Sustaining a health system change with momentum

The Health as a Social Movement project for the National Health Services (NHS) developed the Programme Theory of Change to create system-level changes in health care in the United Kingdom.

The project used this theoretical model to provide impetus for change by defining goals for the change. These goals included connecting individuals, groups and organizations acting as change agents with the health system to mobilize local action for health.

Momentum played a pivotal role in achieving system change and transformation. Indicators of momentum included:

• an increase in social connectedness of individuals, groups and/or organizations 
• higher levels of control, resourcefulness and resilience in the community
• an increase in change agents’ confidence and influence over the health system

The sustained momentum arising from the individual and collective action aimed to support a preventable and sustainable health system, characterized as having:

• improvements in local services
• an integration of determinants of health into service provision
• higher levels of health and well-being (Arnold et al., 2018).