Transforming neighbourhoods

I live in London which is by far the wealthiest and most economically productive of any city in the UK. I also live in one of the wealthiest London boroughs, Bromley,  yet my neighbourhood is in the most deprived decile in England. Headline statistics show problems across the board on employment, skills, health and crime to list a few. 

But I like living here. My neighbourhood has some fantastic local features including access to nearby woodland and green spaces, good bus links into urban centres including Bromley and Eltham town centres, a brilliant local Family and Children’s Centre, a good primary school and a church. And crucially for us, our terraced house was affordable with good links to central London. By train I can reach London Bridge, door to door, in under an hour. The people here are generally great and residents often support each other, my own neighbours would do anything for you and put up with our kids moaning a lot! But here’s the thing, despite these assets, it doesn’t feel like things are getting better for people living in my neighbourhood – many are struggling to get by either out of work or in low paid, stressful jobs.   

I’ve lived here for 7 years. During that time, GP appointments have become harder to get (although there have been some marginal recent improvements), the local pharmacy closed, and its premises have been taken over by fast food outlets. There are several pharmacies a 20 minute walk away – all of which are in closer proximity to more affluent neighbourhoods. Not much use if you struggle to walk. Instead, within 5 minutes, there are fish and chip shops, 2 pizza joints, a greasy spoon, an Indian, and a Chinese takeaway. The economic wealth of Bromley and Greater London hasn’t trickled out to my neighbourhood – a finding consistent with our own research about the isolated nature of the most deprived neighbourhoods in the UK.  

What can be done?  

GPs and prevention  

Health is critical and primary care has a vital role to play in my community as in many others. The GP surgery needs to focus on prevention as much as treatment. I know for a time the local surgery was prescribing (and funding) Weight Watchers for some of its residents which was anecdotally successful, but this was done on an ad hoc basis and was relatively quickly stopped. GPs are often trainees and focus on short term fixes, which is not the fault of individual practitioners, but many residents have multiple complex health conditions with overlapping underlying causes.  Experienced doctors are in incredibly high demand.  

The government’s proposed focus on a new neighbourhood health service could help in this regard if it facilitates genuine join up of local community services, including advice on debt and housing, access to skills and training and supported employment programmes, as well as drug and alcohol interventions.  Recent evaluations of social prescribing suggest that it can reduce pressure on the NHS including A&E appointments, substantially in some cases. But GPs and their trainees will require training and support to do this at scale and lack capacity to do all this link-working alone. 

Nurturing community assets and its people 

In my neighbourhood, nurturing local assets means greater resources for reaching out to the most vulnerable families through the local Family and Children’s Centre. We know from the evidence that Sure Start worked particularly well in the most deprived areas, and where family hubs continue to exist, they must be nurtured. It also means local social housing providers playing a convening and partnership role with other local services including employment support.  In this regard, the DWP funded Jobs Plus pilot programme is a positive development. Evidence from a similar social housing backed scheme in the US revealed that it increased average earnings among residents by 16 per cent relative to a control group, gains which persisted over a 7-year follow-up period. However, we need to go beyond pilots and scale up promising schemes quickly if we are to start transforming lives today, harnessing what works faster than our often plodding and piecemeal approaches to pilots and evaluation allow.   

Nurturing local assets also means ensuring shared green spaces are kept clean, usable and expanded further where possible. It took 2 years, for instance, for the children’s roundabout in the local playpark to be mended and now the park is busier than ever with young families of all backgrounds. And it means using shared civic spaces as a means to address barriers to good work – such as using the church to deliver skills training and support that is responsive to hyperlocal need. On this front there has been some modest anecdotal success such as through the Big Local initiative in my area though greater speed and scale is needed to support employment for more residents here.  

But most importantly it requires taking careful active choices on behalf of local citizens to create a positive neighbourhood environment where all can thrive.  The pharmacy didn’t close by chance; market forces squeezed it out, leaving room for yet another fast food joint. It’s a familiar story—pharmacies in deprived areas are closing nearly five times faster than elsewhere. Similarly, the play park was likely left to rust because council budgets are stretched thin, with 60% now consumed by social care nationwide. And GPs? Overwhelmed, focusing on quick fixes because each GP is responsible for, on average, over 2,450 patients—300 more than doctors in wealthier areas. 

None of these developments are due to overtly vindictive policy design, but they are the result of long-term neglect at national and local government level around neighbourhood regeneration and preventative public service design. These are issues that we as an organisation will be seeking to address through a revamped network of local and combined authority leaders and practitioners to support inclusive growth and public service reform. A renewed focus on neighourhoods is certainly needed - there is a catalogue of policy false starts in recent years - levelling Up, for instance promised a lot but ended up amounting to underutilised fragmented “hanging basket funds”, adding to the complexity of local government funding. 

A new beginning for neighbourhood policy? 

I am somewhat optimistic that things will be different over the remainder of this Parliament. The government funding for the National Plan for Neighborhoods was relatively piecemeal – spreading £1.5bn across 75 areas – but it positively signals a new beginning for neighbourhood policy. For the plan to succeed during a time of severe fiscal constraint, it must be complemented by other initiatives related to devolution and public service reform. Local growth plans and skills improvement plans must, for instance, be relevant for the most deprived neighbourhoods across their geographic footprint. This means going beyond high value clusters and understanding how to create good jobs in all communities including through the foundational economy. New devolved powers to strategic authorities including single settlements, should seek to unlock more preventative spending power on local skills, supported employment programmes and other preventative initiatives as we set out in our work with Core Cities last year. And new neighbourhood health hubs and social housing providers can be the critical link between residents and preventative support programmes where such programmes exist.  

Ultimately, taking active choices for neighbourhood renewal depends on harnessing the insight and capabilities of residents, ensuring they have a stake in creating their own futures. All of the above shifts in policy must be designed with residents to build trust and meaningful solutions. The ongoing devolution of powers to combined and strategic authorities including the reshaping of districts into wider 500,000+ conurbations, must be used as an opportunity to complement this effort rather than taking power further away from the most vulnerable and marginalised communities.  

The new focus on neighbourhoods is very welcome after a 15-year hiatus. Now the hard work begins.