Why health needs planningPamela Chapman, Head of Strategic Asset Management,

Department of Health

15th December 2008

Why health needs planning

1. a healthy built environment

2. planning as an enabler – supporting

strategic change

3. health and the planning system

Planning and health

• with its roots in public health – town planning’s links with health are long established;

• the built environment is no less important to health today;

• a healthy place to live and work can improve both physical and mental well being

• great scope to address social, health and related poverty issues

• planning can ensure that new developments deliver safe, healthy and attractive places for people to live in.

• the proposed eco towns offer an excellent opportunity to model some exemplar developments.

The NHS is a partner in the local

planning community

• Collaboration between healthcare and local planning is driven by evolving healthcare needs and demands for healthy communities.

Key drivers include:

• Demographic change requiring different models of care

• Partnership working to reduce health inequalities and promote healthy lifestyles

• Shifting setting of healthcare from acute to community

• Embedding healthcare needs in whole planning process

• Tapping in to funding streams from developers of new schemes and opportunities for joint funding..

National Institute for Health and Clinical Excellence (NICE) found that the built environment may have a positive impact upon levels of walking and cycling

• improving and promoting parks may increase walking

• changes to the urban structure at street level can lead to increased pedestrian activity

• introducing cycle infrastructure can lead to long-term increase in levels of cycling within the area and a reduction in cycling casualties

• There are links between physical activity levels and

- accessibility of facilities,

- density of residential areas and land use mix,

- perceived safety of an area

- availability of footpaths or equipment for exercising

• traffic calming can lead to increases in walking and cycling(including children’s play)

The built environment impacts on healthy weight

Planning can effect journey types and times, and

therefore healthy weight...

A

B

For example :Poor urban design can compel a drive rather than a walk to school

Reducing obesity is a key priority

• Healthy Weight, Healthy

Lives, January 2008

• Obesity a key cross-

government concern and policy

focus

• Inequalities: key differences by

ethnic and socio-economic

group

• £370m over 3 years

• Commitment to a supportive

built environment

The DH obesity team are developing support for

planners

A joint DH-DCSF team are collaborating upon a support package:

(a) for current planners

– London's Healthy Urban Development Unit (HUDU) is frequently cited as a model of good practice

– Further discussion but aim to roll out the agreed model as a pilot

(b) for future planners

– Influence education of built environment professionals– Building on the successful Teaching Public Health network model,

look to create a network of educators of the built environment– Plus relevant teaching materials - already developed (RTPI) but not

disseminated

The Healthy Towns initiative -

progressing well

• Successful bids to the HCCF recently announced

Region Area

West Midlands DudleyWest Midlands SandwellYorks and Humber CalderdaleYorks and Humber SheffieldEast Midlands CorbyLondon Region Tower HamletsEast Region Breckwood District (Thetford)East Region PeterboroughNorth East MiddlesboroughNorth West ManchesterSouth West TewkesburySouth East Portsmouth

Two

Planning

as

Strategic

Enabler

Achieving strategic objectives

there are a number of areas where we

need to work with local planning

authorities to achieve strategic change…

it underpins so much of what we do…

PSA 20

Aim –

to improve long-term housing affordability and create well-designed, sustainable communities - by increasing housing supply in England andproviding supporting infrastructure.

Current target –

3 million new homes by 2020

Cross government initiative –

Government Departments, Regions and Local Authorities working together to ensure delivery. A high level PSA Delivery Board working to ensure adequate infrastructure to support the necessary housing growth.

PSA 20

DH commitment

• reflect Growth Areas and New Growth Points in primary care trusts (PCTs) revenue allocations post 2007-08;

• produce guidance for PCTs on working with local partners/delivery vehicles to plan for growth

• ensure release of surplus public sector land (held by NHS Trusts) to support the housing growth targets.

(English Partnerships are also engaged in this work)

NHS Next Stages Review: Our

vision

for primary & community care:

• Establish 100 new GP

practices

• Developing over 150

GP- led health centres

• Publication of PCT

strategic plans - Spring

2009

Pre-budget report announcement

• £100 million to advance the upgrading

of up to 600 GP surgeries to training

practices

• creating opportunities for small firms and

targeting funding on those areas that have

historically had a lower provision of

doctors;

Improving access to

services

• Improving primary care services in deprived areas

• Screening, ensuring the recently announced programme of

vascular checks supports our ambitions on health inequalities,

and tackling under-coverage in existing programmes

• Improve the access to services and support for those people

living in vulnerable circumstances

• Increase the reach of the Health Trainer programme into more

communities and settings such as workplaces

Reaching out to

people

• Strengthening choice in primary care

• Enhancing incentives for primary care to diagnose earlier

• The NHS working in partnership with local government and the

voluntary sector

• Ensuring the NHS makes best use of local partnerships to

deliver services relevant to people’s needs

We want to move away from

this…

…..and

this

to facilities like this…

Platt Bridge Health Centre, Wigan

Bunnyhill Primary Care Centre – Sunderland

and this…

Strategic Service Development Planning

Integrated service development and estates planning

– types of services to be delivered;

– service delivery models – shift of care;

– location;

– access standards;

– changing provider market.

And at the end of life when we wish to adapt

or disinvest

Ex-hospital due to become flats

BUILDERS are hoping to construct a

massive housing development on the

site of this former hospital

.

The main listed hospital building,

which is 115 years old, has planning

consent for 42 flats.

Other hospital buildings are to be

demolished and replaced with

18 houses and another 77 flats.

three

the

planning

system

• PPS1: Delivering Sustainable Development. Requires local planning authorities to provide improved access for all to health and community facilities and to services, which promote healthy outcomes, such as open space, sport and recreation facilities.

• PPS3: Housing. Sets out a number of factors to consider when assessing design quality, including design guidance for new residential development, which creates opportunities for physical activity

• PPS11: Regional Spatial Strategies. Requires consideration of other relevant strategies at the regional level including health

• PPS12: Local Spatial Strategies. Requires consideration of other relevant strategies and programmes at the local level including health

• PPG17: Planning for Open Space, Sport and Recreation. Recognises the role that these have in promoting health living and preventing illness and in the social development of children through play, sporting activities and interaction with others.

• Draft PPSS on Eco Towns. Eco-towns should be designed and planned to support healthy and sustainable environments and enable residents to make healthy choices easily.

Health in planning today

Health in planning tomorrow?

Planning Policy

Statement

for

Health and Social

Care ?

the planning system

Planning is “plan led” which means

• Regional Spatial Strategies

• Local Development Frameworks

Specific consultee status of SHAs and PCTs

Strategic Health Authorities - named as one of the specific consultation bodies in the regional planning process (2004)

Primary Care Trusts - named as one of these bodies for local development plans.(2008)

This means that for their respective plans, each must be consulted by the relevant planning body when development plan documents in which they may have an interest are being prepared.

Health in planning today & tomorrow

Delivering health and well-being in partnership: the crucial role of the new local

performance framework (December 2007) - a joint CLG and DH document.

helped to support the related demands in The NHS in England: the Operating

Framework for 2008/09. Promoted the completion of new Local Area

Agreements (LAAs) for each English locality. Primary care trusts and NHS trusts in

conjunction with their Local Strategic Partnership agree LAA priorities for local people

that improve health outcomes. The completed LAAs provide a sound basis to further

PCT health strategies in the preparation of the new Local Development Frameworks.

New

legislatio

n

Planning Act 2008 (received Royal Assent 26 November 08)

• includes proposed changes to the contributions from developers for

infrastructure to give more consistency across Local Authorities.

• A new Community Infrastructure Levy (CIL) will create a tariff to be

levied on residential and commercial developments to contribute to

funding for infrastructure, including medical facilities.

• DH is working with CLG to ensure the Regulations for the levy properly

support PCTs faced with new developments.

Strategic planning

SHAPE available free to SHAs and PCTs

• Evidence based information for supporting and informing strategic health and social care planning

• Email: shape@dh.gov.uk

• http://shape.dh.gov.uk

Strategic

Health

Asset

Planning &

Evaluation

Looking to the future as well as the present...

South West SHA – Predicted Population Change (all) 2006 – 2026 (1000’s)

Three tool collaboration

SHAPE.

The development team are working with HIU to take health inequalities aspects further

• Possibly including local information on LAAs

• And adding data on local government facilities e.g. leisure centres, parks etc

• Creating a bespoke version dedicated to planning for reducing health inequalities

Scenario Generator

• Discrete event simulation tool built as a collaboration between NHS (Institute) and Simul8 Corp, for modelling the potential impact of change on health systems

HUDU

• Healthy Urban Development Unit (LDA and NHS London) an excel-based tool to calculate the impact of population growth on resource requirements in order to influence S106 agreements

Planning guides

A guide to town planning

for NHS staff

A guide to the NHS for

local planning authorities

Published 2007 – available on DH website

NHS

NHS

Primary and social care

guidance

HBN 36 and 46 – designing community

health premises

Both replaced in 2003 by the website Primary

& social care premises – planning & design

guidance

New HBN11 being produced

four

And finally…

Planning and health

• Effective planning has a big role to play e.g.

– It directly impacts mental health & well-being

– It directly affects healthy behaviours (e.g. travel choice)

– It ensures the right health facilities are in the right places

– helping develop sustainable communities and Healthy Towns

– It enables disinvestment when it is needed

• Tools and support are available and are being developed to help health and other planners take account of these issues in their decision –making.

Health and planning working in

partnership

• As a minimum - awareness and mitigation

of the potential health impact of new

development

• Planning at its best - ensuring the

development of community involvement

and social capital –

the sustainable community

thank you

Pamela Chapman 0113 254 5581

07979 770995

pamela.chapman@dh.gsi.gov.uk

Shape helpdesk 0113 254 5738

shape@dh.gsi.gov.uk