There is perhaps no one more informed about the integration of place, health and wellbeing in London than Professor Kevin Fenton CBE, Director for the London region of the Department of Health & Social Care’s Office for Health Improvement and Disparities. In addition to his role at DHSC, Kevin is the London regional director of Public Health for NHS England, and the statutory health advisor to the Mayor of London and the Greater London Assembly.
But it was a previous role within the London Borough of Southwark that gave Kevin the opportunity to develop the experience and insights that he brings to his current activities. As Executive Director of Place and Wellbeing, in a borough undergoing significant regeneration (think Elephant & Castle and London Bridge) he was able to explore, test and learn about how placeshaping impacts health and wellbeing through a formidable roster of projects, initiatives and stakeholders. Placeshaping is defined as the creative use of powers and influence to promote the general well-being of a community and its citizens.
I asked Kevin to share his top three insights gained from that time. He started by describing the “untapped opportunities” he helped to identify and release within local government to integrate place with health, describing the “dividends that are generated” to all stakeholders in regeneration when local communities are connected and cohesive. Health and wellbeing is something shared and valued by all community members, and as such serves as a solid platform for building community cohesion and connectivity in areas undergoing change.
Next he described specific examples of how the shaping of places impacts the health of local residents. Place-based features such as access to healthy food, clean air, green and blue spaces are now recognised and accepted as social determinants of health, which when located disparately and unevenly across places manifest in health inequalities.
Perhaps the greatest insight was gained through the experience of working directly with local communities. “Placeshaping cannot be done without the input and involvement of local communities” he asserts, observing that historically community engagement has been “transactional” but when there is a more holistic approach – one that respects past, present and future of local communities, and all aspects of residents’ lives – new places can develop the connectivity and cohesion that supports health and wellbeing.
He commends the work of Lendlease at Elephant and Castle for continually developing programmes of work to bring community members into each stage of the regeneration scheme.
I questioned whether I would see or could measure a positive impact on local health and wellbeing from these initiatives in Southwark, and he conceded that he had limited opportunity to create the structures for data collection and analysis while he was there. In his role as public health advisor to the Mayor of London, he hopes to develop a process to collect data from regeneration schemes across London to share learnings on the impact of placeshaping on local health.
Joining the Mayor’s office at the start of the pandemic brought on new and unforeseen challenges and opportunities, and Kevin describes his period like running a local laboratory which afforded repeated opportunities to hypothesise and test interventions, and to work with other parties and organisations as part of the process.
He points to relationships built between business, academia and the NHS to keep Londoners healthy and safe during the pandemic which had real impact, and must be leveraged to meet the challenges facing us in a post-pandemic world, particularly with regard to health inequality across the capital.
During the pandemic, a “health in all policies” approach was introduced so that health and wellbeing frameworks were integrated into all programming within the Mayor’s office, citing the collaboration with TfL as a prime example where policies developed during the pandemic have led to broader thinking about public health.
This includes walking and cycling within the TfL network and public messaging. Indeed, this week’s announcement from the London Assembly that TfL intends to provide information about public toilets within the network on the TfL app suggests that a focus on health & wellbeing has been successfully embedded in TfL programming.
Given his direct experience linking placeshaping and health from a national perspective through the DHSC and NHS, at a London-wide level through the Mayor’s office and the GLA, and at local level through Southwark, I asked Kevin what one thing national, local and private sector protagonists in planning & regeneration could do to improve health in the places that are developed and built.
His responses came quick and fast. At the national level, we must legislate to support a housing stock that is fit for the future, providing sustainability in a changing climate and ageing society. At the local level, we must ensure that houses and places are built that integrate people with nature, providing access to blue and green open spaces which we know underpin good health.
As for private developers, Kevin would like to see a different approach to how we think about the importance and even the concept of heritage – not as something that NIMBYs use to block new development, but something to be created as a legacy and as a framework for incorporating community voices and experience into what ultimately is developed and built.
He points out that in the context of health and place, local community groups are seen in two lights. In the planning sphere, they are too often seen as blockages to planning permission and categorised as the proverbial NIMBYs.
But in the health sphere, particularly in the wake of newly-defined Integrated Care Systems, community groups are seen as essential to defining and delivering services. I asked about how we might bridge this divide and leverage the strength of community groups to improve health through the development of places.
As a starting point, “we need to build general acceptance to rid leaders in planning and regeneration of the notion that engaging with communities is purely transactional in winning planning permission” Kevin says, emphasising that community groups are essential for all involved in planning to understand the needs and aspirations of local residents, and for building the support and the connectivity that underpins a successful new development.
On a practical level he cites several things that in his experience have led to better engagement.
First, collecting local data creates an opportunity to shape the quality and quantity of interactions between all involved in regeneration schemes. Along with new methodologies to analyse and communicate insights gleaned from local data and to interact with community members, the “de minimus approach to event-based engagement is rendered nul and void.”
Second, by acknowledging that community groups are often made up of volunteers, who value support and recognition for their activities, developers and regeneration leaders can provide resources that encourage engagement with community groups that is not “episodic but evolves and develops over time, throughout the development process”.
One way of committing these resources is through a dedicated engagement team providing programmes of events to local residents, reaching out to all age groups and vulnerable people. Partnering with local schools to engage kids in the regeneration of their local area, with advocacy organisations like Age UK to hear from older and vulnerable residents, and providing amenities like pop-up spaces for local charities and businesses are all approaches that Kevin has seen to be effective.
Underpinning all of these practical approaches is a commitment to building connectivity and cohesion amongst current and future residents --- essential to supporting health and wellbeing in any community.
As a demonstration of widespread recognition for the challenges of creating and maintaining healthy places, the World Health Organisation along with Bloomberg Philanthropies are spearheading the Partnership for Healthy Cities Summit.
It will be attended by members of the Partnership for Healthy Cities, a global network of more than 70 cities founded in 2017 working to deliver policies interventions to reduce non-communicable disease and injuries in their communities.
Kevin describes this as a very exciting initiative, and an opportunity to showcase how London is promoting health and health equity in a post-pandemic, post-Brexit, climate-changing and inflationary era.
Kevin Fenton is undeniably a thoughtful, reflective and passionate advocate for creating healthy places, and for integrating health and wellbeing into policy and frameworks for planning and regeneration. London and Londoners are fortunate to have him leading the way at DHSC, the NHS and the Mayor’s Office.
Tuesday, 13 June 2023
6:30 pm - 8:30 pm
Book here: Creating a healthier and fairer London
Location: The London Centre, 3 Aldermanbury, EC2V 7HH