Putting public health services at the heart of local communities can also help revive high streets
As leaders of place, councils have already been working hard to repurpose their town centres and respond to longer-term trends in how our high streets are used.
They recognise that the pace of change and intervention will need to quicken as a result of the pandemic.
Councils regard the long-term changes needed as an opportunity to reconnect communities with their high streets and town centres, as well as meet other priorities, such as housing, access to services and better public health.
They want to do what they can to help all areas adapt to changes in the way we use our high streets and town centres.
The most vibrant town centres offer a wide range of services, events and promotions that establish the town centre as a multi-purpose retail, cultural, community and economic hub. This service mix is crucial to the future of high streets, as it is an offer that cannot be matched by its main competitors – out-of-town shopping centres and the internet.
Local authorities understand this and have been working to diversify the high street offer based on local circumstances.
There are social and financial costs associated with empty shops. For example, vacant shops cost London’s economy an estimated £350 million according to the Greater London Authority, through loss of business rates, loss of earnings, and the subsequent cost of unemployment and jobseeker’s allowance. Further to this, empty shops can cause a ‘negative feedback loop’, which means they discourage investment, decrease the offer of a high street, prevent consumers from visiting, and contribute to a general sense of decline and neglect.
There is increasing appetite from across local government and the NHS to realise the role of health in supporting the economic and social recovery, and, in particular, to reimagine our relationship with the high street.
In 2020, the NHS Confederation and the community businesses charity Power to Change published ‘Health on the high street: how integrating health services into local high streets can generate economic, social and health benefits for local communities’.
The report examines how place leaders and managers can begin to better embed health into the heart of our places.
Building health into the high street has multiple benefits. It can play an important role in addressing health inequalities, offer much-needed additional capacity for health service delivery, and attract more people into their local high street, while encouraging healthier lifestyles.
Not only would more people visit and use high streets, the types, ethos and diversity would change. Those who may not use high streets regularly to shop would, for example, use them to attend health services, making more vibrant community spaces.
As high streets tend to be at the centre of public transport networks, this can make a wide range of health services more accessible to people and, importantly, increase their engagement and effectiveness.
Placing this principle at the heart of service design can stimulate a new chapter in how public services, such as local councils and the NHS, engage with citizens and communities.
This can include widening the offer in existing NHS high street premises, such as community pharmacists,and looking at newly vacant space on the high street that could be used by the NHS and local public health services, in partnership with a range of other services.
The case studies below highlight how local areas are working in partnership to make health a focal point within their communities.
The Government has rightly identified local authorities as having a critical role to play in the future of high streets and we welcomed the original and subsequent increase in funding through the Future High Streets Fund.
The Stronger Towns Fund and Towns Deal funding will also help many places to adapt to changes and make the most of opportunities.
High streets are notoriously difficult contexts in which to effect change, with multiple stakeholders and interests that cross local authority jurisdictions and departmental divides.
By learning from others who have taken a wide range of approaches to addressing the multi-faceted issue of retail vacancy, the examples presented here will provide a resource that can support positive action to generate economic, social and health benefits for local communities.
Middlesbrough: one-stop wellbeing clinic
In the heart of Middlesbrough town centre, the Dundas Shopping Centre is home to a host of retailers, from clothes shops to beauty therapists and eateries. Nestled alongside them is the Live Well Centre, a one-stop shop for healthy living run by the council’s public health team.
The centre was launched in 2017 and has gradually been expanded to include a wide range of services, from smoking cessation and substance misuse to an exercise-on-referral service and sexual health clinic.
The Live Well Centre also hosts NHS clinics and works with a range of partners, including Groundwork, which provides employability and skills support, and Impact on Teesside/Mind, a mental health charity.
Leicester: running a sexual health clinic in a shopping centre
In Leicester, a sexual health clinic has been established in the city’s main shopping centre. The retail unit, which used to be home to TK Maxx, was converted in 2019. It was chosen because it was convenient, but also through a desire to destigmatise sexual health.
Historically, sexual health clinics have tended to be hidden away in quiet corners of hospitals or located away from the hustle and bustle of town centres. Now, the glass-fronted clinic is situated right in the middle of the Haymarket Shopping Centre.
Leicester Public Health Lead Commissioner Liz Rodrigo said “The new centre exists alongside coffee shops and clothes shops, and has helped to normalise sexual health. There has always been a stigma around it, but now people see it as part of everyday life. You pop in for a coffee with friends, a bit of shopping, and then to the sexual health clinic.”
Hertfordshire: a network of healthy hubs in community locations
A network of healthy hubs has been set up across Hertfordshire – on high streets, in leisure centres, at food banks and in community halls – to take health and wellbeing services to the public. The hubs provide advice and guidance on everything from weight management and debt advice to mental health problems.
Initially conceived in 2019 as a two-year project, the Healthy Hub programme is a partnership between Hertfordshire County Council and the 10 district councils. The hubs are funded by the county, but run locally by the district and borough councils, with the idea of tailoring services to meet the needs of each area.
Most work with the charity Mind to provide mental health support and counselling. There is also support for weight management and healthy eating, and drug and alcohol dependency, and some offer free NHS health checks.
Health Improvement Lead Fiona Deans, who runs the programme, said “We have found, with the lifting of covid restrictions, that districts have started delivering pop-up hubs in a range of places. Sometimes, it is just for a couple of afternoons in one location before moving on to another. It really depends what works best in that community.”