The Nobody Left Behind (NLO) Service Design Checklist is a tool intended to help

  • Service providers to design and deliver targeted health and social services that are accessible to underserved, marginalised people, including homeless people, LGTBI, people who use drugs, prisoners, sex workers and undocumented migrants.
  • Policymakers at all levels to envision and mandate policy frameworks that encourage inclusivity and equity of access.
  • Community representatives, to raise awareness and advocate for improved access to services.

The Checklist was devised during multiple NLO platform meetings and calls. It was further informed by a literature review, a policy laboratory workshop at the European Health Forum Gastein 2017 and an associated concept paper.1 Further feedback from stakeholder organisations was sought during an NLO Thematic Network webinar via the EU Health Policy Platform in April 2019.

A peer-reviewed article reporting the Checklist in the BMJ Open journal is freely available here (Lazarus et al. BMJ Open 2020;10:e035621. doi:10.1136/bmjopen-2019-035621).

The Checklist comprises a series of questions and considerations to be used when services are being designed or redesigned. It is structured (according to the World Health Organization Health Systems Framework2) into six sections: service delivery, health workforce, health information systems, medical products and technologies, financing and leadership and governance. It is intended as a guide and is not necessarily exhaustive.

Download the checklist

The NLO initiative will seek regular feedback as the checklist is piloted and used, with a view to produce further reiterations of the checklist based on these learnings. We are therefore interested to hear how you intend to use it, how helpful it was or to give any other feedback, please email .


  1. Onyango D, et al. Taking a ‘people-centred’ approach to improving access to health care for underserved communities in Europe. Eurohealth 2017;23:23–27. Available here.
  2. World Health Organization. Everybody business: strengthening health systems to improve health outcomes: WHO’s framework for action. WHO, 2007. Available here.