Back to the future...for health and planning | Kate Henderson

Kate Henderson

Can town planners and health professionals help each other plan for and manage people’s healthcare needs? 

The planning system first evolved as a result of the public health movement over a century ago. Improved planning and better housing have long been identified as essential for improving the health of communities, reducing health inequalities and cutting long-term healthcare costs for the taxpayer. 

Today, in the midst of significant challenges facing health and social care provision and a national housing crisis, how can town planners and health professionals help each other plan for and manage people’s healthcare needs?

The planning system is a hidden gem in the local government toolbox. It takes a long-term 15-year perspective on place-based development and sets a vision for what the local area will be like at the end of that period. Planning brings together a very wide range of different statutory functions and services, including health and care, since most require land and buildings to operate, so it can help to plan for the provision and support the coordination of services. 

Since 2012, the government has supported this aim with the National Planning Policy Framework stating that planning should consider and support local strategies to improve health, social and cultural wellbeing for all, and deliver sufficient community and cultural facilities and services to meet local needs.

Many local authorities, like Stoke-on-Trent and Warwickshire, now have health planners working to bridge planning and public health departments to maximise the health benefits through integrating health improvement interventions into new development and regeneration, and help secure investment into health infrastructure. 

Many other councils have formal engagement processes to ensure the voice of health is represented around the table in planning and developer meetings, and vice versa. 

But in the health sector, planners and the planning system have often been misunderstood, misplaced and largely considered insignificant, as attention is focused on more short-term challenges and crises. 

It is not surprising that our research of London joint health and wellbeing strategies in 2015 found nearly 50 per cent did not set out priorities on planning and the built environment. This is a missed opportunity given the ability of the planning system to lever in private sector investment in local communities and services. 

But things are changing. In giving evidence to the Health Select Committee inquiry on public health post-2013, former Faculty of Public Health president, Professor John Ashton, suggested that that health professionals “are having to become much more interested in the legal powers that might be available to them for pursuing public health objectives”.  

The government has also recognised that the nation needs to undertake a significant housebuilding programme to meet the need for between 225,000 to 275,000 new homes a year. 

Combined with the challenges of additional pressures on existing infrastructure in terms of quantity and quality of services, the time is ripe for greater collaboration between the planning and health systems. Here are three opportunities:

Firstly, ten Healthy New Towns are being developed with support from NHS England as part of the Five Year Forward View commitments. These large-scale new communities provide the opportunity to test the provision and reconfiguration of healthcare services to meet the needs of new and existing communities. 

Secondly, there are significant opportunities for the health and care system to recognise the important role of the planning system, and the 44 sustainability and transformation plans produced by the NHS and local councils covering all of England are an obvious place to start. Further research on these STPs will need to done to ensure that they align and facilitate input from local planning authorities within their respective footprints.  

Thirdly, the Housing White Paper published in early February 2017, proposes to place a renewed policy emphasis on planning for healthcare infrastructure as a strategic priority for local areas. There is an opportunity for the government to now produce guidance on this priority to ensure councils, clinical commissioning groups and the wider health sector are fully aware of this opportunity.  

In summary, it is essential that public health and healthcare professionals grasp these opportunities, out of both financial necessity and interest, and engage proactively with the planning system to tackle the resource and capacity challenges. The TCPA would welcome others to get in touch and join in the national conversation about reuniting planning and health. 

Kate Henderson is chief executive of the Town & Country Planning Association. The TCPA has an active Reuniting Health with Planning programme of capacity building, guidance, research and raising awareness. Follow the organisation on Twitter @theTCPA

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