By Oliver Harmar, Natural England's Chief Strategy Officer
Leaders from national bodies including Natural England, Sport England and NHS England met at the Cabinet Office to explore how to work together to support healthier places. Oliver Harmer reflects on the 20-year gap in healthy life expectancy, a joined-up approach being tested in the West Midlands, and why good health is created in the "gloriously ordinary" parts of everyday life.
Earlier this month, I had the privilege of chairing a meeting hosted by the Cabinet Office that felt different from most I attend in government.
Around the table were leaders from across government: Natural England, Active Travel England, Sport England, Arts Council England, Historic England, NHS England, Homes England, West Midlands Combined Authority, and the Cabinet Office's Test, Learn and Grow team.
The question we had come together to answer was simple to ask, but hard to answer: how do we better align nationally, so we can show up together and support local leaders to create the conditions for good health?
It’s a crucial question, because if you live in one of the least deprived areas of England, you can expect to spend around 20 more years in good health than someone living in one of the most deprived areas. That’s a shocking gap that should motivate us all to act.
We know that health isn't just created in hospitals and GP surgeries. Health outcomes are shaped upstream by factors such as housing, income, transport, physical inactivity and people's wider environment, while the NHS and healthcare often deals with the eventual consequences of ill health. It's created in the parks, libraries, cycle lanes, nature, community choirs, museums, football clubs, the home you live in and the street you walk down.
Each of our organisations already has big ambitions in this space. Natural England helps people access green spaces that lift mental and physical wellbeing, supporting our strategy’s ambition to deliver nature recovery as a foundation for the nation’s growth, health and security. Active Travel England makes it easier and safer for children to walk or cycle to school. Sport England seeks to tackle stubborn inequalities that exist in sport and physical activity by removing the barriers that prevent people, particularly those with the most to gain, from taking part. Arts Council England puts creativity at the heart of healthier communities. Historic England shows how heritage and belonging support happiness and connection. Homes England creates healthier communities through quality housing and well-designed places.
But here's the challenge we set ourselves: too often we work alongside each other, rather than truly with each other. So, we want to test a new way of working together in the West Midlands to find out what it really looks like when national bodies show up as one team in service of a place. This will explore questions over joint governance, shared outcome metrics, how to work across organisational boundaries and how activity can connect at national, regional and neighbourhood levels.
We want to be open about what we're learning, including what doesn't work, so other places can learn with us from the start. We know that what works in one place might not be the thing that’s needed in another but hope that we can develop a repeatable model for how ALBs work collectively in places. At its core will be a more joined up approach that listens to place-leaders so that we can all work more effectively together to support healthier households, communities and neighbourhoods across the country.
Ultimately, this is about enabling us all the “gloriously ordinary” things that enrich our lives - a walk in nature, a trip to a local museum, a safe cycle to school, a seat in a community choir. These everyday activities are where good health is created.
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