Luton Health Equity Town

Health Equity Town Evaluation and Monitoring Framework

We have focussed on developing an evaluation of the work to ensure we know how to continue to maximise impact and get the measures right to assess progress on an annual basis.

Over the last year, an evaluation of the health equity town work has been completed. The evaluation had three main aims:

1.

To understand the impact of the Luton Marmot report on system-wide efforts to tackle health inequalities through the wider determinants of health.

2.

To develop a set of measures to illustrate early impacts of the Luton Marmot report and set out an approach for future outcome measurement structured around the eight Marmot principles set out within the report.

3.

To activate the health equity system through the process of evaluation, through stakeholder engagement and re-enforcement of priorities and direction of travel.

Ways Of Working

We know in Luton that good or bad health is not simply the result of individual behaviours, genetics and medical care. Our residents’ health is shaped by social, economic and environmental factors.

The building blocks of health and wellbeing are the influencing factors commonly known as the wider determinants of health. Examples of the building blocks of health are, good quality homes, access to good education, stable and good employment, social connections and safe neighbourhoods, clean air and access to good quality health services and care.

These influencing factors impacts our health and ultimately how long we will live.

As a Health Equity Town, one of the common ways of working is that we would like partners and anchor organisations to learn to communicate about the building blocks of health. This will give our residents and our partners a clearer idea of what is needed to ultimately improve health and wellbeing, and reduce health inequity.

Logic Models

As part of our
HET evaluation report we
have agreed that we will
utilise theory of change,
logic models. This is to allow
us to have a consistent
approach across our
priorities and measure our
impact as a health equity
system.

Health Equity Town Prize

We utilised our public health funding to engage and stimulate Luton’s partners and wider health equity system to enable small projects that support promoting health
equity.

Sub-groups

We have set up sub-groups which are chaired by partners leading in the topic area and supported by public health. The purpose of these groups is to review and ensure recommendations are realistic and to monitor progress against the report recommendations.

Prize Winners

Measuring our journey

Evaluation report:
We wanted to establish whether the system understood what it meant to be a Marmot Place. We conducted an evaluation led by public health registrars and supported by the IHE. We found that whilst it was too early to evaluate the impact of becoming a Marmot Place, system partners were onboard, committed and understood what it meant to be a Marmot Place.

Reflections and Impact to date

Next Steps

We are committed to continuing to learn and test our Marmot Place approach. Our next steps are to are to understand fully our impact within the health system but also within communities by completing our KPIs.

Access and Prevention

Healthcare

Health Equity

Luton's advice to other areas considering being a Marmot Place:

Ensure system-wide clarity and strengthening of governance and accountability.
Ensure all stakeholders understand the role they can provide and are playing in tackling health inequalities.
Embed Marmot and health inequalities within workforce development across the system.
Develop a coherent workplan around the seventh Marmot principle; tackling discrimination and structural racism and its outcomes.
Use of logic models may be a useful method to build on for future workstreams associated with Luton’s Marmot Town ambitions.
Ensure that we learn from best practice amongst Luton partners and from national and international evidence base, whilst also sharing our own knowledge and learning.

Ingredients For Success

Supportive political and strategic landscape – 2040
Clear articulation of needs and challenges that everyone can buy into
Clear set of recommendations to work from
Recognition of shared sense of injustice, urgency
Shared agreement of key measures of progress
Keeping progress visible – small projects and programmes part of the journey
Keeping momentum through communication and networking – keeping wider system and roles engaged

Challenges For Consideration

Long-termism
Who is leading, who is influencing
Getting the governance right – not seen as a project
Capacity to keep momentum
Complexity of systems and drivers of health equity
Scalability

Collaboration & Partnerships Are Key

Housing and Health

This sub-group represents Housing and Health's sub-group as part of Luton’s Health Equity System. The sub-group will contribute to keeping oversight and strategic delivery of housing and health actions linking to the recommendations in the Marmot report and beyond as appropriate.

Employment, Skills and Work

1. Continued wider workforce wellbeing includes supporting Good Business Charter accreditation work through Inclusive Economy
2. TLC Anchor Institutions Coaching. Worked with commissioned provider and LGA for cultural competency training
3. Scoping with BLMK ICS, OHID and DWP on Workwell programme to support the economically inactive, those on long term sickness, and those with long term conditions back into work
4. Implementation and delivery of wellbeing support for Small and Medium sized Enterprises (SMEs) through the Open University Ageing Well Pledge, leaflets and health promotion

Children and Young People

The Children and Young People’s HET strand is using a quality improvement approach to development. This will involve using quality improvement tools and processes to identify the issues and drivers that will move the recommendations from the report forward. Work areas that are being developed and are in early stages of implementation.

Health and Built Environment

To create healthy, sustainable spaces to support mental and physical well-being while addressing environmental concerns. Key strategies include:

1. Enhancing Urban Planning: Implementing the Local Plan to improve the built environment and promote health-focused spaces.

2. Sustainable Healthcare: Rolling out the Integrated Care System's Green Plan to reduce emissions within the health sector.

3. Business Engagement: Partnering with local businesses to lower carbon footprints and foster environmental responsibility.

Net Zero

Luton has developed a roadmap outlining actions for the next five years to transition towards net-zero emissions. This plan includes measures such as improving the built environment through the Local Plan, implementing the Integrated Care System's Green Plan to reduce healthcare emissions, and engaging with businesses to lower their carbon footprints.