Health Creation … tell us your Trojan Mouse success story!

Public Health

The 5p carrier bag …

The early evidence from the assessment of the impact of introducing a 5p charge on carrier bags from larger retailers suggests that it has been nothing less than a huge success. In the 6 months following its introduction, just 500m bags were purchased compared with 7bn given out in the year prior to introduction of the charge, a more than 85% reduction in plastic bag use. Plastic bags take hundreds of years to break down and in the meantime do significant damage to wildlife and the environment. But the success doesn’t end here; this small change in practice has also led to retailers donating more than £29m to good causes, including charities and community groups.

This is a Trojan Mouse success story!

The idea of the ‘Trojan Mouse’ is part of a discipline called ‘complexity theory’. In complex systems, very small changes can often have very big consequences (both positive and negative). Think about the devastating effect that 1 or 2 degree rise in sea temperature is having on the great barrier reef. Communities are complex systems and we know, from experience of working with people and communities for more than 20 years, that Trojan Mice are powerful agents of change that can transform people’s lives and make them well.

The New NHS Alliance describes the Trojan Mouse phenomenon as ’the introduction of a small change in practice which leads to a large and lasting positive change in the life of a person or a community’. Trojan Mice are valuable and necessary in the practice of Health Creation (see our briefing here). We need to understand them better and practice them a lot more than we currently do.

Trojan Mice can be negative; history is littered with practices, often introduced by well-intentioned people, that actually have adverse consequences on people and communities. And they can be intensely personal; people themselves have imagination and ingenuity and often know best how to make small changes to tackle their own situation. This is why giving people and communities more control over the circumstances of their lives is so important. It liberates them to identify their own Trojan Mice and to self-organise to solve their own health issues.

Attendance at the young people’s renal service at the Salford Royal was low and compliance with treatment was poor, which led in the worst cases to premature deaths and transplant losses. Staff members of the service team decided to listen to their patients, sufferers of Chronic Kidney Disease (CKD) aged between 16 and 32, who told them they were fed up of being seen as ‘just a kidney’ and asked ‘why do I never see other young people like me?’. The renal consultant went 10-Pin bowling with both the staff and young people and found out more about the issues. This led to a complete service redesign, a key element of which was to set up a young adult network group so that people could communicate online, meet up socially and support one another. The difference it has made to young people with CKD is palpable in the video on this homepage:

New NHS Alliance wants to hear your Trojan Mice success stories – where you have experienced or implemented a change in practice that has led to positive and lasting change in your life, in the life of one of your patients or in the life of the community where you live or work?

Your story should involve the individual or community whose life has been changed, and should clearly describe the following:

  1. What the practice, or change in practice, was
  2.    2.  Whose life was changed and how
  3.   3.    What the long-term outcome is, or is likely to be, for that individual or community

If your Trojan Mouse story is one of 3 that we choose, you will be invited to present your story at our Action Summit taking place on 1 December 2016. You will also be awarded a small prize of £100 to support your programme. We will also publish all the Trojan Mouse success stories we receive on our website

Please send your story in whatever medium you wish – written, video or other form of communication – to   by 5pm on Monday 31st October 2016.

We look forward to hearing from you.