Planning
Introduction
The return of public health responsibilities to local
authorities through the Health
and Social Care Act 2012, and changes to the planning system
through the Localism
Act 2011 and the
National Planning Policy Framework 2012 (NPPF) , have resulted
in local government being required to give greater consideration to
local health and wellbeing in formulating policies and making
planning decisions.
The government’s overarching objective for the
planning system is that it should facilitate and promote
sustainable patterns of growth. It should do more than merely
regulate development. Local planning authorities should be
place-shapers and place-enablers focussing equally on environment,
community and prosperity.
This section looks at the role of the planning
system in supporting and creating healthy communities. It has clear
links with many other chapters of this JSNA, for example Housing and Active Travel, and so does not consider
individual subject areas in detail. It gives an overview of the
planning system and how it can influence the health and wellbeing
of our community.
Evidencing the links between health and
planning.
The link between health and planning has
always been acknowledged though it is only fairly recently that its
profile has been raised and health and wellbeing has been
explicitly reported in mainstream planning publications.
In 2008 Professor Sir Michael Marmot was asked
by the then Secretary of State for Health to chair an independent
review to identify the most effective evidence-based strategies for
reducing health inequalities in England. The final report ‘Fair
Society: Healthy Lives’ was published in February 2010 and
concluded that reducing health inequalities would require action on
six policy objectives:
- Give every child the best start in life
- Enable all children, young people and adults
to maximise their capabilities and have control over their
lives
- Create fair employment and good work for
all
- Ensure healthy standard of living for
all
- Create and develop healthy and sustainable
places and communities
- Strengthen the role and impact of ill-health
prevention.
Nationally the government’s Public Health White Paper,
Healthy Lives, Healthy People, cites the 2010 Marmot Review
which states that:
‘There are gaps of up to 7 years in life
expectancy between the richest and poorest neighbourhoods, and up
to 17 years in disability-free life expectancy.’
Following on from Sir Michael Marmot’s work,
in 2011 the Spatial Planning and Health Group (SPHAG) reported on
its extensive review of evidence into spatial planning and health.
SPHAG is made up of planning and health experts: academics,
practitioners and community representatives seeking to improve
public health through the positive use of town planning. In its
report ‘Steps to Healthy Planning: Proposals for Action’
SPHAG found evidence that the following ‘planning’ issues
impact on physical and mental health:
- The location, density and mix of land
uses
- Street layout and connectivity
- Access to public services, employment, local
fresh food and other services
- Safety and security
- Open and green space
- Affordable and energy efficient housing
- Air quality and noise
- Extreme weather events and a changing
climate
- Community interaction
- Transport
The study concluded that formulating and implementing planning
policies and development proposals based on how they affect human
health is likely to improve our health. It is possible to ‘design
in’ health to urban and rural environments in the same way that it
is possible to ‘design out’ crime. Twelve actions are proposed by
SPHAG along with a Spatial Planning and Health Group Checklist.
These provide a useful resource for both planning and health
professionals. (add reference or add as an appendix)
In 2012 and in response to the new
policy environment the Town and Country Planning Association (TCPA)
commenced a ‘Reuniting Health with Planning’ project. An
output of this project is the handbook ‘Reuniting
Health with Planning – Healthier Homes, Healthier Communities’.
The handbook sets out how local areas can use the planning, health
and social care reforms to better integrate planning and
health.
In 2013 the project moved on to phase 2; to
focus on advice to help planning and health practitioners work
together to create healthier places and communities based on real
life case study areas. A second report ‘Planning Healthier
Places’was published by the TCPA in 2013 and draws on
roundtable events in eight case study areas. It considers how local
authorities and partners are putting this agenda into practice and
looks at the challenges they are facing and how places can be
shaped to respond to public health objectives.
December 2014 saw the publication of ‘Planning Healthy-weight
Environments; a practical resource for practitioners to use
when working together to enable the creation of healthy-weight
environments by setting out a framework of six ‘planning healthy
weight environment’ elements; movement and access; open space, play
and recreation; healthy food; neighbourhood spaces and
infrastructure; buildings and local economy.
This was followed in 2015 by the publication
of ‘Public Health
in Planning; good practice guide’ which brings together and
signposts existing guidance on the planning process. It highlights
existing good practice examples and first-hand advice from Councils
about working relationships between public health and planning.
In March 2016 Building the Foundations:
tackling obesity through planning and development was
published. This is a practice based report and is the result of a
workshop series in 2015 demonstrating innovative practice from
fourteen local authority areas across England and their partners on
how to tackle obesity and other problems by using planning policy
and in making decisions on new housing and mixed use
developments.
Looking forward to 2017 the TCPA is proposing
two further projects:
'Developers and
Well-being: gaining a business perspective on
building healthy places' Project. This project
builds on the successful and widely disseminated Planning Healthy
Weight Environments (2014) and Building the Foundations: tackling
obesity through planning and development (2016). There is already a
greater appreciation and understanding of the role of the planning
system to tackling obesity with the support and alignment to public
health objectives from practitioners to elected members. In this
project the TCPA intends to take it to another level to engage with
the development industry and provide insight which can not only
help Local Authorities better engage with developers, but also for
developers to take greater consideration of their schemes of
potential health impacts and benefits. It will seek to follow a
successful model of delivery from previous projects of
collaborating with local partners during the process to ensure
local buy-in and maximise outreach and support. The outputs will be
case studies-based drawing from good practice on developments and
regeneration places.
‘15-Year Forward View: Healthcare
needs in planning and development' Project. This
project builds on the feedback from practitioners about the lack of
and consistent planning guidance around planning for healthcare
needs in the planning and development process. There are a number
of current legal and policy requirements such as the Duty to
Cooperate on Local Planning Authorities and CCGs which are not
being implemented consistently across the country. This can result
in 15-year local plans and planning decisions which do not account
for the population’s health needs and miss opportunities to lever
in development finance to support infrastructure and service needs.
This project will obtain practitioner views, provide practical
guidance on building a shared local evidence base, inform policy
development and commissioning processes, and highlighting
meaningful approaches to collaborating with health providers in
plan-making and on development proposals. The outputs will be a
series of workshops with local planning and commissioning
organisations resulting in a planning guidance publication.
The TCPA offers the view that ‘These are
formative times for the health and planning agenda. There is
pressure to act on a range of public health topics, from providing
sufficient affordable housing, to restricting the spread of betting
shops, to improving access to healthy food. New organisations and
policies will influence planning for health. Evidence on the
solutions the planning system can help to implement will continue
to evolve.’
In their policy rainbow (below), Hugh Barton
and Marcus Grant present a diagram which reflects the relationships
between people, their local and global environments and the
determinants of health and wellbeing.
What is evident from this diagram is the
breadth of other policy areas that planning can influence.
Planning is distinctly different from many other strategic needs
assessment chapters because it is the way that our environments are
planned and delivered that determines how successfully we address
health and the health inequalities described in detail elsewhere in
this JSNA.
By creating health-promoting environments we
can improve the health and wellbeing of people living within them
and reduce health inequalities. By taking effective action and
investing in prevention we may also be able to reduce costs to
health and social care services.
For example, one study in Bristol found that
switching from commuting by car to an active travel mode could
create annual health budget savings from £1,121 (cycling) to £1,220
(walking) per person because of increased health benefits. But such
options will only be taken up where safe and direct routes have
been planned in.
The links between the health and planning
agendas are beyond question.
Hugh Barton and Marcus grant 2006 - -The
Health Map or Policy Rainbow
National Policy
The National Planning Policy Framework 2012 is
a relatively short statement setting out the Government’s approach
to planning issues. It is supplemented by the National Planning
Practice Guidance (NPPG); an on-line resource expanding the
NPPF’s principles and setting national good practice. Locally
produced plans, i.e. Local Plans produced by local authorities such
as Bedford Borough Council and Neighbourhood Plans produced by
parish councils and other neighbourhood forums must comply with the
policies and guidance in NPPF and NPPG unless local circumstances
justify an alternative approach.
In the terms of the NPPF, there are three
dimensions to sustainable development; economic, social and
environmental. These dimensions give rise to the need for the
planning system to perform a number of roles:
●● an economic
role – contributing to building a strong, responsive and
competitive economy, by ensuring that sufficient land of the right
type is available in the right places and at the right time to
support growth and innovation; and by identifying and coordinating
development requirements, including the provision of
infrastructure;
●● a social
role – supporting strong, vibrant and healthy communities,
by providing the supply of housing required to meet the needs of
present and future generations; and by creating a high quality
built environment, with accessible local services that reflect the
community’s needs and support its health, social and cultural
well-being; and
●● an environmental
role – contributing to protecting and enhancing our
natural, built and historic environment; and, as part of this,
helping to improve biodiversity, use natural resources prudently,
minimise waste and pollution, and mitigate and adapt to climate
change including moving to a low carbon economy. (Para 7).
All three dimensions have significant health
components and implications.
One of the NPPF’s core planning principles is
to actively manage patterns of growth to make the fullest possible
use of public transport, walking and cycling, and focus significant
development in locations which are or can be made sustainable.
(Para 17).
Another is to take account of 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 (para 17.)
Section 4 of the document is given over to
promoting sustainable transport. The NPPF recognises that transport
policies have an important role to play in facilitating sustainable
development and also in contributing to wider sustainability and
health objectives. (para 29).
Encouragement should be given to solutions
which support reductions in greenhouse gas emissions and reduce
congestion. In preparing local plans, local planning authorities
should support a pattern of development which, where reasonable to
do so, facilitates the use of sustainable modes of transport. (para
30).
All proposals for development that are likely
to generate significant amounts of movement should be supported by
a Transport Statement or Transport Assessment and possibly a Travel
Plan. These documents will consider the likely impact of additional
traffic on the local area (and possibly beyond) and ways of
reducing that impact. (paras 32-36).
Section 8 of the document is about promoting
healthy communities. It explains that the planning system can play
an important role in facilitating social interaction and creating
healthy, inclusive communities. In order to do this the preparation
of plans and decisions on planning applications should aim to
involve all sections of the community. Plans that enable new
development should promote interaction between members of the
community through positive design measures such as active
frontages. Safe and accessible environments should be created which
encourage the active use of open areas. (para 69).
The NPPF also explains that existing open
spaces should generally not be built upon and that new open spaces
should be created as an integral part of new developments. (paras
73-78).
Health Impact Assessment
The National Planning Practice Guidance
explains that a health impact assessment may be a useful tool to
use where significant impacts may arise as a result of a
development proposal.
A health impact assessment helps to ensure
that health and wellbeing are being properly considered. Whilst
health impact assessments can be carried out at any stage in the
development process they are best done at the earliest stage
possible. They can be stand-alone assessments or part of a wider
sustainability appraisal or environmental impact assessment. The
process looks at both positive and negative impacts as well as
indirect implications for the wider community. The aim of the
health impact assessment is to identify the main likely negative
impacts and prompt discussion about how they might be resolved or
mitigated. The assessment should also look at how the good
consequences for health can be enhanced. Health impact assessments
can be ‘full’, ‘rapid’ or ‘desktop’ depending on the depth of the
study required.
The HIA Gateway is
operated by Public Health England and it gives access to a range of
documents related to health impact assessment. It identifies six
steps in the process of carrying out a health impact assessment.
They are:
- Decide whether a proposal requires assessment
by HIA – often called screening.
- Clarify the questions to be answered by the
HIA and how the assessment will be carried out – often called
scoping
- Decide what the health impacts will be and
how big by considering each pathway by which the proposal could
impact on health – often called appraisal and assessment.
- For each option make recommendations as to
how good health consequences could be enhanced how bad health
consequences could be avoided or minimised and how health
inequities could be reduced.
- Communicate the findings of the HIA to the
decision makers.
- Evaluate the quality of the HIA
highlighting lessons for future HIAs. Monitor which proposals and
if possible assess whether any predictions made were
correct
Bedford Borough Council as place-shapers and
place-enablers
The Sustainable Community Strategy
2012-2016
This is a core document for the Council when
exercising its duty to promote wellbeing under the Local Government
Act 2000. It provides the framework for the policies and objectives
of the Local Plan, for example in relation to quality of life,
safer communities and improving healthy living. It was produced by
the Bedford Borough Partnership in 2009 and its vision challenges
everyone within the Partnership to work together around seven
themes, which each have specific aims, to explain how the Strategy
will be delivered. The seven themes are:
- Thriving:– A strong local economy.
- Greener – Supporting a natural environment
that is valued and enjoyed by all and contributes to the
development of a low carbon community.
- Aspiring – Children and Young people may lead
safe, healthy and happy lives and are provided with life
opportunities.
- Healthy – Everybody has access to high
quality health and social care services when needed.
- Safer – People live without the fear of
crime.
- Inclusive – People whatever their background
feel part of the wider community. Inequalities are reduced.
- Sustainable – The supply and quality of
housing is capable of supporting the anticipated increased
population. Housing and economic growth are built on sustainable
improvements to related infrastructure.
Bedford Borough Council Corporate Plan
2012-16
The Council’s Corporate Plan explains what the
Council will itself do to meet the objectives of the Sustainable
Community Strategy. Four themes are identified and within each
theme a number of distinct objectives are explained. The four
themes are
Theme 1: Providing a Healthy Future
Theme 2: Protecting and Preserving the Local
Environment
Theme 3: Brighter Futures for Children
Theme 4: Serving Customers Effectively
Planning policy documents must deliver the
objectives of the Corporate Plan. It is expected that the Council
will be able to identify clear paths between the broad nature of
its corporate objectives and its specific planning policies and
proposals.
A growing population
With a rising population and increasing demand
for jobs and housing, planning policy documents have a very
important role to play in explaining how the growth needed to meet
the local needs of Bedford Borough will be achieved.
There is a lot of factual information about
Bedford Borough in the Population and
Place chapter of the JSNA.
Working in partnership
Preparing a new local plan containing planning
policies that direct and shape growth must take account of these
facts and trends and also of evidence of future change over the
plan period. It must be an inclusive process. A sound plan
can only be achieved if a wide cross section of the community has
had appropriate opportunity to help shape it. Information and
evidence contained in other chapters of this JSNA will also
influence the plan’s policies and proposals.
In order to judge inclusivity, the Council
regularly gathers information during consultation events to see
whether responses have been received from a representative sample
of the Borough’s residents. It has been difficult to draw any
meaningful conclusions from these exercises because most people
choose not to complete the optional personal information sheet.
However, we are aware that organisations representing hard to reach
groups or those with protected characteristics do not often respond
to our invitations to get involved in plan making. This is a
concern and requires further investigation.
The statutory duty to co-operate requires us
to work with nearby councils and other public bodies to consider
strategic cross-boundary issues. Included in this list are the
Clinical Commissioning Groups and National Health Service
Commissioning Board who are required to work positively with the
council in the preparation of its plan.
Bedford Borough Council has recently updated
its
Statement of Community Involvement; a document setting out when
and how people and organisations are encouraged to get involved in
the plan making process and in the determination of planning
applications. This has helped to raise awareness of the different
opportunities there are for people to become involved in preparing
plans and other policy documents.
Without an up to date local plan the Council
will not be able to guide when, where and how development takes
place. The best way to deliver sustainable growth that meets the
needs (including health needs) of communities is to prepare and
adopt a relevant and up to date plan.
A Local Balance
There are many tensions in the planning
system. For example:
- The Government would like to see local plans
prepared quickly yet the need for a robust evidence base,
consultation and effective engagement, along with the complexities
of the duty to cooperate all add to the timetable.
- In particular political sensitivities and the
re-apportionment of growth across boundaries through the duty to
cooperate (in Bedford’s case potentially from Luton and London)
take time to resolve.
- Nationally there is clear evidence of a
housing shortage yet locally many people are reluctant to support
growth near to where they live. This is especially so in
countryside and village locations where the local context is
particularly valued and change is often resisted.
- Early work on the Local Plan 2035 shows that
there is a reluctance to support additional growth without a
guarantee that local infrastructure will be provided or
improved. This may include open spaces, sports pitches and
health facilities to support growing communities.
- The costs of infrastructure add to the
overall costs of development and in difficult economic
circumstances may make it unviable. This means that unless the
costs associated with development are reduced, development will
simply not happen. The difficult choice may then be between no new
housing or housing delivery with reduced infrastructure
provision.
- The development of brownfield sites is
preferred by many people to the development of greenfield sites but
the supply of available brownfield sites in Bedford Borough is
small. Most of the older outdated industrial sites in Bedford and
Kempston have now been re-developed, predominantly for housing.
Those that remain undeveloped have complex and costly issues to
resolve. Brownfield sites in villages are hard to find and maybe
similarly constrained.
- The most sustainable location in the borough
is the urban area of Bedford and Kempston yet opportunities for
development (not already identified) are few. Congestion, and in
some places air quality, is a concern and new or intensified
development would potentially make the situation worse.
- Locations away from the urban area are less
sustainable and likely to lead to reliance on the car for essential
journeys, unless the location and design make more sustainable
modes more attractive.
- New settlements, perhaps garden villages, may
provide a sustainable alternative to the expansion of existing
communities. However these are complex to plan and deliver with the
first new dwellings being built many years after sites are first
identified for consideration. Alone these will not satisfy the need
for housing growth.
The challenge for the local plan process is to
consider these and other issues and create and deliver a strategy
that provides sustainable growth in the best place to meet local
needs.
What are we doing?
Local planning documents
The NPPF reinforces the plan-led system as the
starting point for making decisions on planning applications. This
means that it is important that the Council has up to date local
planning documents to set out the locally agreed development needs
and priorities of the area.
Bedford Borough Council has a number of
documents that together make up what is known as the statutory
development plan. All current planning policies are contained in
these documents. They are :
These documents make allocations for
development to meet identified needs up to 2021. The Council is
currently preparing a replacement Local Plan that will look forward
to 2035. More information on the progress of that plan can be found
on the Council’s
web site.
The Localism Act 2011 introduced a new tier of statutory
planning documents. For the first time neighbourhood areas can be
identified for which local groups can prepare a Neighbourhood Plan.
This tier of plans sits below the Local Plan and must be consistent
with it. It can however go into far more detail than a borough-wide
plan can and can address issues that are important locally.
Concerns about the health of local residents could help to shape
the policies in a neighbourhood plan.
A Neighbourhood Plan must be prepared in accordance with the
regulations and will be scrutinised to ensure it is capable of
being adopted and implemented. A local council or
Neighbourhood Forum is responsible for preparing the neighbourhood
Plan but Council Officers will provide appropriate help and
guidance. The Council has a web page explaining more about
neighbourhood planning in Bedford Borough.
Development Management; making
decisions on planning applications.
Planning decisions on proposed development are
made in accordance with the policies of the development plan (the
documents listed above).
Design and access statements continue to play
an important role in getting developers to think about design early
on in the development process. Where appropriate these statements
can be used by public health colleagues as the basis for evaluating
the health and wellbeing impact of a proposed development.
In particular people’s health and wellbeing
are influenced by their access to and quality of housing, including
affordable housing. There is more about this in the Housing chapter
of this JSNA.
What do we need to do?
We need to:
- Review saved policies and draft new policies
taking account of the impact that they can have on health, both
positive and negative. Use the JSNA and health and Wellbeing
Strategy to assist this process.
- Use the checklists in ‘Reuniting health With
Planning’ (TCPA) (section 4) and Steps to Healthy Planning (SPHAG)
to guide the development of the Local Plan 2032.
- Work more effectively with CCGs and Public
Health colleagues in preparation of the Local Plan
- Consider health issues as part of
Community Infrastructure Levy list of priority infrastructure
(Regulation 123 list) when it is reviewed.
- Agree the extent to which and how Health
Impact Assessment (HIA) is to be used both in plan making and
development management
- Related to this, consider whether the
articulation of the health impacts of development proposals should
be an integral part of the determination of planning
applications.
- Consider whether it would be appropriate to
add ‘assessment of health impacts’ in all planning committee
reports and prepare standard answers from which to select.
- Monitor the use and effectiveness of HIAs and
consideration of health in the development management process
through monitoring of relevant planning policy in Local Plan
2032.
- Keep up to date with best practice and help
to shape national guidance where possible through responding to
government consultations.
- Continue to improve engagement, especially
with hard to reach groups.
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