Erika Aquino, Qualitative Insights & Engagement Manager, shares how a resident deliberation approach is helping to shape the direction of the new North West London research and innovation mission focused on obesity.
If we want to make progress on obesity as a system in North West London (NWL) we can’t start with assumptions, we have to start with people.
Obesity is complex, personal and deeply shaped by everyday realities like access to food, time, work, housing, culture, and stigma. Improving outcomes isn’t just about better evidence or smarter interventions, it’s about understanding what actually matters to people living with these challenges every day, and designing change with that reality front and centre.
That’s why, as we began shaping NWL new research and innovation mission on obesity, we chose to start by listening to residents themselves. We weren’t asking our community to validate a plan already written, but to help shape its direction from the very beginning.
Why start with residents?
As we began mobilising this new mission for NWL, we gathered extensive system insight – reviewing more than 90 reports, speaking to over 40 stakeholders across the system, and bringing together clinicians, innovators and community organisations through a series of roundtables. This gave us a strong system view but it was only part of the picture – it couldn’t tell us what living with challenges in maintaining a healthy weight actually feels like day-to-day, or where change would genuinely make a difference in people’s lives. And that is the key to this mission delivering lasting, meaningful change.
To move from system conversations to genuine understanding, that meant creating space for residents to explore the issues in depth, consider trade‑offs, and collectively decide what should matter most. That’s why we chose a deliberative approach.
What does deliberation look like in practice?
Deliberation goes beyond traditional engagement. It’s not about quick feedback or headline opinions, it creates the space for people to explore complex issues properly. It gives participants time, information, and support to consider different perspectives, challenge assumptions, and form informed views together.
We worked closely with The Social Agency, who led the design and delivery of a full-day deliberation workshop, bringing together around 40 residents from across NWL. Participants came with different experiences, priorities and perspectives, reflecting the diversity of the communities the mission aims to serve.
On the day, the design deliberately balanced structure with openness, combining:
- Shared sessions to introduce context, evidence and key themes
- Small, facilitated group discussions to explore those themes in depth
- Space to ask questions, challenge assumptions and test ideas
- Time to reflect, revisit earlier discussions and prioritise what matters most
Our role was very clear: we weren’t there to lead the conversation or defend existing approaches, but to listen, provide context where needed, and answer questions in plain language. Creating a safe and non-judgemental environment was essential, given the sensitivity of the topic. A trauma-informed approach was taken throughout, using person-first language and recognising obesity as a complex health condition rather than a matter of individual choice.
What happened in the room?
Residents explored a number of themes rooted in existing evidence, but focused on areas where local action could realistically make a difference. They shared personal experiences, tested different perspectives, and challenged each other thoughtfully.
As discussions evolved, participants worked together to prioritise where change could have the greatest impact, considering not just personal experience but fairness, feasibility and the potential to reduce inequalities across our region. Crucially, this wasn’t a rushed exercise. Participants revisited earlier discussions, challenged their own assumptions and refined their views.
What emerged was more than a list of priorities, but a deeper, shared understanding of the barriers people face and the kinds of support that would actually help.
Why deliberation matters
Deliberation takes more time and care than traditional engagement, but it leads to insight that is richer, more considered, and far more useful for decision‑making. It helps explain why certain issues matter most, builds trust by showing people their views genuinely count, and creates a stronger foundation for shaping a mission that aims to deliver system‑wide change.
Perhaps most importantly, it encourages people to think collectively – not just about individual needs, but about what would work for communities as a whole. Taking this approach demonstrates that residents’ voices are not an add‑on or a sense‑check, but a core part of how decisions are made. For a mission aiming to deliver system‑wide change, that trust really matters.
A strong foundation for what comes next
For a mission tackling something as complex and deeply lived as obesity, listening in this way is essential. Starting with resident deliberation has helped ground this mission in real lives, real priorities and real experiences. As the work moves forward, the insight gathered will directly shape decisions, solutions and ongoing involvement, ensuring change is built with communities, not just for them.
Resident involvement does not end with the deliberation. As the mission moves into its next phase, we are committed to continuing to work with residents, not just drawing on their insight once. A number of participants from the deliberation have told us they would like to stay involved, and we will be going back to them to help co‑design what ongoing involvement should look like. This might include shaping questions for discovery, testing emerging ideas, or acting as a sounding board as options start to take form. Rather than deciding this in advance, our intention is to work with residents themselves to design an approach that feels meaningful, proportionate and respectful of people’s time and experience.
The resident deliberation has been the key factor in determining the mission statement and the themes that will be taken forward into a Discovery phase that will identify the innovation focus areas for the mission.
Want to learn more about NWL’s mission-led approach to Obesity?
