Well-placed: The impact of Big Local on the health of communities

Think tank: New Local

Author(s): Imran Hashmi; Jessica Studdert; Laura Charlesworth

December 10, 2023

This report from UK think tank New Local looks at the impact of Big Local on the health of communities.

New Local measured the impact of Big Local – a programme focused on 150 ‘hyperlocal’ neighbourhoods, which shared common characteristics of high levels of deprivation, low levels of social capital and lower-than-average health outcomes.

Each were given £1 million to spend over the course of 10-15 years from 2010-12 onwards. By placing considerable resource and autonomy over decision-making in the hands of communities, the model offers a unique insight into how communities would understand, identify and pursue their own priorities. For the wider health system, the Big Local model provides a unique source of evidence for the efficacy of community-led initiatives on improving health and wellbeing outcomes.

The experience of Big Local areas is instructive for how emerging local health systems organised around places recognise, work with and support community-led initiatives for improved health and wellbeing. These initiatives could have significant impacts not just for individual experience and outcomes, but hold the potential to alleviate demand pressures on formal healthcare provision.

The report identifies four core conditions that enabled Big Local partnerships to set up, fund and run health activities across seven key themes. It contains examples of communities turning the tides on longstanding health inequalities, and sets out a series of recommendations for the NHS and wider health system to recognise and foster community-based approaches, including by investing more money into their development.