Coventry City Council: over a decade of commitment to the Marmot principles

Over 11 years later, despite challenges such as reduced local government funding, a pandemic, and the cost of living crisis, Coventry remains committed to the mission. The city views reducing health inequalities as a work in progress, with some significant achievements in some areas and evolving priorities in others. 

The pandemic was in some ways ‘the wilderness years’ because it took precedence over any targeted ‘Marmot’ work. However, it led to strong partnerships and collaborations being formed as health services, the voluntary sector, and councils pulled together,” said Cllr Kamran Caan, Cabinet Member for Public Health and Sport, Coventry City Council.

Post-pandemic, Coventry has rebuilt and reinvigorated its Marmot work with 30 different partners. Philips says that while there is no funding directly attached to being a Marmot city, there is no doubt that it attracts funding and resources from external organisations who see it as a driver for improvement.

When Coventry began its Marmot journey, there was no established framework or template beyond the original six Marmot principles. The initiative was driven by the vision of then-Chief Executive Martin Reeves, who recognised the need for independent support and expertise from IHE. The council adopted an asset-based approach, leveraging partnerships across the public, community, and voluntary sectors to form a steering group of senior leaders.

The council adopted an asset-based approach, building on existing partnerships with the public, community, and voluntary sectors to form a steering group of senior leaders.

For many, it was the relationships and sense of shared purpose in addressing a social injustice that encouraged them to work together as partners. This is a view echoed across all Marmot Places.

The aims agreed by founding members of Coventry’s Marmot Partnership were to:

This initial three-year plan, extended in 2016 and again in 2019, laid the groundwork for Coventry’s long-term commitment to health equity.

Coventry has woven Marmot principles across its council departments; transport planning is a good example. 

Marmot principles are woven into their strategies..... the second chapter in our local plan is health. We see ourselves as a Marmot partnership.” says Cllr Kamran Caan, Cabinet Member for Public Health and Sport, Coventry City Council.

There has been a significant cultural shift, with partners ensuring all the policies and services they commission – from planning, housing and transport to licensing, regulation and procurement, consider the impact on health equity before implementation.

Increasing employment, embedded in Marmot Principle three, 'Create fair employment and good work for all,' has been a cornerstone of Coventry’s Marmot work since year one and has continued to thrive.

The Council runs a ‘Job Shop’, a high-street hub offering support for residents seeking advice on employment, education and training. It sees up to 170 people a day. “Anyone can walk in,” says Cllr Kamran. “Within a year, we needed bigger premises. The offer is a proportionate universal service, meaning that some people simply take a job advert but others have not had an interview for 20 years and need support. Others, say ex-offenders, have never had a job, so we offer a range of programmes, getting people into the right job.” 

The service offers one to one coaching, life skills support and builds relationships with local businesses who are struggling to fill vacancies, offering a free recruitment process. 

In line with all Marmot Places, Coventry has developed a series of Marmot indicators related to the principles and the health outcomes the city wants to achieve. In 2016, the programme was reviewed and refreshed with the same aims but with a reduced number of priority areas to provide clearer focus, aligning with the council’s priorities. 

The updated priorities were:

• Tackling inequalities disproportionately affecting young people.
• Ensuring that all Coventry people, including vulnerable residents, can benefit from ‘good growth,’ which will bring jobs, housing and other benefits to the city.

In 2020 the city produced an evaluation of its Marmot work. Measuring the impact of health inequalities work is always challenging, and often it is about qualitative difference that cannot be counted. According to the evaluation, between 2015 and 2019 the number of Coventry neighbourhoods that were among the 10 per cent most deprived in England reduced from 18.5 per cent to 14.4 per cent. In addition, inequality in life expectancy for both men and women in Coventry remained relatively stable, even as they widened nationally.

In 2023, the citywide partnership produced the Marmot Monitoring tool to describe the system-wide programmes of work aligned to the Marmot principles, delivered by partner organisations across Coventry to tackle health inequalities. It provides an updated framework that considers the impact of the pandemic, the cost of living crisis, and the potential widening of health inequalities for residents, and ensuring these are monitored.