The challenge

Cardiovascular disease kills more than 13,000 Londoners every year — one in four of all deaths in the capital. A Londoner dies from a heart attack or stroke every 40 minutes, and the burden does not fall evenly: it lands hardest on people in the most deprived areas and on Black, South Asian, and African Caribbean communities, where rates of undiagnosed and undertreated risk are disproportionately high. Around 650,000 Londoners are living with cardiovascular disease today.

What makes this particularly difficult to confront is that so much of it is avoidable. Around 70% of heart attacks and strokes are preventable through lifestyle changes and the detection and treatment of conditions like high blood pressure, high cholesterol, and irregular heartbeat. More than 500,000 Londoners are currently living with undiagnosed high blood pressure: no symptoms, no reason to seek help, no way of knowing the risk they carry. The challenge is translating that potential at the scale of a city of nine million people, across a fragmented system of NHS organisations, local authorities, community groups, employers, and charities.

By 2030, the London Million Hearts and Minds Challenge aims to ensure up to 661,000 more people receive the best possible treatment for high blood pressure and high cholesterol, helping to prevent around 3,000 heart attacks and strokes, while improving the heart health of one million Londoners overall. It is one of three main priorities in NHS London’s Health Plan and supports the Government’s three shifts in the NHS Ten Year Plan, putting prevention at the heart of London’s health system.

To deliver at that scale requires more than clinical effort. It requires a programme infrastructure capable of coordinating a genuinely cross-sector coalition, maintaining momentum across multiple workstreams, managing funding from diverse sources, and building the shared identity that keeps partners engaged and accountable over five years. That is the gap TPHC was brought in to fill.

Our approach

TPHC acts as the engine room for the Million Hearts and Minds Challenge, leading overall programme management of this London-wide initiative from 2025 onwards.

In the first programme year, we established the governance architecture the programme needed to operate at scale: a Steering Group, six active workstreams, and a reporting structure into the London Regional Executive Team and the Prevention and Health Equity Board. We convened a Community Advisory Board with representation from charities, voluntary sector organisations, and faith-based groups from across London, and ran a community-wide workshop in August 2025 with over 20 organisations to develop the programme’s principles for community engagement.

Alongside governance, we built the coalition. Partners now span the GLA, London Councils, local authorities, NHS commissioners, all three London Health Improvement Networks, and more than ten community and faith organisations. We also engaged potential industry partners, including the British Heart Foundation and Blood Pressure UK.

We coordinated funding from multiple sources, raising more than £250,000 from the London Directors of Public Health and a further £100,000 from NHS England, life sciences partners, and the GLA. This multi-source funding model gives the programme the financial resilience it needs to operate across a five-year horizon without relying on a single commissioner.

We developed consistent branding and templates that have been adopted by eight Pioneer organisations and presented at boards across London’s health and care system, establishing a visible programme identity as a foundation for wider buy-in. We also commenced work on the programme’s first year-long public behaviour change campaign, working with The Elephant Room to target the more than 500,000 Londoners currently living with undiagnosed high blood pressure.

In September 2025, we coordinated the programme’s first community prevention event at the Mayor of London’s Black on the Square event during Know Your Numbers week, working with Blood Pressure UK and Kinetik Wellbeing to test for hypertension among communities at the highest risk of CVD.

The impact

The programme’s first year was about foundations: governance, coalition, identity, and early evidence of reach. All four are now in place.

Being selected as one of five national Prevention Accelerator sites by NHS England is the clearest external validation of the programme’s direction. It brings greater access to national prevention infrastructure and evaluation resource, and positions London’s approach as one of the country’s leading models for CVD prevention at scale.

The September 2025 community event tested 113 London residents for hypertension in a single day, at an event specifically designed to reach communities at disproportionate risk. It demonstrates what targeted, community-rooted delivery looks like in practice and establishes a replicable model for future events.

The February 2026 Summit brought over 130 people from across the system together for the first time: showcases of best practice, six breakout sessions led by the programme’s subgroup leads, and a panel discussion that drew meaningful engagement from senior leaders across the coalition. Twenty-five attendees took a heart health pledge on the day.

The programme is now in an active delivery phase, with The Elephant Room appointed to lead the city-wide behaviour change campaign and a growing body of evidence on what community-based CVD prevention looks like when it is coordinated at a London scale.

What our clients say

‘The Million Hearts and Minds Challenge is a London-wide partnership to accelerate cardiovascular disease prevention. Through TPHC’s expert programme leadership and coordination, we are bringing together the NHS, local government, the Health Innovation Network, businesses, academia and communities to identify people at greatest risk, scale innovation, and strengthen prevention across every borough, saving lives, reducing inequalities and improving health outcomes for Londoners.’

Professor Kevin Fenton, Regional Director of Public Health for London

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