Cicely Ryder-Belson, Senior Policy and Programme Manager for the National Healthcare Inequalities Improvement Programme, shares key insights from her visit to Great Yarmouth’s Apollo Project.

She illustrates how the NHS, by acting as an anchor employer, can help reduce health inequalities in coastal communities whilst also tackling economic inactivity.

Context

Over 4 in 10 (45.9%) working age adults in coastal towns are economically inactive; more than double the national average. Half of these people are economically inactive due to health conditions.

The Chief Medical Officer’s Annual Report in 2021 highlighted that coastal areas face some of the worst health outcomes in England, with people having low life expectancy and high rates of many major diseases. Poor health occurs prematurely in these populations and is often  due to preventable diseases.

The Coastal Navigators’ Network first prospectus estimates that annually this costs the NHS over £910 million in avoidable excess costs; yet coastal towns have 20.2% fewer NHS resources to meet rising demand.

NHS England has identified coastal communities as one of the priority groups within the Core20PLUS5 population cohort, which focuses on the most deprived 20% of the population and ‘PLUS’ groups at risk of health inequalities.

The 2025/26 Priorities and Operational Planning Guidance has maintained an expectation that ICBs and provider trusts are expected to work together to reduce inequalities in line with the Core20PLUS5 approach.

Furthermore, the 10 Year Health Plan has committed to focusing on inequalities in coastal areas, and transforming the NHS into a force for social mobility and local prosperity.

Coastal Navigator Network and The Apollo Project

The Coastal Navigators’ Network (CNN) began as a collaboration between NHS England, Breaking Barriers Innovations and 6 coastal ICBs.

The CNN was established with a shared goal of reducing the unique health inequalities that communities on the coast face.

In its first year, the CNN launched 6 neighbourhood pilot interventions to test scalable local initiatives seeking to tackle preventable root causes of poor health.

In the Spring, NHS England and the Department for Work and Pensions attended a site visit in Great Yarmouth, one of the CNN pilot areas, to see the tangible, place-based opportunities for joint action on health inequalities and economic exclusion.

In Great Yarmouth 26% of population have no qualifications, and the level of GCSE attainment is 44% – well below national average.

Poor education attainment levels to date have stifled opportunities for local people to progress into careers in health and social care and contributed to a large economically inactive population.

The Apollo Project, supported by Norfolk and Waveney ICB and hosted by East Coast College, is a 2-year workforce programme that offers a range of support for people new to health and care looking into their first roles, people looking to retrain and change direction, and employers seeking to upskill the workforce.

Job coaches provide tailored support and vocational trainers offer specialist courses to help individuals enter focused career pathways.

This is complemented by supported internships – aimed at people who may have neurodiversity or experience other barriers into employment – and volunteering opportunities with one-to-one mentoring throughout.

The site visit brought together diverse local voices – from young people and adult jobseekers to community practitioners and NHS leaders – to share their experiences.

Young participants shared honest, unfiltered accounts of life in Great Yarmouth. Despite limited exposure to opportunity and a perception of being routinely dismissed by institutions, they had strong ambitions for their future and career prospects following support from Apollo.

Adult participants similarly told powerful stories of re-entering education, discovering new career paths, and regaining confidence after years out of work.

The Apollo Project moves beyond a one-size-fits-all approach, by offering personalised, embedded, and compassionate support to individuals who may have never considered a career in health and care.

Since its inception, the Apollo Project has engaged 4,491 people and supported 644 into employment.

Crucially, targeted support to individuals is matched by working with local anchor organisations to integrate and adopt inclusive employment approaches, with 838 employers engaged to date.

Through this dual offer, the programme offers a solution to both supply and demand issues by supporting economically inactive individuals to find accessible routes into long-term career paths and addressing local recruitment and retention challenges within the health and social care.

Lessons learnt

The Apollo model offers valuable lessons on how the NHS can act as an anchor employer to address health inequalities and tackle economic inactivity. This includes:

• creating visible pathways into local health and social care careers – involving families, schools, the voluntary, community, faith and social enterprise (VCFSE) sector and employers as part of that pipeline
• developing holistic and personalised neighbourhood models that meet people where they are, and treat volunteering, mental wellbeing and employment as part of the same journey
• co-designing inclusive, flexible, and purposeful roles with employers, and support them to hire differently

This innovation in Great Yarmouth demonstrated the gains to be made when you integrate health, skills and work.

This will be increasingly crucial to meet the government’s mission to move to an 80% employment rate, kickstart economic growth and break down barriers to opportunity.

With the Secretary of State announcing a “decade-long project of improvement […] start[ing] in working class, rural and coastal communities”, the CNN is primed to continue to support systems tackling the deep-rooted challenges facing coastal areas.

This has been illustrated by the CNN’s first prospectus, which brings together 8 months of learning, data, and innovation – with a focus on prevention and economic inactivity.

16 new sites have been confirmed for Year 2 on the CNN.

If you are interested in learning more about the CNN, then please contact Sarah Hough at sarah.hough@bbi.uk.com for more details.