In 2021, as part of Luton’s strategic 2040 vision, Luton Borough Council, in their efforts to encourage  a health equity approach to improving health and wellbeing in Luton, became a Marmot Place. Since then Luton have adopted and supported embedding thinking on tackling health inequalities and promoting actions that impact on the building blocks of health.

The council has facilitated and promoted activities that enable its partners to work together across the 8 Marmot principles.  In order to support the development of our Marmot Town report, we set up a steering group of partners across the system to obtain buy-in. The work of the steering group contributed to the Reducing Health Inequalities in Luton:  A Marmot Town report. The steering group have also coordinated actions across 4 agreed priority areas:

1. Children & Young People – Raising aspirations
2. Housing
3. Business, Employment and Skills
4. Net Zero

Luton’s Health Equity Town (HET) activities include:

System approach to health inequalities

• Communications: We have developed a shared newsletter, where health equity system partners can contribute and share their learning. 
• One year On 2023:  In 2023 the Luton public health team convened a system-wide conference to celebrate our successes and plan for the coming year.  The conference had over 80 delegates in the room and over 18 case studies submitted by various partners showcasing how their organisations were tackling health inequalities.
• Health Equity Town Partnership: As part of Luton’s Health and Wellbeing governance structure.  Luton hosts a system wide partnership focusing on the wider determinants of health and activities supporting community groups to deliver on improving health equity.
• Case studies:  We have encouraged case studies from partners to show case their work.  We continue to work with our principle mental health provider East London Foundation Trust (ELFT) who are also a Marmot Trust.

Ways of working

• 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.
• Set up of subgroups: We have set up subgroups 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.
• 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.

Measuring our journey

Evaluation report: We wanted to understand 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.

Key Performance Indicators: As a result of the evaluation, several recommendations were made including building on ensuring system-wide clarity.  In addition to this, KPI’s have been developed.

Partners

Led by the council’s public health team, the Marmot Place approach is a system-wide way of working. Our partners include:

• VCSE sector
• Primary Care
• Local Authority leads include inclusive economy, climate change and adaption, housing, education services, transport and social justice
• Elected Members
• Public Sector partners including ICS, strategic providers such as Cambridge Community Services, East London Foundation Trust, Police and Active Luton (sports trust).

Luton 2040 vision has 5 priorities, one of which is ‘Improving population wellbeing and tackling health inequalities to enable everyone to have a good quality of life and reach their full potential.’

Luton’s health system is complex but organisations and communities are engaged and we are committed to developing solutions to tackle inequalities in health.

The Marmot Place approach offers a way of achieving our vision on a population level and focuses actions that can be undertaken, giving partners a ‘language’ to feed into the vision. The approach is novel because it enables the 8 Marmot principles to be tackled in tandem and not piecemeal.  All system partners can get behind the Marmot Place approach.

Next steps

We are committed to continuing to learn and test our Marmot Place approach.

Our next steps are to:

1. Understand fully our impact within the health system but also within communities by completing our KPIs.
2. Developing our sub-groups with clear action plans linking to the report recommendations once audited.
3. Developing a way of working amongst partners and system leaders to understand what health equity means, the building blocks of health and ensure our refreshed governance system works.

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

• Work to embed a genuine understanding of health inequalities and a theory of change.  Start with a movement in mind.
• Set up and continue with developing a clear baseline and reference point for improvement
• Communicate, communicate and communicate what you are doing! Look at how the 8 Marmot principles can be integrated into your organisational strategy so that it becomes a reference point for everyone in the organisation.  
• Don’t try to do everything undertaking one or two high impact work can help with getting the message out.