an opportunity. If we can get this right, we can inspire a new generation of citizens to lead the way in helping tackle some of our most pressing social issues. If we can’t, there is a risk that declining trust in institutions turns into a loss of the public consent on which their power resides.

The citizen incubator model

For the last twenty years, I have worked in and around public life. I have seen it from the inside, heading up the offices of MPs, and have influenced it from the outside, leading national lobbying teams and creating UK-wide campaigns.

These experiences have led me to conclude that there is a fundamental flaw at the heart of UK public life – it doesn’t actually involve the public. From Whitehall to town halls, the people creating solutions to our biggest social issues are almost never the ones facing them on the ground. This has left the public on the sidelines, disempowered by a system that often sees them as a problem to be solved rather than an asset to be unlocked.

The evidence is clear that public trust and citizen engagement are mutually reinforcing. Yet, as the Institute for Government point out in their in-depth review of the UK constitution, there are “limited opportunities for citizens to shape the decisions that affect their lives in a meaningful sense.” This has contributed to growing scepticism amongst the public in the institutions that represent them. Recent YouGov polling found that 56% of people believe parliament does a bad job of representing their interests, with only 11% saying it did a good or fairly good job. Hansard Society research reinforces this, finding that 50% believe the main parties don’t care about “people like me.”

Creating a new approach that puts citizens in the driving seat has been my obsessive focus over the last seven years. I wanted to rebuild trust and agency, so designed the ‘citizen incubator’ model to both support those facing social issues to invent the solutions they need, and inspire citizens to recognise their own power to lead change. That’s why the approach is not just about ideas. Equally as important are the opportunities thousands get to play their part as active citizens and their impact on the hundreds of thousands reached through their work. In this way the model is as much about incubating citizenship as it is new solutions.

I have designed and delivered multiple programmes using the model, with thousands of citizens and hundreds of organisations involved, and a range of new community-led businesses are now in the world as a result. An independent university evaluation of the last programme using the model found that in its first year alone, it generated a social return of £6.26 for every £1 invested.

The citizen incubator model has three key elements:

• Citizen facilitation. A unique approach that identifies and recruits active citizens facing social issues as citizen entrepreneurs and pays them a living wage.
• Community innovation. A five-phase process that supports citizens to spend a year inventing impactful solutions with thousands locally.
• Funder collaboration. A model that involves funder organisations throughout, with them ready to invest in credible citizen solutions.

This is the story of the most recent citizen incubator programme.

A mission-led approach

Eastlight Community Homes wanted to be bold and invest in a different way in its North Essex communities. As the biggest community-led housing organisation in the country, its board was passionate about putting power firmly in the hands of local people. The citizen incubator model gave them a chance to support them in a radical new way.

The programme I designed involved recruiting 20 Essex residents and paying them a full-time living wage salary to dedicate a year to going from a blank sheet of paper to inventing new solutions with thousands locally. Based in teams in the Essex towns in which they lived, these citizen entrepreneurs took on four community missions. These focussed on the social issues facing them and their communities, informed by polling we had commissioned locally. We wanted to understand how the model worked in different settings so focussed on a range of geographies, from Halstead, a town with a population of 12,000, to Colchester, a city with a population of 130,000.

The citizen entrepreneurs went through a 12 month innovation process. This involved leading ethnographic research to get under the skin of their problem, running workshops across their communities to generate ideas, designing experiments to test the best of those with local people, and finally delivering their solutions on the ground with a six-week pilot. My team provided the support they needed, but they took every decision. The big question was – through this mission-led approach, could citizens with no experience of social innovation invent impactful new solutions to the issues facing them?

To answer that question we commissioned the University of Essex to independently evaluate the programme. They found the model created impactful citizen solutions to complex social problems, strengthened communities by building trust and engagement, and delivered life-changing experiences for the citizen entrepreneurs.

Impactful citizen solutions

The teams created genuinely impactful solutions to the problems important to them. Each was piloted on the programme with measurable impact. The university calculated a collective social return on these pilots of £668,000. The citizen entrepreneurs went on to use this evidence for their funding proposals, with every one going on to win funding and spin out as its own community-led organisation. Crucially, every aspect of the solutions creation, development and implementation were informed by direct life experience of the social issues they were working on.

A great example was Karen and her Colchester team (which included her daughter Jessica), who had taken on the community mission of the cost of living. Their insight was that those who have the least money are often the best budgeters. And they knew that because that had been them. That insight became Trusted, an innovative peer-to-peer money confidence programme, the first of its kind in the UK. The team piloted Trusted on the programme and its impact blew them away. In the space of just six weeks, the ten pilot participants collectively saved nearly £45,000. Trusted went on to secure funding and become its own community-led organisation with Karen and Jessica at the helm. They have run a number of programmes since, all with similar results, and are busily working to scale the model.

Stronger communities

The University found that “the programme created genuine trust and engagement and fostered community in multiple directions and levels.” Over 5,000 local people engaged with the citizen entrepreneurs over the 12 month period, half of them in person. This was a collective endeavour with the community getting involved because it was their friends and neighbours taking the lead and working on issues that were affecting their lives too.

The reach of the programme was also significant. We estimate their work reached over 100,000 people locally. This was important to us as it demonstrated to local people, with tangible relevant examples from their communities, the power they had as active citizens.

The community incubator model has reached over 100,000 people in North Essex

By Rachel Carter and Lucy Makinson
 
The devolution agenda is likely here to stay. Local councils are closer to their communities and are often better-placed than central government to grapple with their most complex challenges.

To better understand the data challenges faced by local government, and to surface the opportunities that exist through devolution, Nesta’s UK 2040 Options hosted a panel event in late November 2023. Chaired by Nesta’s James Plunkett, panel members were Stephen Aldridge (Department for Levelling Up, Housing and Communities), Cate McLaurin (Public Digital), Gavin Freeguard (freelance consultant and host of the Data Bites event series), Wajid Shafiq (Xantura), and Natalia Merritt (Maidstone Borough Council).

This is what we learnt.
 

Preventing homelessness through harnessing the power of locally held data

Data is both a strength and a weakness when it comes to local delivery. Everything, from the provision of social care for vulnerable children to collection of council tax, produces a huge quantity of data. This data could have huge benefits for councils; helping them better understand their citizens’ needs and behaviours, targeting services more effectively, stopping what isn’t working, and allocating resources to where they have the biggest impact. But in practice, it can be challenging for councils to use this data effectively. It can sit in siloes, and local authorities can lack the capability, time, or investment to draw out what the data means and to utilise it as effectively as possible to improve public service outcomes.

But it quickly became clear that effective use of data by a local council can be transformative. Natalia Merritt spoke about Maidstone Borough Council’s partnership with Xantura to create Oneview: a multi-agency identification system that enables Maidstone to understand which households may be imminently at risk of homelessness. It uses data and predictive analytics to understand the risk factors that contribute to homelessness and alerts the council to households that are at risk, who can then receive targeted early intervention and support. An initial assessment of the programme found that it is accurate in identifying imminent homelessness in 84% of cases.

Often, councils only become aware of an issue when people tell them they have become homeless, which is too late for any preventative intervention and increases reliance on expensive temporary accommodation. Maidstone can only prevent homelessness for a third of the people who walk through their door. However, the preventative approach facilitated by Oneview – of targeted early intervention and support – has already paid dividends. Of the first cohort flagged through the system, only 2% became homeless after early intervention action was taken. This preventive approach has resulted in huge cost and time savings for the council.
 

Laying the foundations for policy success: it’s about more than just data

Maidstone was able to execute its vision of preventing homelessness in the borough through two key enabling factors. Firstly, it had senior leadership with an ambitious but clear vision of what it wanted to achieve, who gave permission and encouragement to tackle this problem head on. Secondly, it had an initial investment that enabled it to establish Oneview.

Our panel members highlighted the factors they saw as critical to creating an enabling environment for local authorities to use data effectively.

• Focus on the use cases, not the data. As one expert put it, “if you want to have a conversation about data, don’t talk about the data”. Data infrastructure and capabilities might be important, but they are not the end goal. Showing people what they can do, and the outcomes they can achieve, through the use of data is far more effective for creating buy-in. This is particularly important for busy frontline staff.
• Senior leadership needs to be on board. We heard that when senior leaders ask the right questions – like in the Maidstone example – they can create a permission space that enhances and accelerates innovation.
• Starting small can pay off in the long run. Getting a small grant, kicking off a programme and working with a first cohort can enable you to test and see if a programme will work. That pilot can then be used to test, evaluate and adapt.
• It’s about more than the data itself. All experts agreed that impact doesn’t just come about with better data, or even improved data capability at the local level. They called for a continued focus on robust policy evaluation, evidence and insight, including tracking impact over time, to deeply understand what works and reallocate resources at pace to what works best.

Large structural challenges can hamper councils’ ability to use data

Panel members were conscious that local councils are currently operating in a challenging context. And while data use can drive some very visible and positive change, the barriers to reaching this for much of local government were repeatedly raised. To harness the potentials at the local level, any next government will need to grapple with several challenges.

• The lack of investment in councils. This is preventing councils’ ability to fix legacy systems – many of which make it very difficult to bring data together around a household, or a citizen.
• The variation in performance between service providers. Even allowing for differences in local costs and the characteristics of the population served, this remains a problem. Reducing this variation by raising the performance of those lagging behind could have valuable impacts on outcomes achieved. And, our experts told us, the newly established Office for Local Government could have an important role in supporting this.
• A monopoly on services. Some panel members spoke about the need for reform in the market for local authority systems and processes. Currently dominated by three of four big suppliers, it is often difficult to get data in or out of these systems, hindering the ability to effectively use the data.
• Barriers exist that prevent data sharing and enhance legal concerns. A lack of legal gateways for accessing and linking administrative data across central and local government, and even within local government itself, was repeatedly raised as a challenge. There is work underway in this space. ONS for example is developing an integrated data service, which – if it works – could overcome the need to put in place legal gateways. At the same time, legislation has often not caught up with technological advancement in this area and is often out of date.
• A lack of “patient capital”. Most interventions are not going to turn problems around quickly – we know that many interventions take time to bed in and to come up with findings, whether they are positive or negative. “Patient capital”, or long-term investment, means that public services can invest in working out what’s working and what’s not, over multiple partners and through different terms.

A way forward?

Maidstone showed us that with investment and ambition, local councils can use data to build the evidence base and draw out invaluable insight, forging a path to solve some of society’s most intractable problems.

But while effective use of data can help, it is only as good as the ability or capacity to do something useful with it out in the real world. And while many local authorities are well placed to gather and use the data they hold to solve problems, there remain significant hurdles to them doing so. This is the case whether it’s about solving homelessness in Maidstone, grappling with methodological challenges to get to grips with what works, or using data to better target services to improve the first years of a child’s life.

At Nesta, our aim is to innovate for social good. And in doing so, we want to give local decision-makers and policymakers the right tools to drive positive change. Nesta’s fairer start mission is working at the local level to explore methods to eliminate the school readiness gap. As part of this, it is hosting an event to help local authorities come together and share ideas on how data can improve services for children and families. Visit the event page to learn more.

Global challenges will provide a backdrop to many of the big decisions that will face us through the 2020s and 2030s – most notably regional conflict, growing climate instability and faltering economic growth. But the UK faces equally pressing questions at a local level.

Quality of life, design and delivery of public services, the shape and limits of the state and how all of this links to issues of identity and connection are critical to how we experience our lives, collectively and individually.

Brought together under the themes of “power and place”, they were the subject of a fascinating workshop hosted by UK 2040 Options and chaired by Demos’ director Polly Curtis, and a subsequent report.

With politics increasingly polarised and both nation and the wider global community facing an endless succession of intractable challenges, attempts to build consensus on the key issues facing us and cross political lines in a search for solutions are both rare and valuable. The UK 2040 Options project falls into the category of initiatives that are both incredibly timely and hugely important.

Rebuilding communities

Seeking to explore two important areas of policy thinking – how we are governed and people’s experiences of life at a neighbourhood level – the workshop examined the case for devolution of power and its limits. It also looked at the growing evidence base highlighting the need for new policy initiatives focused on rebuilding community institutions at a hyperlocal level.

As was noted at the workshop, one of the biggest challenges in developing policy in this space is the extent to which debates around what is often labelled “community power” conflate a number of very different strands of thinking.

On the one hand, there is a very developed debate around issues of devolution, seeking to shake out the best place for state-focused decision-making to sit. This tends to focus on tussles between Whitehall and local government, with the primary argument often being that this would establish conditions for better (or more balanced) economic growth. Alongside this runs a debate over the form of local government, and in particular, the benefits of mayors and combined authorities as both more effective and more accountable models of local governance.

A separate debate focuses on the extent to which local authorities should involve local people in service design and decision-making. Advocates either claim this as a good in itself, or point to ways in which this can improve delivery. Much of this builds on the excellent work of organisations like New Local and its Community Paradigm model.

A final strand of thinking has, until recently, been less well-represented in national policy debates, but is arguably more important to the everyday experiences of people. This is the need to address challenges and inequality at a neighbourhood level, highlighting that these are often as profound as regional differences in outcome.

Neighbourhood-level inequality

Drawing on extensive evidence from evaluations of the hugely successful New Deal for Communities programme, and more recent initiatives such as Local Trust’s own Big Local programme, this line of thinking focuses on the need to rebuild and strengthen local community organisations and institutions as a means of driving better outcomes.

One of the primary drivers of outcomes at a local level, even after accounting for relative levels of deprivation, is the strength of neighbourhood-level social fabric, as we have seen in reports such as Demos’ Preventative State. And that – often – the challenges faced by the state are driven by the need to address the social costs arising from the breakdown of these social structures.

The rise of the ‘social communitarians’?

To help make sense of all of this at the workshop, Demos proposed the existence of three broad policy “tribes” seeking to define the policy landscape in this space. The federalists, focused almost exclusively on issues of devolution of power; the mayoralists, largely focused on the transfer of power to individually accountable local leaders at a city level; and the communitarians, largely focused on building/rebuilding grassroots-level civic institutions and perhaps more agnostic about constitutional reform.

This classification of different approaches feels helpful, not least as a means of ensuring that crucial parts of the policy jigsaw are not lost as a result of shared terminology inadvertently concealing very different policy priorities. But there may be value in seeking to distinguish between two distinct strands of thinking within the communitarian camp.

There are those who see community power within the context of further devolution of power from the state – we can call these ‘democratic communitarians’, who in many ways simply reflect a logical extension of the agendas of federalists and mayoralists. There are also the ‘social communitarians’, who would argue that equal priority should be given to building or rebuilding social and civic institutions at a local level as a good in itself.

While the federalist, mayoralist and democratic communitarian camps have been well-represented in recent policy debates, we have seen little focus on neighbourhood-level policy in recent years. Since the Social Exclusion Unit’s report on a national strategy for neighbourhood renewal 25 years ago, we have had little in the way of new initiatives or engagement with neighbourhood-level, community-focused policy interventions since.

With an election likely in 2024, there seems little time left for either party to initiate new debates or come forward with major new initiatives focused on delivering neighbourhood-level change. But the establishment, post-election, of a new Neighbourhoods Unit, which could build on the example of the Social Exclusion Unit and focus on collating evidence and developing policy on rebuilding the social fabric of local communities, would be a major step forward in addressing a significant gap in our policy landscape. Is it time for a return of the social communitarians?