Cheshire and Merseyside’s collaborative model to reduce health inequalities and improve population health

The Champs Public Health Collaborative is a ground breaking model of collaborative leadership, with its nine councils and the NHS working together to tackle health inequalities across the sub region. Recently recognised by the King’s Fund as an innovative national exemplar, it supports a population over 2.7 million to live happier and healthier lives with a ‘one team’ approach. The Collaborative has been acclaimed by the Institute of Health Equity in its latest report, and its work to tackle poverty has also recently been the subject of a policy briefing, courtesy of the Heseltine Institute at the University of Liverpool.

Through its model, the Collaborative has created a complete alignment between population health and public health leadership. This unique approach has led to successful programmes of work, innovative pilots and hugely impactful behaviour change campaigns. 

This case study focuses upon on the Collaborative’s innovative model to tackling poverty within the sub region. It highlights its unique leadership, the impact of its work, and learnings for local authorities. 

Child and family poverty is one of the most urgent social challenges facing the UK. In total, the Child Poverty Action Group estimates that child poverty costs the country around £39.5 billion a year. But child poverty is not inevitable and can be reduced through sustained, co-ordinated policy interventions.  

Often a lack of joined-up thinking and needless bureaucracy can impede an effective response to this. At a sub regional level, an absence of a clearly articulated mission on family poverty which would bring stakeholders together to maximise synergies and impact means opportunities to make a difference are missed. 

For over 20 years, Cheshire and Merseyside’s nine directors of Public Health have worked together on public health priorities. Over this time, the board has pooled resources and received external funding to create the Champs Public Health Collaborative, with the directors forming a distributed leadership team and influencing strategic policy making sub-regionally and nationally.

By uniting all nine local authorities and the NHS Director of Population Health, the Collaborative can tackle these challenges such as child and family poverty much more effectively. Through working together, the model enables change to happen at a larger scale, facilitating an innovative pathway to addressing the health challenges facing Cheshire and Merseyside. No other area in the country benefits from a Directors of Public Health Executive Board with NHS presence, distributed leadership, and a dedicated support team, making its model truly unique.

The All Together Fairer Programme is the sub region's mission to reduce inequalities and improve health and wellbeing. At the heart of this is an ardent desire to end child and family poverty in Cheshire and Merseyside, a region in which the Collaborative found that over 100,000 children are living in poverty. In 2024, it launched a co-ordinated effort to tackle child and family poverty. This work was in three phases.

Rapid situational analysis 

The Collaborative published its report on family poverty within the region in September 2024, which provided vital insight into the far-reaching consequences of poverty. It revealed that 100,300 children across Cheshire and Merseyside are growing up in poverty, with 60% from working households. The report also outlined the devasting impact of this across education, health, housing, and social cohesion. From the link to child obesity and poor dental hygiene, to noting that disadvantaged pupils are over 18.8 months behind their peers by the end of secondary school, the independent report highlighted the damaging repercussions of child poverty. 

By establishing a robust evidence base, enriched by external expertise, this strengthened the policy development process. The analysis revealed the growing pressure that local services were facing due to the impact of child and family poverty on health, education, and social care support. As such, the report proposed a comprehensive anti-poverty framework.

A framework for action 

A framework for action is is structured around three core pillars: maximising household income, supporting families, and creating inclusive places, illustrating how local systems can co-ordinate strategic efforts around shared objectives.

Driving action

The Champs Collaborative has integrated this framework into existing sub regional health and wellbeing strategies, implemented across the All Together Fairer programme. A unifying ambition was published from public health, the NHS, Children’s Services and the voluntary sector, that no child in Cheshire and Merseyside lives in poverty. 

At this sub regional level, the All Together Fairer team is actively advancing key priorities to drive maximum impact. This includes supporting local areas to auto-award free school meal to those who are eligible, boosting uptake of Healthy Start vouchers, and enhancing the effectiveness of social value and anchor institution programmes. 

The UK Government is developing a nationwide strategy to tackle child poverty, to be published in Autumn 2025. Local councils will therefore be expected to play a vital role in ensuring its effective implementation. The Cheshire and Merseyside Public Health Collaborative model offers a compelling example of how place-based, systems-led collaboration can inform a national Child Poverty Strategy that aligns local innovation with long-term structural reform.

Adopt a framework

Adopting a framework based on the evidence and views of children, young people, and families, provides clarity and structure to a complex programme involving a wide range of stakeholders. Though it is intended to provide a reference point as opposed to a prescriptive model, it can help councils to set priorities and accordingly monitor and drive action.

Have an articulated mission 

The importance of having a clear, articulated mission in ensuring a strategic and coordinated response to addressing poverty is significant. The co-production of an ambition and a narrative on child poverty provides a very public way for relevant partners to commit to tackling the causes and symptoms of poverty. 

Implement collaborative leadership

By positioning child and family poverty as a collection responsibility, the Champs Public Health Collaborative has implemented a model of distributed leadership, empowering local stakeholders to design and deliver interventions. This collaborative approach ensures opportunities are maximised through inter-related programmes and policies. The sharing of research and evidence, best practice, innovation and knowledge mobilisation facilitates change to happen quicker and at scale.