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The Knee High Design Challenge

NEF Consulting has been appointed to evaluate the social and economic impact of new services and products for children under five years old.

Knee High Design Challenge logoThe Knee High Design Challenge is an open innovation programme funded by Guy’s and St Thomas’ Charity, and run by the Design Council in partnership with Southwark and Lambeth Councils. It supports the development of new services and products to raise the health and wellbeing of children under five living in Southwark and Lambeth.

NEF Consulting will evaluate the effect of these services and products while they are piloted over a twelve-month period from January 2015 to December 2015.


Healthy behaviours in childhood set patterns for later life, and inequalities that start from infancy can have enduring and significant effects on a child’s physical and psychological health[1].

‘What happens during these early years (starting in the womb) has lifelong effects on many aspects of health and wellbeing – from obesity, heart disease and mental health, to educational achievement and economic status.’[2]

Child health and poverty statistics highlight the extent of the challenge:

  • More than one in four children lives in poverty in England. In Lambeth and Southwark that statistic is estimated at one in three.
  • Health inequalities between the richest and poorest in society has widened in the last 10 years.
  • More than 1 in 5 children are overweight by age 3 – around one third of young people aged 11–15 are overweight.
  • Only 15% of girls and under a third of boys report meeting the Chief Medical Officer’s guidelines for physical activity of at least one hour of physical activity each day.
  • Postnatal depression is recorded to affect 15% of new mothers, but the figure may be twice as high[3].
  • 63% of children aged 8 -12 play outside less than once a week.
  • One in ten Britons is lonely[4]. Britons are less likely to have strong friendships or know their neighbours than inhabitants of any other country in the EU[5].

Logo-77px-RGBThe Design Council has approached this challenge by supporting unique, innovative projects that take a preventative approach to tackling these issues. These are upstream interventions that aim to prevent harm before it occurs, addressing the barriers to healthy choices for children and their families. This approach has multiple advantages: promoting protective health factors can prevent negative outcomes at an early stage, supporting people to maximise their potential. Problems tend to be easiest to tackle in their early stages, before they become established. Finally, social problems are often interlinked and deep-rooted – addressing underlying causes at the outset can forestall the subsequent onset of multiple related problems, helping reduce inequality and halt poverty cycles.

Knee High Design Challenge logoIn 2012 the Design Council formed a partnership with Guy’s and St Thomas’ Charity and the London Boroughs of Southwark and Lambeth to create an open competition, the Knee High Design Challenge, that would find, fund, and nurture people with innovative ideas for tackling existing health inequalities for young children in these boroughs.

The Knee High Design Challenge began by researching and reframing problems that existing approaches to public health have so far failed to address. It posed questions to inspire new thinking and found people with the capabilities to bring new ideas to life. These people included those working in the public sector who want to innovate from the inside, entrepreneurs who want to increase the impact of their work, and local parents who want to improve things in their community. The Challenge has brought them together to turn their ideas into investable ventures. At every stage, families and children have been involved in the testing and making of these new products and services, which are now being used by families across Lambeth and Southwark.

Three final teams were funded by Guy’s and St Thomas’ Charity to embed their products and services in Lambeth and Southwark, and to be part of the 12-month evaluation.

The teams:

Design Council Knee High Challenge Creative Homes

Creative Homes

  • Creative Homes: An artist-led service and product range that promotes interactive play within the home and relieves day-to-day stress within a family.
  • KidsConnect: An online tool that offers accurate, relevant and up-to-date information about local activities for families.
  • Pop up Parks: Transforming neglected urban outdoor spaces into sensory and playful interactions.

NEF Consulting has been commissioned to form an understanding of:

  1. The impact of the funded projects on short-term health, development and wellbeing outcomes of children, families and the wider community in Southwark and Lambeth.
  2. The linkages between early development outcomes and medium and longer-term health and wellbeing outcomes for children.
  3. The cost effectiveness of early intervention, taking into account the prevented costs to the state.

As well as a published report, there will be an event to share the findings with stakeholders in public health, child development, evaluation and social innovation.

For more information and to view short films about the final teams visit the Knee High Design Challenge pages on the Design Council website:

To find out about the journey of each team, see the Knee High Design Challenge blog.


[1] Graham Allen (2011) Early Intervention: The Next Steps. An Independent Report to Her Majesty’s Government.

[2] ‘Fair Society, Healthy Lives’ (The Marmot Review). Available at:

[3] 4Children (2011), Suffering in Silence Report


[5] Office of National Statisitcs (2014)