As overstretched NHS leaders seek to best serve communities, town planning presents opportunities to significantly support the populations health. In this article we will consider how can health care providers be more proactive in town planning.
By factoring health considerations into new developments, planners and developers can help build environments promoting prevention and wellbeing.
We know health is shaped by so much more than medical care alone. Social factors like housing, transportation, environment and community ties profoundly impact wellness. Strategically aligning development with public health strategy can therefore ease future demand on strained services.
This is where proactive health boards have a role. By understanding local planning processes and engaging early, health boards can help guide proposals to optimize health benefits. A few well-placed facilities or design tweaks may save substantial treatment costs over the long term.
Is there legislation to secure health improvements?
Recent or proposed legislation in England aiming to secure health improvements from developments includes:
- National Planning Policy Framework (NPPF, 2023) – Requires local planning policies and decisions to support healthy and safe communities, including access to green infrastructure and layouts that encourage walking/cycling.
- London Plan (2021) – Sets strategic targets for housing, employment and infrastructure. Includes policies on improving access to nature, requiring major developments to conduct health impact assessments.
- Environment Act (2021) – Proposes mandatory net gain for biodiversity from developments. More natural spaces would boost mental health.
- Housing Standards Review (2015) – Recommended minimum space standards for all new homes to support healthy living. Many councils have adopted nationally described space standards.
- Planning for the Future White Paper (2020) – Proposed reform placing sustainability at the heart of the planning system, with all new developments expected to be net zero carbón by 2050. Better insulated, greener homes would ease winter pressures on NHS.
- Future Homes Standard (2019) – All new homes built after 2025 will be required to produce 75-80% lower CO2 emissions compared to current standards. Energy efficient housing supports respiratory and cardiovascular health.
- Levelling Up and Regeneration Bill (LURB) – proposes to impose a duty to promote healthy homes and neighbourhoods. The Bill sets out basic principle for securing healthy homes.
What role do Health Impact Assessments have in town planning?
Conducting a Health Impact Assessment (HIA) as proposals are taking shape helps decision-makers properly weigh all consequences. A HIA systematically explores potential effects to determine how changes might influence people’s physical and mental health. It is most useful when performed early in the process, so data can truly shape proposals. With proactive insight into health drivers and differences made, leaders can best design communities promoting population wellness from the beginning. A diligent HIA builds an evidence base to nurture communities optimising positive outcomes and minimizing risks to residents. Overall, thoughtfully integrating health consideration sets policy and projects on a course to enhance community thriving. Some examples of how a health impact assessment (HIA) can inform project design:
- An HIA may find a development will increase traffic in an area with many schoolchildren. It can then recommend design changes like improved pedestrian/cyclist infrastructure to promote safety.
- Assessments showing lack of open space increasing obesity/mental health risks could influence a proposal to include parks, trails or community gardens.
- If an HIA identifies nearby pollution sources exacerbating asthma, it may suggest electrification, green building materials or additional buffer zones.
- Results highlighting inadequate access to fresh food could help redesign a layout with a farmers market/grocery store located near housing.
- Assessments determining noise from a new highway could harm schools may impact route selection or inclusion of noise barriers.
- Finding limited social supports increasing isolation for older adults could warrant community centre design/amenity elements.
- Air/water quality, physical activity, injury prevention and mental wellness are all areas HIAs commonly aid by identifying modifiable health factors to improve at the planning stage.
The early insight HIAs provide allows for low-cost adjustments that enhance outcomes versus costly later interventions.
Influence Master Planning
So how can health care providers get involved? Local plans determine growth patterns for decades. Work with councils to stress health objectives during consultations. For example, emphasise walkability and mixed-use areas to encourage physical activity and social cohesion.
Highlight opportunities to locate new healthcare infrastructure strategically as populations increase. Request health impact assessments for large developments to flag issues early. The expertise of health care providers ensures wellness remains a core priority as visions take shape.
Secure Developer Contributions
The Planning Obligations process presents a chance to cost-effectively expand local services and amenities. Identify priority health-focused projects that strategically leverage housing growth, such as:
- Expanding a primary care centre to serve new residents
- Building multipurpose community centres for exercise classes and counselling
- Developing a connected greenspace network to promote active travel and leisure
Section 106 agreements or Community Infrastructure Levy’s (CIL) funds can secure facilities, land or assistance from housing developers.
NHS boards can maximise benefits from developer contributions by:
- Quantify expected health impacts – Use data analytics to project costs avoided over 10-20 years from prevention initiatives vs treatment if no action taken. For example, modelled reductions in hospital admissions.
- Tie funds to strategic plans – Link s106 proposals directly to clinical commissioning group strategies, integrated care system priorities to ensure investments strategically address priority conditions in the local population.
- Bundle asks – Rather than many small s106 pots, request larger bundled funds for signature preventative projects, i.e. a comprehensive community wellness centre providing various programs.
- Leverage partnership funding – Approach developers earlier to jointly fundraise/crowdfund, applying for national grants together to expand scope of initiatives s106 supports.
- Track outcomes – Work with academia to monitor progress of s106 projects, collecting usage rates, hard outcomes like BMI/A1C (diabetes) changes, soft data like well-being surveys. Provides accountability and advocacy for future projects.
- Highlight Return of Investment (ROI) – Publish case studies post-implementation spotlighting financial and non-financial returns, like increased independence or productivity, to bolster future negotiation positions.
With a calculated, partnership-focused approach to S106, NHS boards can strengthen community infrastructure and services in high-growth areas in a cost-effective way that pre-emptively eases future healthcare burdens.
Partner for Best Outcomes
Developers want expert guidance ensuring proposals align with strategic visions and funding opportunities. NHS staff understand local health profiles intimately.
Work closely with master planners, councils and builders from project inception. Provide health impact reviews and advice leveraging your insight. Partner to integrate appropriate care services within new neighbourhoods organically.
Together we can shape our environments to proactively support community wellbeing for generations to come. By playing an active role in the planning process, the NHS equips itself to better serve populations as they grow.
You might find some of the articles below helpful:
More information for you is available in our series of eBooks and Practical Guides which cover everything from the very basics of town planning to application processes and what developers need to consider.