MD2915 School Superzones work programme 2021-22 to 2023-24

1.1. The London Recovery Board (LRB), jointly chaired by the Mayor of London and the Chair of London Councils, was established in response to the impact of the Covid-19 pandemic. The Board’s remit is to plan and oversee London’s wider long-term social and economic recovery; and to reshape London as a fairer, more equal, greener and more resilient city than it was before the crisis. The Board is taking a mission-based approach to achieving this, aiming to foster strong collaboration across different sectors; to reduce the stark inequalities that Covid-19 has exposed; and to prioritise those most impacted by the pandemic.

1.2. The LRB has agreed a total of nine missions, one of which focuses on healthy places and the healthy weight of children and families, with the ambition that “by 2025, all London’s families will find it easier to eat healthy food and be active where they live, learn, shop, work and play”. This mission will be delivered through place-based interventions that make local environments healthier, embedding principles including: early intervention and prevention; putting communities at the heart of design and action; building on what works and what is already successful; and taking whole-system approaches.

1.3. Obesity is a significant health issue in London, with almost 40 per cent of children in year six being overweight or obese; and around two-thirds (63 per cent) of adults above a healthy weight, half of whom are living with obesity. This increases the risks of a wide range of chronic diseases, as well as reducing quality of life and life expectancy. Obesity is also associated with worse outcomes from Covid-19. Additionally, a fifth of London’s children have asthma, and particulate levels exceed the 2021 WHO PM2.5 guidelines at almost all London schools.

1.4. Many of London’s schools are situated within environments dominated by traffic, with unrestricted advertising of unhealthy products, too many unhealthy food outlets, polluted air and limited access to high-quality green spaces. Environmental harms tend to cluster in areas of high deprivation, affecting the most vulnerable communities and widening health inequalities. Unhealthy exposures in childhood can affect physical, social and cognitive development; and can have lifelong effects on educational achievement and skills, employment prospects, and both physical and mental health.

1.5. In November 2017 the Mayor, central government, and national health and care partners signed the London Health and Social Care Devolution Memorandum of Understanding. This included a commitment to exploring the interaction between planning, urban spatial policy, and London’s health and wellbeing objectives, through work to create healthier environments around schools, and healthier and safer places for children and young people to live, learn and play. The idea of School Superzones was developed and supported by the GLA working in partnership with Public Health England (PHE) London (now the Office for Health Improvement and Disparities (OHID)), London Councils, the London Association of Directors of Public Health (ADPH London), the Healthy Urban Development Unit, the Town and Country Planning Association (TCPA) and the NHS (Healthy London Partnership).

1.6. A pilot scheme ran from 2018 to 2019 in 13 participating London boroughs. This was supported by in-kind commitments from partners, and £10,000 of funding towards the development of supporting resources and workshop facilitation.

1.7. The pilot areas established partnerships often led by local authorities and involving schools and other community partners. These groups came together to co-produce action plans involving children and young people and addressing key health-related issues in the area around the relevant school. This often included the food environment, air quality and active travel in pilot areas, but Superzones can also address a range of health-related issues including advertising for products high in fat, salt and sugar; smoking; alcohol; gambling; crime; and anti-social behaviour. The pilots showed political support for Superzones in many boroughs, and demonstrated multiple benefits of partnership working and significant shared learning. A celebration and learning event took place in September, and a brochure has been produced to capture these case studies and inspire other areas to take part.

1.8. The Mayor of London committed in his 2021 manifesto to “roll out [his] plan that by 2025 every Londoner lives in a healthy food neighbourhood – with an expanded role for School Superzones”. School Superzones will play a central role in the delivery of the Healthy Place Healthy Weight recovery mission, in particular through creating healthier food environments for children and young people in deprived areas and making physical activity easier. The multi-partner Superzones Steering Group has now reconvened after a hiatus during the pandemic. The programme will be accountable to the LRB via its oversight role of the Healthy Place Healthy Weight recovery mission, and to the Healthy Place Healthy Weight mission steering group. This group includes the NHS, OHID, London Councils, the London Food Board, ADPH London and voluntary-sector representation.

Evaluation findings to date

2.1 The evaluation of the pilot Superzones by the London School of Hygiene and Tropical Medicine was severely impacted by the Covid-19 pandemic, and as a result changed its scope to a broader focus on place-based public health interventions in the context of Covid-19. However, an early process evaluation of the Superzones pilots conducted by the University of Manchester (which has not yet been peer-reviewed) found that School Superzones are a mechanism for the identification of common issues affecting the environment around schools; and that they provide an opportunity to explore how best to address these issues through close partnership working across different local authority teams, schools, businesses, and voluntary and community-sector organisations.

2.2. The process evaluation by the University of Manchester also demonstrated a number of early benefits, including:

• improved working relationships: Superzones were a catalyst for forming and enhancing relationships across council departments and other agencies

• identification of opportunities for collaboration where interests aligned

• raised awareness of unhealthy environments. and their impact on health and wellbeing, among a range of stakeholders including local communities

• identification of barriers to healthy living such as, for example, barriers to active travel, healthy diet and use of local green space by schoolchildren.

2.3. The evaluation also highlighted the importance of flexibility for areas to adapt their Superzone activities to their local context; and the value of capacity, coordination and programme support.

Programme objectives

2.4. Following the pilot in 2018 and 2019 with 13 boroughs, the School Superzones programme will be expended to deliver up to 50 Superzones across the capital by 2025. The programme will form a key plank of the Healthy Place, Healthy Weight recovery mission and help deliver the Mayor’s 2021 Manifesto commitment to deliver “an expanded role for School Superzones”. It will also contribute to the commitment of the London Child Obesity Taskforce to halve the percentage of London’s children who are overweight at the start of primary school, and obese at the end of primary school; and to reduce London’s social gradient in childhood obesity rates.

2.5. The roll-out of the Superzones programme aims to:

• reinvigorate and support the existing School Superzones established in the 13 pilot boroughs to develop further and progress their action plans, and/or expand their work to encompass new Superzones (starting in 2021-22 with support for 10 boroughs)

• support other London boroughs (which did not participate in the pilot scheme) to join the scheme and develop additional Superzones (starting in 2022-23), opening up the offer to all boroughs whilst prioritising areas of higher deprivation.

Expected outcomes

2.6. School Superzones can play an important role in local placemaking and community development. In the longer term, it is envisaged that the Superzones will support coordinated borough-led approaches to investment in the built environment; and serve as an important element within systems-based local responses to complex challenges such as obesity and air pollution.

2.7. Depending on the range of interventions prioritised by a Superzone partnership, expected long-term benefits may include:

• an increase in the proportion of children participating in active travel to and from school

• a positive impact on active travel by the wider community

• improvements in air quality around schools

• the creation of healthier food environments around schools

• improvements in green assets close to schools

• improvements in the use of community assets and in their connectivity to schools

• improved navigability and safety around schools.

2.8. The expected overall long-term benefits of Superzones include reduced exposure to a range of harmful elements in the urban environment; and increased exposure to health-promoting elements for children, young people and others in these communities, leading to reduced health inequalities linked to place. The proposed funding outlined in this decision includes provision for a high-level independent evaluation of the programme. In addition, further funding for evaluation will be sought from relevant research funders such as the National Institute for Health Research, and UK Research and Innovation.

Breakdown of deliverables and costs

2.9 The table below gives a breakdown of key deliverables and indicative costs for this programme over 2021-24. This will amount to funding of £810,000 in each year (£1.62m in total over the two years from 2022 to 2024). Additionally, £260,000 of funding is required before the end of 2021-22. Therefore, the total budget over 2021-22 to 2023-24 is £1.88m.

2.10 Expenditure will take the form of grant awards or payment for services procured, depending on the nature of the work concerned and in line with relevant GLA procedures, including the GLA’s Contracts and Funding Code.

3.1. Under section 149 of the Equality Act 2010, as a public authority, the GLA must have ‘due regard’ of the need to:

• eliminate unlawful discrimination, harassment and victimisation

• advance equality of opportunity and foster good relations between people who have a protected characteristic and those who do not.

3.2. The Mayor’s Equality, Diversity and Inclusion strategy sets out how the Mayor will help address the inequalities, barriers and discrimination experienced by groups protected by the Equality Act 2010. In this strategy the Mayor of London has, for the first time, gone beyond these legal duties and contributed to addressing wider issues such as poverty and socio-economic inequality, as well as the challenges and disadvantage facing different groups in London including young people.

3.3. School Superzones provide an opportunity to address health and environmental inequalities around schools in areas of deprivation. They are prioritised in areas that fall in the bottom 30 per cent of the national Index of Multiple Deprivation, identified using the national indices of multiple deprivation; or where communities have poorer health-related outcomes across issues such as child obesity, air pollution and asthma.

3.4. Nearly 40 per cent of all London’s children are overweight or obese, with the highest rates occurring in the areas of greatest deprivation. The effects of deprivation can be seen at ages 4-5 and 10-11, but they widen with age. At age 10-11, a child in one of London’s poorest neighbourhoods is nearly twice as likely to experience unhealthy weight as a child living in one of London’s richest neighbourhoods (47.6 versus 24.9 per cent). Significant differences in relation to healthy weight also exist between ethnic groups in London. Between ages four and five, the prevalence of unhealthy weight ranges from 14.2 per cent among both White and Asian children, to 31 per cent among Black African children. Despite rising rates of unhealthy weight in all ethnic groups, inequalities are starkly apparent, ranging from 27.1 per cent in White and Asian children to 46.5 per cent in Black African children.

3.5. Covid-19 changed the daily lives of children and their families in ways that are likely to exacerbate levels of childhood obesity, such as increased food insecurity and long periods of physical inactivity. These impacts have been disproportionately felt by communities who already experience the greatest health inequalities in London.

3.6. Air pollution and rates of childhood asthma are both also generally highest among communities, and around schools, in the most deprived and the most ethnically diverse areas of London, particularly those with high levels of road traffic. This is despite lower rates of car ownership by Londoners in the lowest-income deciles.

3.7. By prioritising locations in areas that fall in the bottom 30 per cent in the national Index of Multiple Deprivation, and those with particularly poor health-related outcomes, for development of School Superzones, the programme is expected to play a valuable role in reducing these inequalities. Health inequality considerations will also be included within evaluation plans.

Key risks and issues

4.1. The key issue is that the work over Summer 2021 to re-engage with stakeholders on the focus of the mission has caused delays to delivery. Delivery is expected to begin however, before the end of the financial year.

4.2. Risks are assessed and managed on a programme basis. Cross-cutting and major risks are reported quarterly through the GLA’s corporate performance management process. The key risks for the Superzones programme are currently as follows:

*Red = highly likelihood and/or high impact; amber = medium likelihood and/or impact; green = low likelihood and/or impact

Links to Mayoral strategies and priorities

4.3. Tackling child obesity has been a long-term priority for the Mayor. An objective in the Health Inequalities Strategy is that action is taken to help children achieve and maintain a healthy weight, with focused support for those communities with high rates of child obesity. Reducing child obesity is also one of the 10 areas of focus for pan-London collaboration in “Our Vision for London”, to which the Mayor is a signatory.

4.4. In 2018 the Mayor established the London Child Obesity Task Force with the purpose of bringing about a transformation so that every child in London has a chance to grow up eating healthily, drinking plenty of water and being physically active. The Taskforce’s call to action in “Every Child a Healthy Weight” sets out 10 shared ambitions that need to be achieved if we are to create a healthy-weight city. The London Child Obesity programme ended in November 2021, and the Taskforce will become a new Mayor’s Advisory Group on Child Obesity that will provide external advice to the Mayor on: delivering against the recommendations set out in “Every Child a Healthy Weight”; the development of the Healthy Place, Healthy Weight mission; and the refresh of the Mayor’s Health Inequalities Strategy implementation plan.

4.5. School Superzones support and complement a number of the objectives in the Mayor’s statutory Health Inequalities Strategy, published in 2018:

• for children to achieve and maintain a healthy weight

• for London’s air quality to improve, and fewer Londoners to be exposed to harmful pollution, especially in priority areas such as schools

• for the planning system to be used to create healthier neighbourhoods, including adoption of the Healthy Streets approach

• for London to be a greener city where all Londoners have access to good-quality green and other public spaces.

4.6. Superzones have significant potential to drive progress on several aims of the Mayor’s Environment and Transport Strategies; and can play an integral role in the GLA’s health-in-all-policies approach, supporting the GLA’s leadership role in place-shaping, empowering communities and tackling health inequalities. They are closely aligned with other place-making initiatives such as School Streets and Play Streets.

4.7. School Superzones will play a central role in the delivery of the Healthy Place Healthy Weight recovery mission; but they also support a number of other recovery missions, namely High Streets for All, A New Deal for Young People and A Green New Deal.

4.8. The Mayor committed to an expanded role for Superzones in his 2021 manifesto.

Consultations and Impact assessments including data protection (as per the GLA’s requirements under GDPR), health and safeguarding where relevant

4.9. The concept of Superzones was explored, tested and developed in an 18-month pilot project in 13 London boroughs. Activities were coordinated with support from PHE London (now OHID), the GLA, ADPH London, the Healthy London Partnership, London Councils, the TCPA and the London Healthy Places Network.

4.10. Local authorities worked with the local community – including the school, pupils and parents, community groups, businesses, and local councillors – to understand local needs and assets. This enabled the partnerships to build a clear picture of what actions were needed, and how they could help to achieve local public health and wider council priorities. The pilot programme demonstrated strong community and local political support for School Superzones where they were implemented.

4.11. A re-engagement exercise in relation to the Healthy Place, Healthy Weight mission was undertaken over Summer 2021 with partners and stakeholder from a range of different sectors, including those who had been less engaged on the mission to date (such as faith groups and other civil society organisations). The aim of the exercise was to gauge views on the focus on the mission including testing appetite for a focus on the healthy weight of children and families. Stakeholders were asked to respond to a number of questions about the direction of the mission, including reviewing and prioritising interventions, such as School Superzones, for the mission to take forward.

4.12. There are no known conflicts of interest to note for any of those involved in the drafting or clearance of this decision.

5.1 Approval is also being sought for expenditure totalling £1,880,000 for the Superzones programme over three financial years (£260,000 in 2021-22; £810,000 in 2022-23 and £810,000 in 2023-24).

5.2 The expenditure of £260,000 will be funded by the 2021-22 Healthy Food Highstreet budget. The expenditure of £810,000 in 2022-23 and 2023-24 will be funded by the Superzones budget for each respective financial year.

5.3 This decision is requesting funding that is not yet assured for 2022-23 and 2023-24. The GLA may be subject to future funding cuts and the expenditure planned here may not be affordable. To this end, break clauses have been incorporated into contracts to enable future cuts. Officers need to be aware that this programme will not be subject to any more favourable treatment in future funding rounds than programmes that have not requested funding for future years, meaning the break clauses may well have to be exercised. The funding allocation in future financial years will be subject to the normal annual budget setting process and is subject to change.

5.4 The expenditure detailed within this decision all sits within the ‘Healthy Place, Healthy Weight’ mission.

6.1. The foregoing sections of this report indicate that the decisions requested of the Mayor fall within the statutory powers of the Authority to promote and/or to do anything that is facilitative of, or conducive or incidental to, improvement of the environment within Greater London; and in formulating the proposals in respect of which a decision is sought, officers have complied with the Authority’s related statutory duties to:

• pay due regard to the principle that there should be equality of opportunity for all people

• consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom

• consult with appropriate bodies.

6.2. In taking the decisions requested of him, the Mayor must have due regard to the Public Sector Equality Duty; namely the need to eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010, and to advance equality of opportunity between persons who share a relevant protected characteristic (race, disability, gender, age, sex, sexual orientation, religion or belief, pregnancy and maternity, and gender reassignment) and persons who do not share it; and foster good relations between persons who share a relevant protected characteristic and persons who do not share it (section 149 of the Equality Act 2010). To this end, the Mayor should have particular regard to section 3 (above) of this report.

6.3. Officers must ensure that any external services, supplies or works required for the project be procured in accordance with the Authority’s Contracts and Funding Code (the Code) and with the assistance of Transport for London’s commercial team. Furthermore, officers must ensure that appropriate contractual documentation be executed by both the Authority and the relevant contractor prior to the commencement of the required services or the provision of supplies or works.

6.4. Section 1.1 indicates that some of the budget that is the subject of this decision form will be distributed as grant funding. To that end, the officers must ensure that that they comply with the requirements of section 12 of the Code. Moreover, they must ensure that a written funding agreement be put in place between the Authority and the recipient before any of the funding be paid.

Appendices:

None

Supporting papers:

• The London Health Inequalities Strategy 2018-28: www.london.gov.uk/programmes-strategies/health-and-wellbeing/health-inequalities-strategy
• The London Health Inequalities Strategy Implementation Plan 2018-2020: www.london.gov.uk/sites/default/files/his_implementation_plan.pdf
• The London Health Inequalities Strategy annual report 2018-19: www.london.gov.uk/sites/default/files/his_annual_report_1819_final.pdf
• The Health Inequalities Strategy Consultation Integrated Impact Assessment: www.london.gov.uk/sites/default/files/the_mayor_of_londons_health_inequalities_strategy_iia_report_-_final_23.08.17_0.pdf
• School Superzones brochure: www.london.gov.uk/sites/default/files/superzones-_final.pdf
• The University of Manchester process evaluation: Making the urban environment around schools healthier, developing an initial programme theory: an early realist process evaluation of the London superzones pilot