Context
Introducing the East Sussex Approach to Planning for Health
For East Sussex ‘Planning for Health’ by definition is:
‘Planning for Health’ whereby the planning system(s) works with public health to deliver a conscious and cooperative approach to maximise planning processes that enable and support positive population health and wellbeing outcomes. The intention is to ‘develop’ healthy and sustainable built and natural environments, where communities can enjoy healthy and sustainable lifestyles, healthy life expectancy and healthy places.’ (Madigasekera-Elliott, 2026)
In East Sussex, Public Health, all the Local Planning Authorities, the County Planning Authority and the Highway Authority have agreed to work together to improve and maximise the health and wellbeing of residents through the planning system. A coordinated and consistent strategic approach to ‘Planning for Health’ has been developed across all of the East Sussex planning authorities. (Eastbourne, Hastings, Lewes, Rother, Wealden and the South Downs National Park). This has been enabled, facilitated and supported by the East Sussex Public Health, Healthy Places Team.
The East Sussex Public Health and Planning Memorandum of Understanding, August 2022 sets out the high-level actions that will be taken. Supportive collaborative working agreements (called Engagement and Process Protocols) between Public Health and all of the individual Local Planning Authorities in East Sussex, have also been signed. These include detailed actions on processes, procedures and engagement.
An East Sussex Planning for Health Working Group has been established with representatives from all the Local Planning Authorities, the Public Health Team, Highway Authority and County Planning Authority within East Sussex County Council. The group supports the co-development of agreed local approaches, processes, protocols, tools and guidance to deliver ‘Planning for Health’ to improve health outcomes for people and place. It strengthens knowledge and provides a network for discussion and dissemination.
The Working Group has developed an East Sussex Health Impact Assessment (HIA) Toolkit (add link) to support the implementation of HIA requirements on planning applications within the county. The Framework supports the HIA process by outlining evidence, priorities, issues and considerations on health and wellbeing and by highlighting potential opportunities and measures to address issues, challenges and increase benefits.
This work being undertaken by planning and public health helps to support delivery of the:
- The Integrated Care Strategy (aspirations for health, people and places).
- The Healthy lives, healthy people: East Sussex Health and Wellbeing Board strategy (with the aim of reducing health inequalities)
- The East Sussex Council Plan (priorities: Driving sustainable economic growth. Keeping vulnerable people safe. Helping people help themselves. Making best use of resources now and for the future).
- Adult Social Care Prevention Strategy (vision: Every person in East Sussex lives in the place they call home. With the people and things, they love. In communities where we look out for each other. Doing the things that matter to them”).
- The East Sussex Children and Young People’s Plan (priorities: best start in life, physical health and mental health and emotional wellbeing).
- The East Sussex Housing Partnership Strategy (vision: Healthy, safe and affordable homes for all).
- East Sussex Local Transport Plans (objective to support healthier lifestyles and communities).
Aim and Purpose
The East Sussex Planning for Health, Wellbeing and Sustainability Framework (the Framework) has been developed to provide Public Health information, guidance and intelligence on ‘Planning for Health’. Its aim is to help enable the creation of healthy and sustainable places in East Sussex. It aims to protect the health and wellbeing of current and future generations.
The Framework provides information and guidance from a health and wellbeing perspective in line with Public Health duties and responsibilities under the Health and Social Care Act (2012) to improve health and wellbeing and reduce health inequalities. It informs and complements but does not replace statutory documents such as Local Plans and Local Transport Plans which provide the policy requirements for developments with health, wellbeing and sustainability in mind.
The purpose of the Framework is to:
- Provide the national planning policy context, local data and evidence that justifies and supports the need to deliver ‘Planning for Health’.
- Communicate and provide a clear steer on health, wellbeing and sustainability considerations related to ‘Planning for Health’.
- To communicate planning opportunities through a health, wellbeing and sustainability lens. This includes communication of the ‘five aspects’ of the built and natural environment and their determinants of health.
- Make connections and links between health, wellbeing and sustainability within Planning and Public Health.
- Identity and outline the health, wellbeing and sustainability issues, priorities, outcomes, implications, consequences and impacts that the planning system can influence and deliver.
- Give consideration to the impacts, effects (including cumulative) and implications from development on vulnerable groups and how those impacts, effects and implications vary across them.
- Create a consistent and easily accessible evidence-based resource and approach across the county. The resource will support the delivery of a consistent, comprehensive and holistic approach to healthy placemaking in East Sussex that is targeted on maximising health, wellbeing and sustainability outcomes.
- Provide a step-by-step explanation of what standards are expected and what can be delivered as part of efforts to deliver healthy and sustainable developments in East Sussex. Case studies and best practice are provided as examples.
Who the Framework is For
The Framework is for everyone wanting information on how to deliver ‘Planning for Health’ in East Sussex. All those involved in place making and decision taking. This includes:
For Developers:
A guide to understanding the links between planning, health, wellbeing and sustainability measures that development proposals can take. The guide helps developers work through the cumulative impacts and effects, considerations and opportunities within their plans, at the earliest opportunity, in a holistic manner that is clearly prescribed in line with the Public Health standards expected for healthy and sustainable, development within East Sussex.
For Local Planning Authorities:
A consistent understanding and evidence of the wider context of health and wellbeing to inform Local Plan policies and planning application decisions.
For Parish and Town Councils:
To provide information and evidence to support Neighbourhood Plan development on health, wellbeing and sustainability to align to the broader planning system as well as ‘Planning for Health’.
For Public Health:
A communication and guidance planning and public health tool. It provides the evidence and links between planning and health, where the support, justifications and information are centralised. The tool provides the rationale for how public health will be engaging and working with the planning system including responding to planning applications.
For Decision Makers:
Support a greater understanding of health and wellbeing issues and the potential within developments to mitigate negative impacts and unintended consequences and effects, at the earliest opportunity as well as to maximise benefits.
For Communities:
A better understanding of ‘Planning for Health’ to enable more informed and better engagement with the planning system on health, wellbeing and sustainability.
For Other Stakeholders:
A useful tool to understand health and wellbeing priorities and issues, and what can be done to address them within the planning and health contexts.
Overarching National Planning Policy on Health and Wellbeing
The National Planning Policy Framework (NPPF) (2024) sets out the Government’s national planning policies and guidance for England and how these should be applied. Local Plans produced by Local Planning Authorities must be consistent with the NPPF. The NPPF in Chapter 8 ‘Promoting healthy and safe communities’ highlights that planning policies and decisions should aim to achieve healthy, inclusive, and safe places which promote social interaction, are safe and accessible and enable and support healthy lifestyles, especially where this would address identified local health and wellbeing needs and reduce health inequalities - for example through, the provision of safe and accessible green infrastructure, sports facilities, local shops, access to healthier food; allotments; and layouts that encourage active travel.
NPPF paragraphs on specific areas are contained within relevant sections of the framework.
The government published a revised version of the NPPF in December 2025, for consultation. The revised version is only a proposal at this stage and therefore is subject to change. When the new NPPF is finalised and published, expected later in 2026, the Framework will be revised to acknowledge any relevant updates from the NPPF.
National Planning Practice Guidance (NPPG), Healthy and Safe Communities expands on the NPPF guidance and acknowledges that the design and use of the built environment are major determinants of health and wellbeing. It states that planning and health need to be considered together in terms of creating environments that support and encourage healthy lifestyles.
The NPPG states in paragraph 3 that:
‘A healthy place is one which supports and promotes healthy behaviours and environments and a reduction in health inequalities for people of all ages. It will provide the community with opportunities to improve their physical and mental health, and support community engagement and wellbeing. It is a place which is inclusive and promotes social interaction. It meets the needs of children and young people to grow and develop, as well as being adaptable to the needs of an increasingly elderly population and those with dementia and other sensory or mobility impairments.’
Framework Content and Structure
The Framework Guidance Section is structured around the five ‘Aspects’ of the built and natural environment that have been identified as the main characteristics that can be influenced by the planning system to achieve positive public health outcomes and support effective population health management. Under each ‘Aspect’, relevant Health and Wellbeing ‘Determinants’ are grouped to communicate what is required to create healthy and sustainable places in East Sussex.
Aspect 1: Neighbourhood Design
Determinant 1a - Quality provision of local services and facilities.
Determinant 1b - Quality provision of local employment sites.
Determinant 1c - Inclusive design
Determinant 1d - Safety and security
Determinant 1e - Social cohesion and interaction
Determinant 1f - Arts, culture and heritage: attractive and distinctive places
Aspect 2: Housing
Determinant 2a - Quality housing
Determinant 2b - Accessible and adaptable homes
Aspect 3: Food
Determinant 3a - Access to healthy food
Determinant 3b - Food growing
Aspect 4: Natural Environments
Determinant 4a - Environmental hazards: air, noise, light and odour pollution
Determinant 4b - Access and provision of quality public green and blue spaces
Determinant 4c - Outdoor play and recreation
Determinant 4d - Climate change adaptation: flood risk and extreme temperatures
Aspect 5: Transport
Determinant 5a - Local connectivity
Determinant 5b - Mobility and accessibility
Determinant 5c - Active travel: walking, wheeling and cycling
Determinant 5d - Public Transport: buses and trains
Information under each Determinant includes:
- Requirements: What it means and covers.
- Issues, Impacts and Links to Health and Wellbeing Effects: Outlines the importance of the determinant, its connection to health, wellbeing and sustainability outcomes, and how it affects different population groups, particularly the most vulnerable.
- The Opportunities: What the Planning System Can Do:
- Positive actions, principles and measures that should be considered and where feasible implemented to address adverse effects and enhance health and wellbeing benefits.
- Local Data and Evidence
- Signposts to Data: relevant indicators available on the East Sussex Healthy Places Data Profile and links to other key external data sources.
- Signposts to Evidence: County-wide plans, strategies and reports.
- National Planning Policy Context: Provides a summary of relevant national planning policy.
- Other Key Guidance and Standards: Provides links and summaries of other relevant key documents.
- Examples: Provides best practice/case studies as examples and supporting information.
- Links with Other Determinants: There are overlaps and synergies between ‘Aspects’ and ‘Determinants’. As a result, some considerations and measures will influence multiple determinants. For example, initiatives and measures which support ‘Active travel’ could also contribute to improvements in ‘Environmental hazards’, ‘Inclusive design’, ‘Safety and security’, ‘Social cohesion and interaction’, ‘Access to green and blue spaces’ and ‘Climate change adaptation’. This section identifies the other determinants that are interconnected and cross-cutting with the determinant.
All ‘Determinants’ within the Framework need to be considered to create healthy and sustainable places. However, some will be more relevant than others for specific places and developments. Their relevance and the measures which are required and can be feasibly implemented will depend on the proposal including its scale, impacts and effects, and the specific location characteristics, sensitivities and opportunities within each site.
Healthy Life Expectancy and Vulnerable Population Groups
The built and natural environment does not affect all individuals or groups across a community in the same way or equally. Likewise proposed developments will affect varying groups and communities differently. There is substantial evidence which highlights the relationship(s) between vulnerable groups and poor health and wellbeing outcomes which reduce 'healthy life expectancy' (HLE)
People’s life expectancy (LE) is a summary measure of the average time someone is expected to live, based on the year of their birth, current age and other demographic factors including their sex. (HLE) is the average number of years that somebody can expect to live in good self-reported health. Years lived in poor health reduce quality of life, increase demand on healthcare services, and have wider economic effects, such as reduced ability to work. LE and HLE varies between different geographical areas. This captures socio-economic inequalities, as differences between places tend to reflect characteristics of places (including available amenities and jobs) and population characteristics (such as education and income levels).
Key findings on Neighbourhood Health Disparities based on HLE (JSNA: Improving Healthy Life Expectancy in East Sussex, 2024) include:
Significant Gaps: The gap between areas with the highest and lowest HLE in East Sussex is nearly 20 years.
County Differences: HLE is highest in Frant and Groombridge in Wealden and lowest in Central St Leonards and Hollington in Hastings.
Growing Inequality: There is a gap of 14.9 years for males between the most and least deprived areas, and 13.4 years for females.
Drivers of Inequality: Major contributors to this variance include diet, smoking, obesity, disability and health conditions, education, employment and physical inactivity.
The government’s 10 Year Health Plan: Fit for the Future (2025) includes aims to shift from ‘treatment to prevention’ and from ‘hospital to community’. The 10 Year Health Plan pledges to improve HLE for all citizens. The government will introduce neighbourhood health centres in every community, starting with areas that have the lowest HLE.
By understanding the health composition of a local population and place, consideration can be given as to the impacts and effects proposals can have on existing communities and the future health and wellbeing outcomes they will generate. This importantly includes consideration of the impact and outcomes of planning policies and development proposal on vulnerable groups within the community.
Vulnerable population groups are those who may experience poorer health due to social, economic, environmental, or biological factors. This includes people with protected characteristics under the Equality Act 2010, but also other groups identified through public health evidence.
Below is a list of the vulnerable groups which need to be considered. It is based on the WHIASU Population Groups Checklist, which is a commonly used best practice framework to identify groups at greater risk of health inequalities and which can be influenced by the planning system. The list covers the statutory protected characteristics under the Equality Act 2010.
Sex/Gender related groups
- Female
- Male
- Transgender
- Other genders and groups
Age related groups
- Children and young people
- Early years (including pregnancy and first year of life)
- Older people
Income related groups
- Economically inactive
- People on low income
- People who are unable to work due to ill health
- Unemployed
Groups at higher risk of discrimination or other social disadvantage
- Black and minority ethnic groups
- Language/culture
- Lesbian, gay and bisexual people
- Gypsies and Travelers
- Homeless
- People with long term health conditions
- People with mental health conditions
- People with physical, sensory, or learning disabilities/difficulties
Geographical groups and/or settings
- People in key settings: workplaces/schools/hospitals/care homes
- People living in areas which exhibit poor economic and/or health indicators
- People living in rural, isolated or over-populated areas
- People unable to access services and facilities