Intended for healthcare professionals


Local, local, local: the regeneration project that puts the community in charge of its health

BMJ 2017; 359 doi: (Published 12 October 2017) Cite this as: BMJ 2017;359:j4594
  1. Anne Gulland, freelance journalist, London, UK
  1. agulland{at}

The opening of a progressive general practice completes the first phase of a development that aims to address the wider determinants of health by linking schools, healthcare, and housing, writes Anne Gulland

The NHS is “broken” according to Andrew Mawson, social entrepreneur and cross-bench peer. But unlike the “liberal Guardian readers,” whom he says produce reports and policy documents but don’t get things done, he is doing something to tackle the problem.

Mawson is the driving force behind the transformation of a community in Tower Hamlets, east London, the ultimate aim of which is to improve the health, wellbeing, and prospects of its people. Mawson wants to cut through the bureaucracy and “liberal rhetoric” that he believes is stifling any possibility of real change for deprived areas.

The St Paul’s Way transformation project that Mawson launched in 2006 has brought together a secondary school, pharmacy, housing association, Prince’s Trust centre, and—finally, in January—a general practice to help transform a road and the community around it. The idea is that all of these organisations working together—staffed by local people and involving the community—will be better able to deliver the change that Mawson desires.

Social prescribing

Such cooperation can, for example, make social prescribing more powerful, says Joe Hall, lead GP at the St Paul’s Way Medical Centre. The concept, pioneered by the nearby Bromley by Bow Centre founded by Mawson in 1984, is one way the practice aims to fulfil its mission to address the wider determinants of health. Hall, who began working at the Bromley by Bow Centre in 2003, says that when a new patient comes in the consultation does not just cover health but other matters such as housing, education, counselling, or befriending. If necessary, the patient is referred to a social prescribing coordinator.

Hall says, “When patients have other …

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