Across North West London, we are facing a public health challenge that is both urgent and deeply complex, nearly 1 in 5 adults and over 1 in 5 children are obese. 18,000 people are formally diagnosed each year, however many people remain undetected within the NHS system. The burden is not shared equally: obesity is consistently more prevalent in our most deprived communities, deepening the health inequalities that already exist across the area.
We know the scale of the problem. What matters now is whether we can respond differently, moving beyond fragmented approaches to act as a system around a shared outcome.
As we transition into the “Discovery” phase of our new mission focused on obesity, that’s the shift we are now making.
Over the past four months, we have taken a structured, evidence-led approach to define an ambitious shared goal:
By 2030, stop the rise in obesity in North West London and set it on a sustained path towards reduction, starting where need and inequality are greatest.
This ambition reflects a rigorous process, combining data, insight, and engagement. Delivering it now, however, will depend on the collective power of the health and care ecosystem.
Building the foundations: what mobilisation has achieved
Mobilising the mission was about bringing together three complementary forms of insight and engagement.
- We underpinned this work with robust quantitative and desk research, drawing on a wide body of evidence to understand population trends, system pressures and the opportunity for innovation.
- We brought together a broad spectrum of system stakeholders, across clinical, commissioning, local authority, VCSE, academic and industry partners, to provide both practical insight and strategic challenge. This ensured that what we developed was not only ambitious, but grounded in the realities of delivery.
- We placed resident voices at the centre of decision-making. Through a full-day deliberative workshop with 37 residents from across North West London, people with lived experience were given time, information and space to explore priorities, debate trade-offs and shape the direction of the mission.
Together, this provided a strong and credible foundation for the next stage of the mission. While the mobilisation phase highlighted the complexity of obesity and the many factors that influence it, it also helped identify areas where there was significant need and a clear opportunity for collective action.
As a result, three clear themes emerged:
- Children, Young People and Family Prevention: Optimising prevention for children that are at risk of obesity by taking a holistic family approach including nutrition, exercise, and mental health.
- Access to Weight Management Services: Optimising access to adult weight management services to ensure people, particularly those most at risk, are aware and engaged with services.
- Access to GLP-1s & Wraparound care: Improving access to GLP-1 treatment and wraparound care to ensure people, particularly those most at risk of developing obesity-related LTCs, can access these resources.
These three themes will provide the foundation for the “Discovery” phase, helping us identify where the mission can add the greatest value and where innovation, partnership and collective action have the strongest potential to improve outcomes.
What we learned: embracing complexity and making choices
If mobilisation gave us clarity on ambition, it also sharpened our understanding of the complexity of the challenge.
One of the clearest signals from residents was the importance of prevention, particularly for children and families. Yet this also presents a fundamental tension: prevention is essential to long-term change, but it takes time to translate into measurable impact on population outcomes.
At the same time, there was strong recognition that no single intervention would be sufficient. Obesity requires a portfolio approach, combining prevention, service transformation and treatment, reflecting its deeply interconnected drivers.
However, this ambition sits alongside a hard reality: resources are finite. The system must make deliberate choices about where to focus effort and investment to achieve the greatest impact.
This is particularly evident in areas such as GLP-1 treatments, where the evidence base is developing rapidly and the potential for impact is significant, but where access, affordability and system readiness remain key constraints.
Taken together, these insights point to a clear conclusion:
Delivering the mission will require not just innovation, but disciplined prioritisation, system alignment, and a willingness to act collectively.
From insight to action: what the “Discovery” phase of the NW London obesity mission must deliver
As we move into the Discovery phase of the obesity mission, following mobilisation, this has a clear and practical purpose.
Firstly, we’ll prioritise the areas of innovation within our core themes that are most likely to deliver the mission goal, translating broad ambition into a set of “innovation focus areas”, supported by evidence and a clear theory of change.
Secondly, we will design how the system works together to deliver them. This will include defining roles, responsibilities and partnerships across the ecosystem, ensuring each initiative creates value for partners, and clearly identifying where accountability sits to support delivery.
By the end of Discovery, we expect to have:
- A prioritised pipeline of delivery-ready opportunities
- A clear articulation of system roles and contributions
- A partner ecosystem model capable of supporting delivery at scale
In short, this is the point where the mission moves from defining the problem to organising for delivery.
Why this moment matters: moving beyond pilots
This transition reflects a broader shift in how we approach innovation in health and care. It builds on three years of mission-led working in North West London, set out in our recent report, Missions for better health, and reflects the national shift from sickness to prevention, that is central to the future of the NHS.
Too often, progress is fragmented: multiple pilots, delivered in isolation, each addressing part of the problem but rarely achieving system-wide impact. As ICHP’s Associate Director of Strategy and Insights Hannah Fontana set out in her recent blog for the Health Innovation Network, innovation only delivers value “when systems are organised to adopt, adapt and scale those ideas” collectively.
A mission-led approach challenges this by:
- Aligning partners around a shared population outcome
- Creating a clear demand signal for innovation
- Moving from isolated projects to coordinated, system-wide action
For commissioners, this creates an opportunity to align strategy, resource, and accountability more directly with population outcomes.
For industry and innovators, it signals a shift toward clearer system priorities, stronger partnership opportunities, and a more coherent pathway from innovation to scale.
An invitation to the system
As we enter the “Discovery” phase, we know partners across North West London will see this as a collective mission. One that benefits from the contribution of many organisations, each bringing their own strengths, insight and leadership.
Over the coming months, we will bring together commissioners, providers, innovators, industry partners, community organisations and residents to identify, prioritise and shape the interventions with the greatest potential to improve outcomes across NWL. We will continue to test ideas, challenge assumptions, and build a clearer picture of where the mission can make the greatest difference.
Across the system, Discovery is an opportunity to:
- Explore where greater collaboration could unlock additional value
- Build connections across organisational and sector boundaries
- Contribute to a shared effort to tackle one of the most complex challenges facing our population
For ICB and commissioning leaders, there is a critical opportunity to:
- Support and accelerate the “Discovery” phase by actively contributing time, expertise and strategic insight
- Align priorities to drive movement toward shared outcomes
- Champion cross-system collaboration and model shared accountability needed for success across organisational boundaries
For industry and innovation partners, we aim to create:
- Clearer visibility of system priorities and unmet needs, enabling more targeted innovation
- Early opportunities to engage and co-shape solutions, ensuring relevance from the outset
- A more supportive environment for collaboration, testing and scaling, so impactful approaches can move further, faster.
Whether through sharing expertise, contributing evidence, highlighting what has worked elsewhere or helping to build new partnerships, there are many ways to be part of this next phase. If you would like to find out more, please contact Adam Ashworth, Mission Lead: adam.ashworth@imperialcollegehealthpartners.com
Looking ahead
The mobilisation phase has given us something often missing at the start of system change: a shared ambition, grounded in evidence and shaped by the people it is intended to serve.
The discovery phase will now help us translate that ambition into action and working together effectively, the system can come together to deliver it.
