One of the founders of Growing Health Together. is Katherine Saunders, the Chief Executive of ABC GP Federation. In the landscape of health, what are GP federations?

“GP Federations are organisations that represent and support GP surgeries. We have been working with the surgeries in Horley since we came into existence as a primary care network, including with Michael Bosch, who is a GP and is one of our directors,” says Katherine.

Growing health grew

Katherine, who also lives in Horley, got her head together with Michael and Gillian Orrow about what they could do to improve the wider determinants of health. They started with small steps: meeting headteachers and organising some initial engagement events. And growing health grew from there.

“I’ve always had a strong belief that you can have the biggest impact by working at a local level first and working ground up,” says Katherine, whose background is in big NHS transformation programmes. “I often find that the higher up you start, the harder it is to actually make any real change.”

Making connections

She’s also an advocate of making connections between the people and building community capital.

“We’ve lived in Horley for about 12 years. My husband’s a town councillor, we’ve done various voluntary activities, and you can start to see how that does make an impact and actually does improve health

“I was a school governor in Horley, and we’ve been talking about what can you do in partnership to try and create health. From my point of view, we’re living it already.

“We had a decent amount of support right at the beginning,” says Katherine. “We did have barriers in terms of pure funding. We were lucky that the Primary Care Network that Gillian works in agreed to fund a little bit of her time,” says Katherine. Nevertheless, project management work has been ‘donated’.

“After we got the initial business case through, it’s become much easier,” says Katherine. They put bids into organisations which profess to support health creation-type activity. “They talk about being grassroots and bottom-up, but they very much expect a professional writing team to have the resource to put it all together,” says Katherine.

Barriers start to come down

“The barriers have started to come down since we’ve got a bit more established. But getting it off the ground at all at the beginning was quite difficult.”

Activities that are immediately on Katherine’s radar include Carol’s project, community growing schemes in Smallfield, a community orchard in Horley and a community garden space at the Horley Health Hub.

“It’s been more and more about bringing different groups together,” says Katherine, who tries to get the resource into the right project.

Katherine Saunders and the team working in the community garden in Horley

So far, those conversations about how many emergency admissions have been saved with a gardening scheme haven’t been stultifying, but they do come up. Katherine’s expertise can be used in response to those comments.

“I’m part of this because I’m used to putting in big business cases,” says Katherine. “I can translate it into the right language and say, ‘Look, this is the potential impact.’


“But being realistic, growing health has a 10,15, 20, 30-year impact. It’s trying to find a degree of pragmatism for people. This feels like the right thing – we’ve committed to it as a health system and we’ve all said it reflects our values. It’s what we think is important for people. So we do need to invest in it, not just wait until we can really show an impact on health spending before we do anything, because it’s too late by that point.”

Covid restriction has obviously had an impact. But when people have been able to do things together, “those little conversations start to make an impact,” says Katherine. You can already see it in clinicians, GPs and the managers who are part of it. And the fact of Growing Health Together is a relief in a landscape of conversations about Covid and ICU beds, she says.

Impacting the everyday

That sense of well-being is already impacting the everyday for Katherine.

“I love coming into my office through the back garden. We will have volunteer groups in here who will be able to come in and do their gardening, or Men’s Sheds for isolated elder men. It is happening, and that’s really nice. We’ve been together weekends to help with some of the gardening and that’s been nice.

“There are still health risks even in leafy Surrey. And I don’t think any part of levelling up is saying we just ignore those people or help them when they get really sick. We’re going to do health creation where it’s more needed.”