About Nesta

Nesta is an innovation foundation. For us, innovation means turning bold ideas into reality and changing lives for the better. We use our expertise, skills and funding in areas where there are big challenges facing society.

Our work launched in 2014 with a pilot programme taking place across Essex. Since then we have delivered 100 Day Challenges across 30+ locations around the UK. Hundreds of ideas have been tested by hundreds of frontline staff, which have directly benefited over 10,000 citizens.

What we work on and where

Our work has addressed a wide range of issues across health, care, education and more. Below you can find out more about some of the impact that the 100 Day Challenge approach has achieved for systems and places.



Working alongside the Integrated Personalised Commissioning (IPC) team at NHS England and local health and care partners, we supported frontline multi-disciplinary teams in Stockton-on-Tees and Hertfordshire to translate the emerging IPC framework into practice. Frontline practitioners tested care and support plans with citizens, worked out how to coordinate their services better, and explored the use of integrated budgets to help citizens with their health and care goals.

We are currently working with NHS England to scale up the implementation of their Universal Personalised Care plan so that personalised care becomes business as usual across the health and care system, reaching 2.5 million people by 2023/24.

This approach includes supporting the Personalised Care Group to develop knowledgeable, skillful and confident Peer Leaders through the Peer Leadership Programme to influence the way personalised care is developed and delivered.

Care for older people

A number of our 100 Day Challenges have focussed on older people. In Hertfordshire we supported teams to give frail older people more choice and control. The teams achieved a 19 per cent decrease in A&E attendances, 11 per cent decrease in zero day admissions and 18 per cent decrease in one-plus day admissions. In Stockton-on-Tees a hospital initiative focused on reducing lengthy stays led to a 35 per cent drop in delayed discharges, contributing to potential annual savings of over £900,000.

Personalisation and population health

We have worked across the region to drive the implementation of the Greater Manchester Population Health Plan.

This has included in-depth work in Bolton, Tameside and Manchester City to support people living with long-term conditions using person- and community-centred approaches, such as peer support, to prevent ill health and reduce costs.

Diabetes and those at risk of diabetes

In Tameside and Glossop, teams tested new ways of engaging people.

Ideas included holding events in community rather than clinical settings and setting up peer support groups. By the end of the challenge, 49 per cent of people tested were no longer pre-diabetic and 67 per cent had reduced their HbA1c levels. There was also an average increase in physical activity of 155 minutes and an average waist measurement reduction of six cm.

Elective care


We worked with NHS England to translate a national agenda of transforming elective (planned) care into action across 20 local health and care systems. The work took place across multiple clinical specialties ranging from ophthalmology to diabetes.

Our work with the Elective Care Transformation Team began in 2017 and in partnership with the team, 100 Day Challenges have been run across the country, from Stockport to South Somerset. Teams were challenged to try out their ideas and adapt and adopt a range of evidence-based interventions to better manage the rise in demand for elective care.

Demand for planned care

In Norfolk, the ophthalmology team introduced a nurse-led clinic for low-risk glaucoma referrals and reduced referral to treatment (RTT) times from 20 weeks to 13 weeks.

Preventative approaches and technology

In Stockport, a new teledermatology service introduced to ten GP practices identified three patients with cancer lesions earlier than would have otherwise been the case, while reducing the average wait time on the emergency pathway from 15 to just two days.

Health inequalities

Young people’s mental health and wellbeing

Many of the 100 Day Challenges that we have delivered in partnership with local health and care systems across the UK have sought to respond to rising levels of health inequalities.

Increasing access to health services

A recent 100 day challenge in Essex was focussed on meaningful lives for people with Learning Disabilities and Autism. One of the challenge teams tested introducing health check and signposting questions in Trusted Assessor reviews across the county, leading to at least 50 people being more informed about how to manage their health. Another team organised a regular health and care ‘One Stop Shop’ where people were supported to think about their housing, employment, and assistive technology options. One session was attended by 20 people with learning disabilities and autism, along with 15 professionals from 6 providers.

Marginalised communities

In order to tailor care to local needs, Manchester Local Care Organisation (MLCO) set up twelve neighbourhood teams across the City to design and deliver services in partnership with local people. To kick start this work, we are working in partnership, delivering three 100 day challenges consecutively, each involving 4 of the new neighbourhood teams.

So far, teams have tested a number of ideas that have sought to support a number of marginalised communities including people who feel isolated in their own neighbourhoods, people with diabetes whose first language isn’t English, and asylum seekers and refugees and those who have chronic conditions but are disengaged from services.

One team tested ideas to uncover how practitioners could speak with people about isolation and how they could connect people with each other. They reached out to over 700 people during the 100 days including through a Wellbeing Conversation Tool designed by the team. As a result of their engagement efforts, over 100 health checks took place, 10 new referrals were made to Manchester Cares, 40 people were signposted to local services and 130 people attended the team’s Vintage Tea Party.

Beyond health

Learning disabilities and autism

As the method has grown and developed, we have started to experiment with applying the approach to issues that go beyond health.

Learning disabilities and autism

In 2019 we worked with Essex County Council to support collaboration between adults with learning disabilities and autism, council and community partners. The focus was testing new ways of supporting people to live meaningful and fulfilling lives.

People with learning disabilities were involved from the beginning, which led to new ideas and initiatives being co-produced at both a team and strategic level.

At a team level, teams in three local places have tested ideas ranging from an inclusive cricket team to pooling direct payments for healthcare, supporting employers to create specialist jobs and running a pop-up cafe and shop.

Young people’s mental health and wellbeing

A challenge focused on improving mental health and wellbeing for children and young people in Midlothian. One team, based in a secondary school, gathered insights from 158 young people via surveys and focus groups, ran two mental health-focused PSE sessions involving 35 students, and trained 97 school staff (from teachers to playground monitors) in mental health first aid.

Report: Five Years of People Powered Results

To find out more about how your organisation could benefit from the 100 Day Challenge, drop us a line: [email protected]