• Cycle of Demand

    A New Way of Thinking About Relationships

    Find out how Harford Health Centre and those in E1 have got to know each other and built new relationships
    over the last couple of months.

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  • Cycle of Demand

    How Can We Diversify our Workforce?

    Read more about working towards collaborative working among community organisations and practices.

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  • Cycle of Demand

    Spreading Innovation

    Learn more about the incredible work happening across the borough to address issues of demand in general practice, and improve the health and well-being of local communities.

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  • Cycle of Demand

    How Do Local People Take Charge of Their Own Health?

    Watch some examples of local people taking proactive steps in their community to improve health and well-being.

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  • Cycle of Demand

    A New Way of Thinking about Health?

    Discover co-production – an approach to improving health and well-being that assumes equal relationships, and shared skills and expertise.

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Demand for GP consultations continues to rise. To address this the Prime Minister’s GP Access Fund has increased the number of appointments available, but this only addresses one side of the problem – the supply side – and does not consider the wider determinants of health, the impact of health inequalities, the importance of patient capabilities and the centrality of self-care and self-management – the demand side. The Cycle of Demand work aimed to discover examples across the borough of ways in which demand is being addressed, spread these new ways of working, and catalyse change. Read the full report here.



We discovered over 150 initiatives across the borough working to reduce demand in primary care.



We have supported the development of nearly 40 initiatives aimed at reducing demand in primary care.



Over 50 people have been trained in ‘co-production,’ with 6 subsequent DIY Health projects initiated.


We have gathered resources to inspire change, and offer practical steps to get started. Click each of the tabs below to explore how you can get started – from closer working between the voluntary sector and primary care, to learning from work already happening in local practices.


Financial urgency and uncertainty for contracts call for radical action in response to imminent policy changes policy changes across the primary care landscape. In Tower Hamlets, there is an acute need to develop primary care in a way that truly meets the complex, diverse and changing needs of the population. These changes require a range of individuals outside of the NHS – communities themselves, voluntary sector organisations and those located in statutory organisations – to support others to live and sustain healthy lives. The elements of a more holistic model that could be imagined include thinking about Practice Capacity, Staff Well-Being, People’s Participation In Health, Whole Community Well-Being, Wider Determinants Of Health. We have collected incredible examples from across the borough that you can learn from and adapt to your own context to address the Cycle of Demand in primary care.


The Cycle of Demand Team consisting of Challenge Facilitators, Health Champions and Community Researchers were deployed to understand the perspective of local people, general practices, and community organisations across all of the themes. We set about exploring the ‘primary care’ landscape in the borough and unearthing examples of solutions to challenges born from rising demand.

We Can Work Together

What we have discovered is the start of a social movement of health in Tower Hamlets. People are already organising themselves to affect health in a different way. We conclude this work by suggesting building on the work of the​ GP​ Networks to affect:

  • Population health
  • M​aximising the connections and networks of local people
  • F​ocusing on healthy citizens
  • D​iversifying the workforce to draw on the skills and expertise of a range of people

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Challenge Facilitator


With Cycle of Demand we’re looking at an alternative way of working, so how do we start utilising the services we already have around us...That’s where the facilitating comes in, we find out stuff and we share it with our colleagues and the surgeries.

Health Professional


The first Breakfast was amazing; I can’t wait to attend the next one. Harford Health has secured space for our staff exercise classes and presently discussing some shared work streams with others who attended and that’s from just one meeting! The possibilities are endless.

Community Member


I do believe in food… food to cheer us up or to reward us, so I thought about fish and chips as a thing that most people like, so I started talking to people, “if we were bringing fish and chips would you be interested?” Gradually we built up a list of about 50 people.

Community Group Founder


I decided, with the help of people in the practice, and with the support of the practice, to set up a group for women like me, cause I thought, there must be others out there... I set up the group, but the group has given me so much back in return as well.