Devolution and health

  • RESEARCH

    Essay: addressing health inequalities through employment

    14th July 2025
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    • Getting it right

    The new health duty on strategic authorities

    This article originally appeared in the Municipal Journal.

    The Government’s White Paper on devolution in England introduces a commitment to create a bespoke duty related to health improvement and health inequalities for strategic authorities (SAs).

    The Centre for Local Economic Strategies (CLES) and The King’s Fund are working jointly on a programme of work, commissioned by The Health Foundation, to understand the potential for strategic authorities to have an impact on health inequalities. As part of this we have thought through how this new duty needs to be designed and implemented to be successful, taking into account learning from existing duties.
    “a narrow focus could actually exacerbate health inequalities”
    In our earlier briefing we recognised that English devolution could have a positive impact on health inequalities, but that it is viewed as a primarily economic policy lever, to generate economic growth in lagging regions.  Our evidence review showed that a narrow focus could actually exacerbate health inequalities if the distribution of growth benefits is not considered; and even in other countries where regional policy has narrowed economic inequalities, it does not necessarily follow that health inequalities narrow too.  The inference is that health inequalities will not narrow simply as a result of the fact of more devolution, it needs to be accompanied by strong and consistent intent. This has been the case in Greater Manchester which has had clear success, and in other areas such as the West Midlands where health has been a core area for action of the Combined Authority.

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  • RESEARCH

    Essay: getting it right

    23rd June 2025
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    • 2024: our greatest hits

    As the year draws to a close, our Chief Executive, Sarah Longlands, looks back at the last twelve months of CLES’s work.

    It has been a turbulent 12 months, with change – both good and bad – very much at the forefront on the domestic and international stages. Yet, despite the uncertainty of the times in which we find ourselves, at CLES we remain simultaneously pragmatic and optimistic about the power of our mission: delivering local economic change. As we wrote in our general election manifesto – Our Local Economic Future – change may be dreamt of by aspiring national leaders, but it is both delivered and felt in communities.
    “the growth of ideas, of confidence, of time and of resources”
    But this kind of change doesn’t happen by invoking economic growth as the key to every lock. The kind of change that our communities need comes instead from the growth of ideas, of confidence, of time and of resources: to challenge preconceptions and tired economic assumptions, to think differently and with ambition.

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  • FINDINGS

    Tackling health inequalities through English devolution

    24th October 2024
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    • Combined recipe for healthy communities

    How can mayoral combined authorities use their powers and resources to keep us well? In a new programme of joint working launched last month, CLES, The King’s Fund and the Health Foundation have come together to answer this key question. This project builds on a £1.3m Health Foundation award to the West Midlands Combined Authority, who will be working in partnership with eight other combined authorities over three years to drive action on health within the regions.

    English mayoral combined authorities have been established with a remit to boost sub-regional economic growth, enhance local democratic engagement and accountability and address knotty policy problems. Through their distinct powers, responsibilities and resources, they are also able to affect the wider determinants of health, such as people’s access to good quality work, transport and housing.

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