Introduction to Planning for Health
for Public Health Professionals
Training Slides
2015
Notes for Presenters
1. This Training is aimed at Public Health and presented by
Planning. It provides high level information, and should be
seen as the minimum and supported by local materials.
2. At the start of each section, key learning outcomes for
Public Health are set out.
3. The Training should be tailored to the style of the Presenter
and needs of the audience, including use of images and graphics
to liven up the text.
4. Consider building in interactive discussion elements as
and when necessary and required.
5. These slides should be updated regularly to reflect
changes in national or local policies or structures.
“An important step in tackling the social
determinants of health at a local level would be
greater integration of health, planning,
transport, environment and housing
departments and personnel.”
Sir Michael Marmot, Marmot Review of Health
Inequalities, E2.2
Training structure
1.
2.
3.
4.
5.
6.
Making the case for planning for health
What do we mean by Planning?
National Policy Context for Health
London Planning for Health
Local Planning for Health
Development Management (Planning
Applications process)
7. Planning mechanisms
8. Further information and resources
1. Making the case for planning for
health
Learning outcomes
1. Understand and reinforce current
understanding of shared issues and actions
for improving health through planning
Indicators of a Healthy Environment
Lucy Saunders,
Transport for London
In numbers
£900 million
The amount that could be saved in the UK annually if everyone exercised as much as
the suggested recommendations, such as walking for 20 minutes 5 days a week (RIBA,
2013)
40 per cent
The increase in trade that has been reported when places are made more attractive for
walking (Living Streets, 2013)
168:1
The outcomes versus costs when modelling the health benefits of improving cycling
infrastructure using ‘high-standard’ spatial planning (NICE, 2010)
£7,000
The amount ecotherapy can save the public purse each year for every person with
mental health problems that is referred (Mind, 2013)
2. What do we mean by Planning?
Learning outcomes
1. Understand the legal basis of the planning
system
2. Appreciate the hierarchical nature of the
Planning System with its different levels
3. Understand the structural links between the
Planning and Public Health Systems
The Plan led system.
Town and Country Planning Act 1990
“the authority shall have regard to
(a) the provisions of the development plan, so far as
material to the application,
(b) any local finance considerations, so far as material
to the application, and
(c) any other material considerations.”
So the local plan will have primacy – presumption is
that determinations will be made in accordance with
the plan, unless …
The Planning and Health Frameworks
National Planning
Policy Framework
NATIONAL
NATIONAL
DCLG
DH and PHE
?
Planning Practice Guidance
The London
Plan
Duty
to
Cooperate
Local Plan
Neighbourhood
Plan
Development
Management
Building Regulations
SUB-REGIONAL
SUB-REGIONAL
Groups of Local
Planning
Authorities
CCGs
LOCAL
Local Planning
Authority
COUNTY
Upper tier
authorities/
HWBs
LOCAL
AREA
Lower tier/
unitary
authorities
Neighbourhood
Forums
AREA
AREA/ SITE
?
Public health/
NHS providers
Health and
Wellbeing Strategy
?
Developer/ Applicant
BUILDING
Developer/ Applicant
TCPA, 2015
National Policy Context for Health
Learning outcomes
1. Recognise key policies in the National
Planning Policy Framework (NPPF)
2. Identify key policies with relevance to Public
Health in the NPPF
3. Be made aware where the national policy
guidance is located and how to access it.
National Health Guidance
• JSNA to consider wider environmental factors –
access to green space, housing, community safety,
transport.
• JHWS – explain priorities to tackle needs identified in
the JSNA
DH JSNA-JHWS Statutory Guidance, 2013
• Improvements against wider factors that affect health
and wellbeing and health inequalities
• People are helped to live healthy lifestyles, make
healthy choices and reduce health inequalities
Public Health Outcomes Framework, Domains
The National Planning Policy
Framework (2012)
• ‘Legal’ status as guidance in law for Local
Planning Authorities in making Local Plans
and planning decisions.
• Produced with public and sector
consultation by DCLG but no immediate
plans for a review.
Planning for Sustainable Development
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
The National Planning Policy
Framework (2012)
Planning should take account of and support local
strategies to improve health, social and cultural
wellbeing for all.
National Planning Policy Framework (NPPF 2012) Core
Planning Principle Paragraph 17, final bullet point
Local planning authorities should work with public
health leads and health organisations to understand
and take account of the health status and needs of
the local population (such as for sports, recreation
and places of worship), including expected future
changes, and any information about relevant
barriers to improving health and well-being
National Planning Policy Framework (NPPF 2012) Health and
Wellbeing evidence in plan-making, Paragraph 171
Planning Practice Guidance (2014)
http://planningguidance.planningportal.gov.uk
• Provides more detailed guidance
on NPPF policies
• Subject to regular review. Sign
up to receive notifications.
Relevant guidance
• Air quality
• Climate change
• Design
• EIA/ SEA/ SA
• Health and wellbeing
• Contaminated land
• Light pollution
• Natural environment
• Noise
• Transport
• And more!
London Planning Context for Health
Learning outcomes
• Understand London-wide policy requirements
on and those relevant to health and wellbeing
What is the Mayor of London’s role in
planning?
• Develop the London Plan (formally known as the
Spatial Development Strategy for London).
• Ensure Boroughs’ Local Plans are in general
conformity with his London Plan.
• Powers to ‘call-in’ planning applications for
strategic developments with the power to
determine applications on his own.
• Note: The Mayor also has other statutory duties
on promoting Londoners’ health and housing
The London Plan
• London’s spatial plan for the next
20-25 years
• All Borough Local Plans must take
it into account
• Relevant policies:
– POLICY 3.2 IMPROVING HEALTH AND
ADDRESSING HEALTH INEQUALITIES
– POLICY 3.16 PROTECTION AND
ENHANCEMENT OF SOCIAL
INFRASTRUCTURE & POLICY 3.17
HEALTH AND SOCIAL CARE FACILITIES
– POLICY 6.10 WALKING
– POLICY 7.18 PROTECTING OPEN
SPACE AND ADDRESSING DEFICIENCY
– POLICY 7.22 LAND FOR FOOD
Supplementary Planning Guidance
Developed to provide further non-statutory guidance to
implement London Plan policies:
• Housing SPG (May 2015)
• Social Infrastructure SPG (May 2015) – including health
and social care
• Accessible London: Achieving an Inclusive Environment
Supplementary Planning Guidance (October 2014)
• Sustainable Design and Construction SPG (April 2014)
• Shaping Neighbourhoods: Play and Informal
Recreation (September 2012)
• Health Issues in Planning (2007)
Local Planning for Health
Learning outcomes
1. Understand the Plan-Making process for a
Local Plan
2. Understand what makes up a Borough Local
Plan
3. Ability to identify key health-relevant policies
in your Borough Local Plan
What is a Local Plan?
• Set out a spatial vision, objectives and policies
for the Borough for the next 15-20 years for
the use and development of land (JHWS is for
3 years)
• Must conform with NPPF and Local Plan
policies
• Should link up with corporate and health
strategies
• Prepared by the Planning team and can take a
number of years from start to finish
What makes up a Local Plan?
Suite of planning documents a Council will have/
be working towards
• Core Strategy/ Local Plan (strategic policies)
• Development Management (detailed policies
to help decide planning applications)
• Site Allocations (land for housing)
• Supplementary Planning Documents on
various planning topics (including open space,
hot food takeaways, design etc)
How can Public Health formally
engage with Planning?
1. Health in Local Plan-Making
• Continual and regular engagement throughout
the process (previous slide)
2. Policy Screening of Plans or Strategies
• Conduct a HIA process on a Plan or Strategy to
identify and prioritise health impacts to
address through Planning
Local Planning Structure
• Planning Policy
– Prepare local plan
including strategic
policies and allocated
sites
– Supplementary Planning
Documents
– Advising applicants on
policy compliance
– Comment on planning
applications
– Monitoring
• Development
Management
– Process Planning
Applications
– Advise applicants
– Advise planning decision
makers
– Present at Area
Committee Meetings
Top Forward-Planning Tips
• Help feed into the long term vison for the
Borough in the next Local Plan review
• Focus on the opportunities of planning
• Have a strong evidence base to support your
planners
• Make documents and processes accessible
• Ensure the policy is effective and deliverable
• Keep monitoring the results as part of the
Authority Monitoring Report
What does your Local Plan say about
health?
A chance to explore what your Local Plan says
about Health
• When was it adopted?
• Describe key Development Plan Documents
• Highlight key Strategic Objectives
• Highlight key health-related Policies
• Is the JHWS/ JSNA referenced?
Reviewing the Local Plan for health
Town and Country Planning Association (TCPA) undertook a policy
review of Borough’s current Local Plans (Strategic Policies and
Development Management Policies Plan), using the framework below:
Findings of the Policy Review
Local Plan Adoption
• 18 Local Plans adopted before the NPPF in 2012
• 15 Local Plans adopted after the NPPF in 2012
Achieving sustainable
development
• Sustainable development already a legal planning duty.
• Health reference mainly through Community Strategy.
Core planning principles
• 21 Local Plans have a specific health policy.
Promoting sustainable
transport
• All Local Plans have transport policies.
• 60% of policies do cite health but 40% do not.
Requiring good design
• Promoting good design is a legal planning duty.
• 45% of policies do cite health but 55% do not.
Promoting healthy
communities
• Wide ranging policies on open space, play and recreation
• 68% of policies do cite health but 32% do not.
Plan-making: Health and
wellbeing
• 21 Local Plans has the JSNA as part of the evidence base
while 12 do not refer to the JSNA at all.
Monitoring and review
(indicators)
• Some have contextual indicators on mortality/ life
expectancy, and on new healthcare provision.
• Opportunity for Public Health officers to influence the
range of relevant indicators.
Development Management (Planning
Applications Process) and health
considerations
• Learning Outcomes
1. Understand what the Planning Application
process is and how Public Health can be
involved to maximise health benefits/
minimise health impact of development
2. Understand what can/ cannot be considered
in Planning – material consideration
3. Recognise others in the decision-making
process
Development Management
• A process of considering applications for
Planning Permission
• This process is needed to ensure a
development is sustainable and beneficial
• Decisions are made by considering Policy and
other material considerations related to
impact on the community/ environment
• Decisions are made by Planning Officers or
Planning Committee for main applications
How can Public Health formally
engage with Planning?
1. Public Health Through the Planning Application Process –
Identify where health can be involved (see previous diagram)
2. Public Health Response to Planning Application – a process
for formalising consultative relationship with Planning
3. Public health comments – Submitting a Public Health
response to highlight health impacts and suggest improvement
4. Monitoring Public Health in Planning Application – Public
health assisting with monitoring and implementation of Planning
Conditions/ Section 106
Material considerations?
The adopted
Local
Development
Plan
Material
considerations
any consideration which
relates to the use and
development of land is
capable of being a planning
consideration!
What is the Councillor role?
• Councillors on Planning Committees consider
major and controversial applications made to
the council on the recommendation of
Planning Officers.
• Sometimes they will go against the advice of
Planning Officers but must be based on
planning reasons.
• Public Health can bring a different perspective
and advisory information.
Top Decision-Making Tips
1. Think about the bigger picture – the outcomes for people,
2. Respect the (statutory) process,
3. Understand roles and responsibilities of different actors and
decision-makers in the process,
4. Think positive - How can you make the development
acceptable?
5. Seek advice from planning officers, solicitors and other
technical experts,
6. Carefully consider the reasons for your recommendations,
and robustness against appeal and legal challenge,
7. Have the right planning reasons: do not make a decision and
instruct officers to come up with reasons,
8. Regularly review your decisions.
Planning mechanisms
• Learning outcomes
1. To understand what mechanisms could be
applied to further maximise health benefits
from development
2. To understand purpose, limitations and
opportunities
Planning Conditions
What it is
• To mitigate a specific impact and to enhance a
development which otherwise would be refused planning
permission.
• A condition must be necessary; relevant to planning and;
to the development to be permitted; enforceable; precise
and; reasonable in all other respects
What it means for Public Health
• Make sure health impacts can be mitigated through a
Planning Condition
• Assist Planning in monitoring and implementing the
Condition
Examples of Planning Conditions
• Restrictions on Takeaways: The use hereby
permitted shall not include use for the sale of
hot food for consumption off the premises
An aspirational Planning Condition could be:
• Health Survey: No development shall take
place until a health survey of the area in
consultation with the Director of Public Health
is submitted to the Local Planning Authority
Section 106 Planning Obligations
What it is
• Financial or in-kind contribution measures to mitigate the
impact of unacceptable development to make it acceptable.
• These measures can include provision of open space, public
realm improvements, security measures, affordable housing,
transport improvements, healthcare and leisure provision.
• They are agreed with the Developer on a site-by-site basis,
and subject to considerations for financial viability.
What it means for Public Health.
• Maximise the benefits for health promotion when Boroughs
spend Planning Obligations money, ie public realm
• Consider whether in-kind contributions of certain measures
can have better health outcomes.
Examples of Section 106 policies
relevant for health
Waltham Forest (2014)
• Environment and outdoor recreation
• Air quality
Lancashire County Council (2013)
• Community safety
• Extra care housing
Lewisham (2015)
• Affordable and wheelchair housing
• Children’s play space
Community Infrastructure Levy (CIL)
What it is
• A discretionary approach for local authorities to charge a levy
(£/sqm) from new development to help deliver local infrastructure
• Setting this levy is subject to a stringent process of testing of
evidence similar to that for a Local Plan
• Identifying local infrastructure to be funded is up to each Borough
and often referred to as a ‘Regulation 123 List’.
• Healthcare, parks and open space are often included
What it means for Public Health.
• Engage NHS England to secure quality local healthcare to support
health improvement initiatives
• Consider health promotion opportunities in open space provision.
Health Checklists
• Some Councils have developed and adopted a process of
using a Health in Planning Checklist, sometimes supported by
a Supplementary Planning Document (SPD). A checklist is
designed to help developers and building professionals to
evaluate the health impacts of projects.
• Checklists can be a material consideration
• But there is no pass mark but different levels of standards
Examples
1. Stockport sustainability checklist
2. Wakefield health in planning checklist
3. London HUDU checklist
Need more support and resources?
• Learning Outcomes
1. Signposting to relevant and key resources and
sources of information.
Key legislation
• Town and Country Planning Act 1990 – main planning law
• Planning and Compulsory Purchase Act 2004 – changes relating to local
planning and planning applications
• Greater London Authority Act 2007 – Mayor’s planning and housing
responsibilities
• Planning Act 2008 – changes in relation to major infrastructure
• Localism Act 2011 – introducing neighbourhood planning and changes to
local planning and planning applications
• Use Class Order - relating to classification of uses within buildings
Note: They have all been amended several times so make sure you refer to
the most recent iteration.
Key References and links
• National Planning Policy Framework – main policy guidance
from DCLG
• Planning Practice Guidance – guidance supporting the NPPF
and is in an online format
• London Plan – main policy guidance from the Mayor for all
London Boroughs
• Planning Portal – online planning and building regulations
advice. It is also the portal for submitting planning
applications
• Planning Inspectorate – contains information on appeals,
examinations in public for plans and CIL
Key organisations and agencies
•
•
•
•
•
Planning Advisory Service
Greater London Authority
Transport for London
Planning Officers Society
Royal Town Planning Institute
Acknowledgements
These slides are put together by the Town and
Country Planning Association (TCPA). It
acknowledges materials from the TCPA and
Stockport Council, and others as referenced.
July 2015