Case Study

TELCO (The East London Citizens Organisation) is the founding chapter of Citizens UK. TELCO is an alliance of over 50,000 people from more than 80 member institutions across East London, including schools, universities, churches, mosques, migrant groups and other community organisations. Together, they organise to overcome injustice and win change on the things that their local communities care about most.

Barts Health NHS Trust is made up of five hospitals: St Bartholomew’s Hospital in the City, The Royal London Hospital in Whitechapel, Newham Hospital in Plaistow, Whipps Cross Hospital in Leytonstone, and Mile End Hospital. Our group provides a huge range of clinical services to people in east London and beyond. Each hospital has a unique mix of specialist skills and cares for their local communities.

Our vision is to be a high-performing group of NHS hospitals known for leading innovation, reducing inequalities, and transforming lives by championing excellence and providing outstanding healthcare. We’re moving towards a future that focuses on combining specialties and clinical expertise, prevents ill health, embraces digital innovation, and expands our care closer to home. Aligned with national NHS goals, this transformation puts patients first and is shaped by the experiences, insights and voices of the people we treat.

The services we offer are driven by the unique needs of our people in one of the most diverse and fast-growing populations with some of the most deprived and under-privileged communities in the country. Every day, we provide a mix of specialist and routine care for over 7,000 people. Working as a group enables us to combine our strengths, share expertise, and deliver consistent, high-quality care for more than 2.5 million people.

The Health Equity Action Leadership (HEAL) project is a transformative partnership that aims to redefine how the public is supported to influence and shape healthcare, at Barts Health and beyond. TELCO is an alliance of over 80 diverse institutions including faith groups, schools, and third-sector organisations, trusted by local communities and traditionally under-served groups across the Barts Health patch.

At the partnership’s core is the HEAL Champions initiative which aims to develop health leadership capacity in local communities. Developed following structured community listening, the co-produced programme provides innovative training in health literacy and community organising to equip leaders to support their communities to navigate healthcare, not only as service users, but also as transformation partners. Champions lead peer engagement, collect lived-experience feedback, and co-design campaigns that tackle systemic healthcare barriers.

The pilot has already yielded powerful results: 100% of HEAL Champions report increased confidence in navigating and advocating within healthcare systems, rebuilding trust with providers, and fostering wider participation. Our scalable and sustainable framework grounded in local leadership, cross-sector partnership, and ongoing community feedback, offers a replicable model that deserves recognition as a bold, people-powered approach that engages, uplifts, and champions the public in the transformation of health equity.

The Covid-19 pandemic exposed and intensified deep-rooted health inequalities in East London, disproportionately impacting ethnic minority communities across boroughs served by Barts Health, namely Tower Hamlets, Newham and Waltham Forest. Residents in these areas, already facing high levels of poverty, struggled with barriers to accessing healthcare, including language and cultural barriers, and systemic mistrust of providers.

Barts Health knew they needed to work differently to reach these under-served groups. TELCO mobilised quickly in response. With 28 years of experience in community organising, leadership development, and grassroots advocacy, TELCO was well positioned to listen to local concerns and act. TELCO organisers, already embedded in local communities, gathered powerful testimonies of families missing work or school to support relatives in navigating healthcare, and of residents hesitating to seek help due to cultural barriers. In partnership, TELCO helped establish the Barts Health Faith and Community Leaders Forum bringing together trusted leaders to co-design pandemic responses, communicate vital health information, and increase vaccine uptake.

This collaboration bridged critical trust gaps and led to impactful initiatives such as pop-up vaccine centres in mosques and churches. These experiences laid the foundation for further partnership working that would begin to address the inequalities exposed during the pandemic. Our subsequent HEAL project is focused on building long-term health equity through empowered local leadership.

The aspect of our partnership that this application is focused on is our HEAL Champions programme pilot. This was co-designed in partnership with three TELCO member institutions, each representing diverse communities across East London. Key leaders from these institutions formed the HEAL Steering Committee with TELCO and Barts Health staff, ensuring inclusive governance and relevance to local needs.

This committee co-produced the initiative from the very beginning, however our involvement of patients, carers, and the public was built in from the start. Through a structured community listening process, we held Health Bank Surgeries (like Food Banks) in TELCO institutions to create safe spaces for residents to voice health concerns and share their lived experiences.

One of the themes that emerged was a disconnect between the support that Barts Health could offer to make its services more accessible (i.e. travel schemes, translated patient information, interpreting and advocacy, etc.), and the awareness of the public in how to access this. Our Steering Committee devised a programme that empowers HEAL Champions, based in their community institutions, through training in health literacy and TELCO community organising, to act as a bridge between the public and the healthcare system. The Champions empower members of their community to access and navigate Barts Health services, but also feed insight directly back into Barts to inform areas for improvement through an ongoing feedback loop. Our Steering Committee ensures continuous community influence on project direction, from the recruitment of local leaders to the design of the training and delivery.

At the end of the programme, each Champion receives a certificate and their institutions are awarded a HEAL badge recognising their role in advancing health equity. This initiative not only builds trust and leadership but also ensures that planning and delivery remain grounded in community voice and action.

Rooted in equity, the HEAL initiative is creating a paradigm shift in East London, empowering communities to advocate for themselves, breaking down systemic barriers and laying a foundation for sustained, community-driven change.

To assess the impact of the HEAL Champions project specifically, the Steering Committee agreed pre- and post-training surveys, qualitative feedback, and engagement metrics, each designed to capture changes in knowledge, confidence, and behavioural intention, and the broader relational impact between the partners.

Key Outcomes:

• Participant Empowerment: Attendees described HEAL Champion training as eye-opening and empowering, providing clear guidance, fostering trust, and inspiring them to engage others.
• Confidence Transformation: Before training, 87% of participants felt not at all confident giving feedback or finding information about healthcare services. After the session, 100% reported being very confident in both areas.
• Direct insight: The insights from our HEAL Champions feed directly back into TELCO campaigns and Barts Health’s experience of care insight governance structure.
• Wider Engagement: HEAL Champions now serve as trusted connectors, leading Health Bank Surgeries themselves and engaging residents in meaningful dialogue about their healthcare experiences.

Quote from a Steering Committee member: “The HEAL (Health Equity Action Leadership) training was incredibly empowering. It provided us with simple yet essential information on navigating Barts Health from the perspectives of both a patient and a visitor, information that was entirely new to me. This is crucial because it allows HEAL champions to pass on what we’ve learned to others in our community. In doing so, we can correct misunderstandings and share vital resources and information that, despite being readily available, remain largely unknown to many. Grasping this information is key to better managing our health. Furthermore, the HEAL training empowers leaders to advocate effectively for themselves or others.”

The HEAL Champions initiative is highly relevant to a broad range of groups, both within the NHS and across wider civil society. Its core principles of community leadership, health literacy, and trust-building are adaptable to any setting where health inequalities persist. The model has already gained attention from schools, faith groups, housing associations, and migrant support organisations, all of whom recognise the value of embedding health awareness and access within trusted local institutions.

HEAL offers a replicable approach for other NHS Trusts and Integrated Care Systems looking to meet the goals of the Core20PLUS5 strategy. By equipping community leaders with the skills to engage in dialogue and co-produce solutions, HEAL compliments efforts to improve patient participation, reduce avoidable hospital admissions, and improve culturally responsive care.

We have already received expressions of interest from community organisations beyond our pilot sites to incorporate HEAL into their work and participate in the next cohort of HEAL Champions training. TELCO’s decision to place health at the centre of its broader campaigns alongside housing, migration, and youth opportunity demonstrates strong potential for cross-sector collaboration and scale.

What makes the HEAL initiative truly stand out is it’s deep foundation in relational, community-led action. Unlike traditional top-down interventions, HEAL is rooted in the lived experiences and leadership of local people. The initiative centres on trust-building, shared learning, and long-term collaboration between healthcare professionals and communities most affected by health inequalities. HEAL’s potential for far-reaching impact lies in it’s flexibility, alignment with national health priorities, and it’s proven ability to engage communities that are often left behind.

The Barts Health Director of Patient Experience and Community Engagement captured this essence: “Whilst NHS Trusts have a duty to tackle health inequalities, we know we cannot do it alone. The HEAL partnership provides an opportunity to focus on our shared resources and build trusted relationships to support those most affected.”

HEAL Champions are not just traditional trained health champions that signpost one-way to services, they are skilled in community organising and are embedded community leaders who engage in genuine dialogue with residents and healthcare providers. This two-way relational sharing of insight feeds directly into Barts Health’s continuous service improvement and TELCO’s campaign priorities.

The success of HEAL lies in its relational values, community accountability, and its shift from an illness-based model to one focused on equity, wellness, and shared leadership making it a blueprint for transformative change in public health. The initiative has the power to bridge cultures and drive system change through collective action.

The HEAL initiative has surfaced several key learning points that are essential for others looking to replicate or adapt this model:

1. Start with Relationships, Not Services: In community organising we say people before programme, building trust takes time. Real change begins with listening to communities, understanding their lived experiences, and valuing their voices as equal partners in shaping healthcare solutions.
2. Train and Empower Local Leaders: Investing in community leadership through training in health literacy and organising creates a sustainable foundation for long-term engagement, advocacy, and cultural change.
3. Co-Production Leads to Stronger Outcomes: Designing solutions with communities rather than for them results in more relevant, equitable, and effective services. The success of the HEAL Champions and Health Bank surgeries stems from this principle.
4. Embed Equity at Every Level: Addressing health inequalities is not just a project goal, it must be a guiding value, influencing how resources are allocated, decisions are made, and success is measured.
5. Partnership is Power: Collaboration between the NHS, community organisations, and local leaders creates the conditions for systemic change. HEAL shows that when institutions and communities come together with mutual respect, lasting transformation is possible.