The King's Lynn and West Norfolk journey to becoming a Marmot place
Background
In March 2024 the Borough Council of King’s Lynn and West Norfolk, Norfolk Public Health, and Norfolk and Waveney Integrated Care Board (ICB) formally agreed to work together with the Institute of Health Equity (IHE) to support King’s Lynn becoming a Marmot place. Other areas that have become Marmot places have transformed the way health inequalities are viewed in those systems and have been able to gain traction on the wider determinants of health. Part of the work with the IHE gives us access to the community of practice which will allow us to learn from other areas around how this work has benefitted them and where changes have been made.
As the 5th of 5 Places securing a place on the IHE programme for 2024/25, we began working with IHE in October 2024. The Institute of Health Equity (IHE) will work with partners over a two-year period to support a collaborative approach to embedding and shaping services around the Marmot Principles across the system. This will include a final report from the IHE in October 2026, providing an independent assessment of health inequalities in King's Lynn and recommendations for working together to tackle these now and into the future, creating sustainable change.
Strategically, this programme is aligned to:
- The ICS wide Health Inequalities Strategic Framework for Action
- Norfolk and Waveney Integrated Care Strategy and Norfolk Joint Health and Wellbeing Strategy
- The BCKLWN corporate strategy 2023-2027
- The KLWN Health and Wellbeing Partnership’s Health and Wellbeing strategy 2023-2026
What is a Marmot Place?
A Marmot place is one which has a significant and collective commitment to tackle health inequalities through action on the social (also known as wider) determinants of health and has strong and collaborative plans and policies to achieve these reductions in health inequalities. The term is named after Professor Sir Michael Marmot, author of Fair Society Healthy Lives (The Marmot Review), a strategic review of health inequalities in England post 2010, and Marmot Review 10 Years On.
The wider social determinants of health can be explained as:
"People with higher socioeconomic position in society have a greater array of life chances and more opportunities to lead a flourishing life. They also have better health. The two are linked: the more favoured people are, socially and economically, the better their health"
(Marmot, 2010)
A thriving society needs all the right ‘building blocks’ of health in place, such as stable jobs, good quality housing and education. If these building blocks are missing, such as in areas of deprivation, poverty, poor housing or unemployment, significant health inequalities are evident, and lives are being cut short.
Health inequalities are the unfair and avoidable difference in health across a population, and between groups in society. Life expectancy isn’t the same across the UK; in our most deprived neighbourhoods’ people are dying years earlier than they should. To address gaps in life expectancy and prevent lives from getting shorter, businesses, communities and governments can create healthy places by working collaboratively to repair the missing building blocks to health.
The Marmot Principles
These are eight broad policy objectives aimed at reducing health inequalities by improving the conditions of everyday life and reducing socioeconomic inequalities, introduced in the Marmot Reviews:
- Give every child the best start in life
- Enable all children, young people and adults to maximise their capabilities and have control over their lives
- Create fair employment and good work for all
- Ensure a healthy standard of living for all
- Create and develop healthy and sustainable places and communities
- Strengthen the role and impact of ill-health prevention
- Tackle discrimination, racism and their outcomes
- Pursue environmental sustainability and health equity together
Why Marmot?
- Marmot places benefit from an independent and impartial view of health inequalities
- Provide an education piece for all key stakeholders and partners
- A tailored evidence base with recommendations for Place to take forward
- A collective systemwide approach to tackling health inequalities and the wider determinants of health
- Can be used to stock take and gain assurance on provision as well as identify areas for improvement
- Provides a framework to collectively hold each other to account in achieving and exceeding the priorities
- Leads to long-term sustainable change
- Easily links in with Core20plus5 priorities
- Aligns with local strategies.
By focussing on the eight Marmot principles, the outcomes of the work in the West of Norfolk will include system change and culture shifts via strong governance, accountability, leadership, partnerships, networks, training/capacity building and advocacy. This is a long-term piece of work that aims to provide systemic change in the West of Norfolk to improve health equity across all sectors, including housing, education, early years, health care, business and the economic sector. Reducing deprivation and mitigating its impacts is the central theme for all Marmot Places.
There are over 60 "Marmot Places" in the UK, which are local areas and regions that have committed to tackling health inequalities based on the Marmot review principles. These include places like Greater Manchester, Cheshire and Merseyside, Scotland, and individual towns like Luton, which range from rural to urban, and wealthy to deprived areas.
Why King's Lynn?
- 29,000 residents in King’s Lynn and West Norfolk live in areas amongst the 20% most deprived in England.
- Around 9,000 people reside in the top 10% most deprived areas (North and South Lynn as well as Gaywood)
- Life expectancy for men in North Lynn is 10.8 years shorter than men in Dersingham, Sandringham & Massingham (72.5 and 83.3)
- Life expectancy for women in North Lynn is 8 years shorter than for women in Grimston, Gayton & East Winch (78.2 and 86.2)
- Rates of childhood obesity, older people living alone and unemployment are comparatively high, particularly in North Lynn
- The population in the King's Lynn and West Norfolk Local Authority area is expected to grow by about 11,000 between 2025 and 2045; the largest growth is expected in the older age bands
See this video from Professor Sir Michael Marmot, The West Norfolk and King's Lynn health inequalities landscape for more information.
The West Norfolk, A Marmot place Journey so far
The launch event for the programme was delivered in March 2025 at the Corn Exchange in King's Lynn to an audience of our system’s key stakeholders and interested parties. With over 120 people in the audience Professor Sir Michael Marmot and his team from the IHE presented a range of data on our local population, making the connection between the information and the impacts of the wider determinants of health on outcomes for our residents.
Over the summer we held a series of stakeholder events in Hunstanton, Downham Market and King's Lynn, engaging in conversations on the first priority area, ‘Starting Well’. Reports from each session are available on the West Norfolk Marmot Health Equity Network page,(Live feed | West Norfolk a Marmot Place) as well as the data pack that covers West Norfolk data across the 8 marmot principles. Through the launch and these sessions, we have engaged with approximately 300 key stakeholders across the system, holding conversations that have enabled the programme to collate additional quantitative data as well as key qualitative information that has helped build the narrative of what it is that helps or hinders people to start well. The year 1 report will explore this narrative bringing this information together, exploring the local context for West Norfolk and Kings Lynn, communicating the key messages and setting the foundation for continuing the engagement with stakeholders to develop the cross-system actions that will drive real change in this area..
The Marmot Advisory board, made up of our system leaders, has identified the second priority area of the West Norfolk Marmot programme to focus on as ‘Skills and Employment’. As the programme moves forward, and engagement continues, this area of discussion will be added to conversations and developed to be included in the final report due to be published November 2026.
We already work collectively as a system to understand and tackle health inequalities. Two key forums are the King’s Lynn & West Norfolk Health & Wellbeing Partnership and the West Norfolk Place Board.
The King’s Lynn & West Norfolk Health & Wellbeing Partnership has existed since 2022, enabling local partners from across local government, housing, health, voluntary, faith, community and social enterprise sector, and others to work together to address health inequalities and prioritise prevention.
The Health and Wellbeing Strategy was published in 2023 with the following focuses:
- Enhance mental health & wellbeing
- Improve weight management
- Reduce alcohol consumption.
The partnership has funded and delivered a variety of projects working towards these focuses.
The West Norfolk Place Board brings together colleagues from health and social care to integrate services with a focus on effective operational delivery and improving people’s care. The Board works with the Health & Wellbeing Partnership to join up where possible.
Their priorities are:
- Urgent and emergency care
- Tackling health inequalities
- System integration.
The natural next step to our ongoing Place work and strong partnerships across West Norfolk was to begin this work with the Institute of Health Equity to become a Marmot Place. We look forward to learning from other Places, and Professor Sir Michael Marmot and his team to make West Norfolk a happier and healthier place to live with less health inequalities.
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