East Sussex Public Health and Planning Memorandum of Understanding, August 2022
1. Purpose
1.1
This Memorandum of Understanding (MOU) sets out how the Public Health Team within East Sussex County Council (ESCC) and Local Planning Authorities (LPAs) will work together to deliver the County Council’s statutory public health responsibilities and LPAs duties to deliver relevant elements of the National Planning Policy Framework through the planning system. This MOU includes all LPAs within East Sussex which are Eastbourne Borough Council, East Sussex County Council, Hastings Borough Council, Lewes District Council, Rother District Council, South Downs National Park Authority and Wealden District Council.
1.2
This MOU provides the policy context and links between planning and health. It provides an overarching agreement and intention to work together countywide to improve the health and wellbeing of our residents. It sets out the high-level actions that parties will take, including working together to agree specific actions around processes, engagement, and parameters to establish robust working outcomes and objectives. These will be developed into detailed agreements between Public Health and individual LPAs.
2. Background
2.1
Population health and wellbeing is impacted not only by individual behaviour, but by the wider determinants such as those within the built and natural environment as depicted below:
2.2
Some of the most pressing health challenges: such as obesity, mental health issues, physical inactivity, and the needs of an ageing population, can all be influenced by the quality of our built and natural environment. These wider determinants of health are influenced by the planning system and therefore improving both physical and mental health and wellbeing is integral to land use planning. This is through areas such as place-making, design, regeneration, sustainable development, green infrastructure, active and sustainable travel, and development management. The links between health and planning are recognised in the National Planning Policy Framework 2021 (NPPF) and its accompanying Practice Guidance (NPPG).
2.3
It is acknowledged that whilst most of the public health agenda is nothing new for land use planning there is growing policy, guidance, and evidence of the specific links between the two areas and therefore there is now a real opportunity to strengthen how health and wellbeing is addressed within the planning system. This will add value not only to existing work which already considers health impacts and inequalities but will also support work addressing shared objectives with health on tackling the climate change emergency and delivering an economic recovery post COVID 19.
2.4
It is also acknowledged that other health teams and organisations input into the planning system to improve health and wellbeing such as environmental health teams, health and wellbeing teams in district authorities and the National Health Service (NHS). This MOU will support and link in with the work being done by these other partners.
2.5
This MOU has been developed between public health and planning officers to build consensus and mutual understanding. It will build consistency across the county in the approach to creating healthy and sustainable places, strengthening compliance to the Duty to Cooperate. It will also be a mechanism which will help to deliver against the East Sussex Health and Wellbeing Strategy, the Creating Healthy and Sustainable Places – A Framework for East Sussex, and Local Plan policy objectives concerning health, wellbeing, and sustainability.
3. National Policy Context
Health and Social Care Act
3.1
In April 2013 the Health and Social Care Act (2012) gave upper tier and unitary authorities a new duty to improve the health of people in their area including encouraging healthier lifestyles and addressing health inequalities. The transfer of responsibilities from the NHS to local government was intended to shift the emphasis from treatment towards a more preventative agenda which tackles the wider social determinants of health such as the environment, housing, education, and employment.
3.2
As part of the Health and Social Care Act local areas had to establish multi-agency Health and Wellbeing Boards. The Boards are charged with producing the Joint Strategic Needs Assessment and a Joint Health and Wellbeing Strategy for their local areas.
Integrated Care Systems (ICSs)
3.3
Constraints on NHS funding over the past seven years, combined with rising demand from a growing ageing population, have put the NHS under enormous pressure. It has been clear for some time that simply working our current hospital-based model of care harder to meet rising demand is not the answer. Rather, the NHS needs to work differently by providing more care in people’s homes and the community and breaking down barriers between services.
3.4
The NHS also needs to give greater priority to the prevention of ill health by working with local authorities and other agencies to tackle the wider determinants of health and wellbeing. This means tackling risk factors such as obesity and redoubling efforts to reduce health inequalities. And it means fully engaging the public in changing lifestyles and behaviours that contribute to ill health and acting on the recommendations of the Marmot Review Report ‘Fair Society, Healthy Lives’(2010) and other reviews to improve population health.
3.5
ICSs are geographically based partnerships that bring together providers and commissioners of NHS services with local authorities and other local partners to plan, co-ordinate and commission health and care services. They are part of a fundamental shift in the way the health and care system is organised – away from competition and organisational autonomy and towards collaboration, with health and care organisations working together to integrate services and improve population health. Integrated care partnerships (ICPs) will operate as a statutory committee, bringing together the NHS and local authorities as equal partners to focus more widely on health, public health, and social care. ICPs will include representatives from the Integrated Care Boards (ICB), the local authorities within their area and other partners such as NHS providers, public health, social care, housing services, and voluntary, community and social enterprise (VCSE) organisations. They will be responsible for developing an integrated care strategy, which sets out how the wider health needs of the local population will be met.
National Planning Policy Framework, 2021 (NPPF)
3.6
The NPPF requires public health to be considered in both plan-making and decision-taking and states the purpose of planning is to contribute to the achievement of sustainable development, with delivery of the social objective of sustainable development being paramount to supporting health.
3.7
The social objective in paragraph 8b supports strong, vibrant, and healthy communities, by ensuring that a sufficient number and range of homes can be provided to meet the needs of present and future generations; and by fostering well-designed, beautiful, and safe places, with accessible services and open spaces that reflect current and future needs and support communities’ health, social and cultural wellbeing.
3.8
Section 8 ‘Promoting healthy and Safe Communities’ paragraph 92, requires planning policies and decisions to aim to achieve healthy, inclusive, and safe places which promote social interaction, that are safe and accessible, and enable and support healthy lifestyles, especially where this would address identified local health and wellbeing needs.
3.9
Paragraph 93 requires planning policies and decisions to provide the social, recreational, and cultural facilities and services the community needs, through planning positively for the provision and use of shared space, community facilities and other local services to enhance the sustainability of communities and residential environments.
3.10
Paragraph 98 recognises the importance of access to a network of high-quality open spaces and opportunities for sport and physical activity for health and wellbeing of communities which can also deliver wider benefits for nature and support efforts to address climate change.
3.11
Further links to health and wellbeing can be found throughout the framework including in sections on housing, transport, design, and the natural environment.
National Planning Practice Guidance (NPPG), November 2019
3.12
The NPPF is supported by additional guidance set out in NPPG specifically in the ‘Healthy and Safe Communities’ category. This acknowledges that the design and use of built and natural environments 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.
3.13
Paragraph 3 describes a healthy place as one which:
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Supports and promotes healthy behaviours and environments and a reduction in health inequalities for people of all ages.
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Provides opportunities to improve physical and mental health and supports engagement and wellbeing.
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Is inclusive and promotes social interaction.
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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 sensory or mobility impairments.
3.14
Paragraph 5 states that it is helpful to consult Public Health on planning applications that are likely to have a significant impact on the health and wellbeing of the local population or particular groups, this would allow partnership working on any necessary mitigation measures. It also mentions that a health impacts assessment is a useful tool to use where there are expected to be significant impacts.
4. County Policy Context
East Sussex Health and Wellbeing Board Strategy ‘Healthy Lives, Healthy People’, 2022-2027
4.1
The Strategy’s vision is to protect and improve health and wellbeing and reduce health inequalities in East Sussex, so that everyone has the opportunity to have a life that is as safe, healthy, happy and fulfilling as possible.
4.2
The Strategy recognises that health and wellbeing is not just about services, it is improved by access to good jobs, transport, housing and green space as well as opportunities for learning, exercise, good nutrition and supportive networks and relationships within communities. The priorities include promoting strong awareness of the impact of these wider determinants and seeking to engage everyone to play their part to ensure those determinants are as positive as possible in the county.
4.3
It recognises the partnership work being undertaken to develop shared plans in other areas that influence the health of the local population. It stresses the importance of making sure that all organisations can play an effective part in delivering these strategies and plans. This includes local planning authorities bringing together plans aimed at creating healthy and sustainable places across the built and natural environment and other factors that affect health and wellbeing locally.
Annual Report of Director of Public Health ‘Health and Housing’, 2019/20
4.4
The report illustrates the very strong link between our physical, emotional, and mental wellbeing and our living environment. It states that people living in areas of deprivation and those who are already vulnerable suffer the most harm in relation to physical health and emotional and mental wellbeing and for children, future life chances.
4.5
The report shows that housing related harm is largely hidden, including the impact of living in insecure accommodation or poor-quality housing. It indicates by taking a whole systems approach in-roads can be made to improve the availability of affordable, decent housing; reduce inequalities; and improve health and wellbeing.
4.6
The report makes strategic recommendations to build on the existing work and strengthen the ability of housing in East Sussex to secure good health for all, these include:
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To make all housing and neighbourhoods healthy: ESCC and the District and Borough Councils will work more collaboratively on Local Plans, sharing data and intelligence to fully understand housing needs and hardwiring the principles of ‘Putting health into place’ to ensure health is central to place making, and the design and delivery of homes and neighbourhoods.
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To make all homes healthy: ESCC, the District and Borough Councils and the NHS will support and promote initiatives that improve the health and safety of homes, including adaptations that improve environmental sustainability, and promote independent living.
East Sussex Whole-System Healthy Weight Plan 2021-2026
4.7
The Plan highlights that living with excess weight is a well-established risk factor for a range of chronic diseases, including type 2 diabetes, cardiovascular disease, many cancers, liver, and respiratory disease.
4.8
Partners across the whole system need to work together to address all the causal factors which lead to an unhealthy weight and physical inactivity. This includes improving access to and safety of cycle lanes, ensuring planning and development prioritises physical activity and making our outdoor spaces safe and accessible for all.
4.9
Three priority action areas were chosen: environment, physical activity, and food. Specific actions under these include:
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Physical activity: Make walking and cycling the easier choice for short journeys or part of longer journeys wherever possible.
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Food: Create an environment where healthy food is the preferred choice, whether eating in or out of the home.
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Environment: Ensure that healthy weight and physical activity is prioritised within local planning and development processes; and improve access, promotion, and safety of public outdoor spaces, and encourage a sense of shared ownership by those who use them.
4.10
The Action Plan includes the area: Creating a healthier weight environment. This includes the structures level action:
‘Work with the local planning authorities to embed a ‘health in all policies’ approach to their planning processes e.g. health impact assessments, design guides, supplementary planning documents, etc. which support a ‘healthier weight’ environment.’
And the belief action:
‘All organisations with responsibility for planning in East Sussex recognise and prioritise getting ‘health into place’ in their local areas.
East Sussex Environment Strategy 2020
4.11
The strategy sets out the key challenges and opportunities within five priority environmental themes: climate change, natural capital, air quality, water, and resource efficiency. The environmental challenges make it clear that urgent action is needed, however these also provide opportunities. It stresses that investing in a healthier and more productive environment will deliver economic and social benefits and is essential for sustainable social and economic prosperity. The benefits include improved health outcomes and reduced health costs.
4.12
Reducing the impact of environmental pollution on health, notably air pollution will reduce mortality and morbidity rates. The strategy’s long-term aim is for all of East Sussex to meet the air quality standards recommended by the World Health Organisation. Spending time in the natural environment improves mental health and wellbeing, by reducing stress, anxiety, and depression, whilst physical activity measurably reduces the risk of type 2 diabetes, heart disease and hip fractures. The strategy’s long-term aim is to achieve a growing and resilient stock of natural capital.
East Sussex Joint Strategic Needs Assessment (JSNA)
4.13
The JSNA provides a detailed information base on the health of the local population in areas relevant to planning. Local Health Profiles identify local public health inequalities and priorities which require improvements to overall health and wellbeing.
ESCC Local Plans
4.14
The County Council is the local planning authority for its own development (for example libraries and roads) and determines planning applications for such proposals. The County Council is also the waste and minerals planning authority for East Sussex. As such it determines planning applications for waste management and minerals development, and also is required to prepare waste and minerals planning policies for the area. The adopted Waste and Minerals Local Plan, prepared jointly with Brighton & Hove City Council and the South Downs National Park Authority (SDNPA) is currently being reviewed with Examination expected later in 2022.
ESCC Local Transport Plan
4.15
As Highway Authority the County Council is responsible for producing the Local Transport Plan. Work is currently being undertaken on Local Transport Plan 4 (LTP4). This provides an opportunity for Public Health to work with transport planners and with local planning authorities to ensure health and wellbeing issues related to travel are consistently addressed and opportunities for benefits are maximised.
4.16
The Local Transport Plan is supported by other key documents such as the ESCC Local Cycling and Walking Infrastructure Plan and the ESCC Bus Service Improvement Plan and forthcoming thematic plans which will be developed as part of LTP4 in relation to Strategic Road & Rail, Freight and Smart Mobility.
5. Local Policy Context
Local Plans
5.1
Local Plans, which set the levels and location of future development, are produced in East Sussex by districts, boroughs, and the SDNPA. All LPAs are currently reviewing their Local Plans and are at a relatively early stage in their development, this provides a key opportunity for health and wellbeing to be strengthen within these emerging plans.
Eastbourne Corporate Plan 2022-2026
5.2
The Eastbourne Corporate Plan identifies a vision for strong communities where individual residents and their different organisations and support networks have the resources they need to be healthy, feel safe and thrive.
5.3
As part of the priority for Thriving Communities, Eastbourne will promote physical health and mental well-being through working with Wave Leisure, other activity providers and the East Sussex Public Health team to promote physical activity; improving the facilities provided at the Sovereign Leisure Centre; and promoting walking and cycling as both leisure and commuting opportunities.
5.4
In addition, the Corporate Plan aims to promote homes that sustain health and well-being through measures such as developing integrated health, housing and care strategies, and improving infrastructure through new integrated cycling and walking routes.
Eastbourne Borough Council Biodiversity Strategy, 2021
5.5
Eastbourne Borough Council is committed to supporting measures to help arrest biodiversity losses, restore habitats and species and work for climate resilience to promote healthy and thriving communities. This is recognised through the biodiversity strategy, with the need to protect and maintain as well as enhance and increase biodiversity and nature across Eastbourne.
A Whole Systems Approach to Creating Health Equity, and Prosperity in Hastings
5.6
In June 2021 the Hastings Local Strategic Partnership (LSP) Board agreed to establish a health inequalities task and finish working group. This was in part in response to the motion to Hastings Council in February 2021 regarding health inequalities, in recognition that across Hastings 74% of the population is living in the worst 20% deprived communities in England.
5.7
The discussion paper ‘Creating Health Equity and Prosperity in Hastings a Whole Systems Approach’ was endorsed by the LSP in June 2022. The paper provides recommendations to capture, identify and deliver key actions across services and organisations in which to tackle the wider determinants of health, create health equity and prosperity in Hastings across the ‘whole system’. A whole system approach is a long-term endeavour and seeks to work with communities and stakeholders to both understand the problem and to support identification and testing of solutions.
Healthy Hastings and Rother – Working Together to Reduce Health Inequalities, Summer 2019
5.8
The Healthy Hastings and Rother programme was set up in 2014 by the NHS East Sussex CCG (now known collectively as the Integrated Care Board, NHS Sussex) to tackle long-standing problems of relative poor health in Hastings and Rother, aimed at reducing health inequalities by improving local services and supporting people to live healthy and happy lives.
5.9
Hastings and Rother contain the eight most deprived council wards in East Sussex. These experiences of deprivation contribute to higher rates of long-term illness, disabilities, cancer, lung disease and heart problems as compared with the rest of England. The programme aims to reduce health inequalities by improving the health and wellbeing of people in Hastings and Rother’s most disadvantaged communities.
Lewes District Council Corporate Plan, 2020-2024
5.10
The Corporate Plan sets out the goals and ambitions for the 4-year period. One area of focus under Sustainability and Climate Change is to improve air quality through the development of a district Air Quality Action Plan. This will combine and update the two current Action Plans which focused on the two Air Quality Management Areas (Lewes Town centre and Newhaven). Another area of focus under this theme seeks to improve the energy efficiency of homes including supporting low-carbon heating technologies in our council houses.
Lewes District Council Biodiversity Strategy, 2021
5.11
Lewes District Council’s broad key aims within the strategy can be summarised as follows:
- To seek nature-based solutions, ecosystem services and re-naturing or rewilding opportunities as guiding principles in all council and partnership.
- To maintain and increase biodiversity on council-owned and managed land.
- To engage and enable community-led nature-based projects and to be involved in partnerships that promote natural capital and biodiversity across the district.
- To ensure that all developments maximise the opportunities for well- considered gains in biodiversity.
5.12
The council is committed to supporting measures to help arrest biodiversity losses, restore habitats and species and work for climate resilience to promote healthy and thriving communities. This is recognised through this strategy, with the need to protect and maintain as well as enhance and increase biodiversity and nature across Lewes District.
Rother’s Corporate Plan, 2020-2027
5.13
A priority objective of the Corporate Plan is to build a fairer society. A series of aims have been set to achieve this including, amongst other things, developing an Anti- Poverty Strategy (published in draft in April 2022). This identifies significantly higher levels of people with long term health problems in Rother compared to the south- east region and to England and Wales. An additional Corporate Plan aim is to improve levels of physical activity amongst residents experiencing socio-economic deprivation and poor health outcomes.
People and Nature Network: Green Infrastructure in the South Downs and wider South East
5.14
The South Downs People and Nature Network (PANN) was published in 2020. The PANN aims to protect, enhance and create a network of green and blue spaces which sustainably meet the needs of local communities, support natural ecosystem services and respects the special qualities of protected landscapes by proposing the strategic principles for planning, delivery and management of natural capital assets in the area. It recognises the importance of nature for health and wellbeing. Objectives include using natural assets to support health and wellbeing and improving access opportunities to green spaces. The PANN area shows information beyond the SDNP, showing important relationships between, and opportunities for, people and nature across a wider area. A full evidence report accompanies the PANN which includes data related to health and wellbeing. A series of Natural Capital Investment Areas are identified, accompanied by an analysis of the strengths, weaknesses, opportunities, and threats particular to that area.
South Downs National Park, Partnership Management Plan, Outcome Health and Wellbeing
5.15
The South Downs National Park is a well-used and recognised asset for sustaining mental and physical health and wellbeing. The South Downs Partnership Management Plan 2020-2025 includes outcome 7 on health and For this outcome the priorities for the next five years are to develop initiatives which enable local communities and individuals to improve health and wellbeing. The Authority is building a partnership with health bodies and local networks of providers and commissioners, both in and around the National Park, to encourage a better appreciation of the potential of the South Downs as a place for healthy outdoor activity and relaxation, and as a place where mental health and emotional wellbeing can be nurtured and supported.
South Downs National Park Authority Health and Wellbeing Strategy
5.16
The South Downs Health and Wellbeing Strategy 2020-2025 sets out the ambition for Health and Wellbeing is that the South Downs National Park is a well-used and recognised asset for sustaining mental and physical health and wellbeing across all sectors of the community. The strategy sets objectives and a delivery action plan under three themes: (1) realising wellbeing benefits for communities, (2) realising wellbeing benefits for individuals and (3) Promoting the South Downs National Park as a place for health and wellbeing. Several spatial health and wellbeing priority areas are also identified.
Wealden Health and Wellbeing Strategy
5.17
The Strategy sets out Wealden District Council’s health and wellbeing priorities to improve and protect the health and wellbeing of all those who live and work in the district as well as maintain Wealden as a healthy place to live, work or visit. The Strategy provides details on how the Council intend to deliver its health and wellbeing agenda over the next three years. The priorities include: Mental health and resilience: Loneliness, social isolation and connected communities; Positive health choices; and Active communities, environment, and facilities.
6. Links between Planning and Health
6.1
The following section outlines the potential links between planning principles and measures and health and wellbeing impacts and outcomes. The information has been adapted from ‘Public Health England’s Spatial Planning for Health’ [Footnote 1] and ‘Strengthening the links between planning and health in England’ [Footnote 2]. The section is grouped under the 5 aspects of the built and natural environment that have been identified as the main characteristics that can be influenced by local planning policy:
- Neighbourhood design
- Housing
- Healthier food
- Natural and sustainable environment
- Transport
6.2
These aspects of the lived environment can be designed and shaped, by planners, to promote certain health outcomes. Changes to the design of the environment can support improvements in health and reduce the risk of developing certain diseases, and also help to improve people’s physical and mental wellbeing. Many of planning principles will already be being considered but a greater understanding of the potential health and wellbeing impacts and/or benefits can support and further justify the inclusion and implementation of policies and measures to address them.
6.3
Various organisations influence the planning system and help to deliver and address these planning principles and measures. Environmental Health Teams, that sit within district and borough councils and the SDNPA, monitor and control environmental pollution to reduce chemical and other environmental exposures in air, water, soil, and food to protect people and provide communities with healthier environments. The NHS through Sussex NHS Commissioners is responsible for providing additional healthcare facilities to meet increased population growth. Wealden District Council has a Health and Wellbeing Team who work with a variety of partners to delivery health activities, interventions, and programmes within the district.
6.4 Neighbourhood Design
Planning principles and measures
- Improved connectivity and walkability.
- Mix of land uses with provision of services: health, education, retail, community, cultural and recreational.
- Local employment, workspaces, and training opportunities.
- Inclusive and accessible places and buildings for all ages and abilities.
- Well-designed attractive, safe public realm where people can meet.
Impact on health and wellbeing
- Social engagement, interaction, and cohesion
- Increased physical activity opportunities for all.
- Improved access to health and social facilities, services, and employment.
- Reduction in harmful pollutants due to reduced reliance on cars.
Health and wellbeing outcomes
- Improved mental wellbeing.
- Reduced risk of cardiovascular disease.
- Reduced risk of type 2 diabetes.
- Keeping musculoskeletal system healthy.
- Reduced obesity and overweight levels and associated conditions.
- Improved mobility among older adults.
6.5 Housing
Planning principles and measures
- Improved quality of housing.
- Good design including orientation, ventilation, and energy efficiency.
- Increased provision of affordable and diverse housing for all, including groups with specific needs for example elderly and disabled.
Impact on health and wellbeing
- Warmth and energy efficiency.
- Improved indoor air quality and light exposure.
- Improved engagement with healthcare services
Health and wellbeing outcomes
- General health improvements.
- Asthma outcomes improved.
- Reduction in excess winter deaths.
- Reduced risk of cardiovascular disease, type 2 diabetes, some cancers.
- Improved quality of life and mental wellbeing.
6.6 Healthier food
Planning principles and measures
- Community food growing infrastructure including allotments and gardens.
- Access to healthier, affordable food for all.
- Healthy high streets with a diversity of shops and retail outlets selling healthier food.
Impact on health and wellbeing
- Healthier eating and change in dietary behaviours.
- Change in attitudes towards healthy eating.
- Increased access to healthier food.
- Opportunities for physical activity and social connectivity.
Health and wellbeing outcomes
- Reduction in obesity and associated conditions.
- Improved mental health and wellbeing.
- Reduced risk of cardiovascular disease type 2 diabetes, stroke, some cancers and musculoskeletal conditions.
6.7 Natural and sustainable environment
Planning principles and measures
- Reduced exposure to environmental hazards (air and noise pollution, light and odour).
- Access to and engagement with nature.
- Safe, improved existing and new open green and blue natural spaces.
- Integrated play and recreation opportunities for all.
- Adaption to climate change: flood risk and temperature changes.
- Urban greening: street trees, green roofs, and walls.
Impact on health and wellbeing
- Reduced exposure to particulate matter and excessive noise.
- Increased physical activity opportunities for all.
- Reduced impact from weather extremes (hot and cold).
- Social participation and cohesion.
Health and wellbeing outcomes
- Reduced risk of chronic obstructive pulmonary disease, reduction in infant mortality and improved respiratory function among children.
- Reduced risk of developing lung cancer.
- Reduction in obesity and associated conditions.
- Reduced risk of cardiovascular disease, type 2 Diabetes, stroke, mental health, problems, musculoskeletal conditions, and some cancer.
- Improved mental wellbeing.
6.8 Transport
Planning principles and measures
- Safe, attractive active travel infrastructure for all which links to key destinations.
- Public transport opportunities.
- Prioritise active travel and road safety.
- Enable mobility for all ages and activities.
Impact on health and wellbeing
- Increased mobility.
- Increased physical activity opportunities for all.
- Social participation and cohesion.
Health and wellbeing outcomes
- Reduction in obesity and associated conditions.
- Reduction in road traffic accident injuries.
- Reduced risk of cardiovascular disease and type 2 diabetes.
- Keeping musculoskeletal system healthy.
- Improved mental wellbeing.
7. Actions
7.1
The actions below are high-level countywide actions. Detailed actions and agreements on specific parameters, engagement, and processes, particularly around Health Impact Assessments (HIA) and planning application consultations, will be further discussed and agreed between Public Health and individual LPAs. These will be set out in further detailed agreements between Public Health and individual LPAs. This is in recognition of the further liaison required and that the needs of each LPA will vary.
7.2
Actions have been numbered for ease of reference only, there is no priority in the numbering.
Public Health will:
- Work proactively with local planning authorities to develop programmes and policies which address public health objectives through the land use planning process.
- Make the JSNA evidence base relevant and available to local planning authorities and provide advice and support in interpreting it and applying it to local circumstances. Where required submit further evidence on national and local policies and health needs. Where necessary this could include joint commissions to obtain evidence to support policies and actions which address specific local issues related to health inequalities.
- Support LPAs when progressing policies to help ensure that policies address the issues and are customised to local circumstances as appropriate. This will include an early review of policies ahead of any formal consultation to assist LPAs in getting policies right ahead of consultation. Support LPAs should any health and wellbeing policy or initiative be challenged through the local plan preparation or planning application process.
- Use the Healthy Places Team as a first point of contact for Public Health’s input into the planning system on health and wellbeing issues. The Healthy Places Team will liaise with other teams and organisations to ensure links are made, and will provide formal comments to Local Plan and Neighbourhood Plan consultations through the existing coordinated County Council response provided by officers in the Communities, Economy and Transport Department.
- Encourage and support NHS Estates and NHS health service commissioners, who are responsible for identifying and delivering healthcare facilities, in responding to consultations on local plans, including infrastructure delivery plans and major planning applications. This should help to ensure the requirement for healthcare facilities and public health population needs are given full consideration in both local plans and planning decisions.
- Provide support to planning authorities to help identify appropriate trigger points for HIA within local areas, as appropriate.
- Support planning authorities to develop and implement HIA including providing training as necessary and consider developing any necessary specific countywide tools and guidance. Work with LPAs to develop an appropriate approach and process on implementing HIA including Quality Assurance. Specific working arrangements will be agreed and set out within detailed agreements with individual authorities.
- Work with LPAs to establish a process for consulting Public Health on applications both at pre application and submission stages. Parameters and processes will be within existing processes, resources, and capacities wherever possible. Specific working arrangements will be agreed and set out within detailed agreements with individual authorities.
Local Planning Authorities will:
- Endeavor to include an overarching strategic policy in Local Plans on health and wellbeing that sets out the overall principles of planning for health and wellbeing and how the plan will meet NPPF requirements to achieve healthy, inclusive, and safe places which will reduce health inequalities and promote healthier lifestyles.
- Ensure all policies reflect planning for health and wellbeing priorities and principles (Health and Environment in All Policies) either on their own or in combination with the overarching health and wellbeing strategic policy.
- Use the JSNA, academic evidence and other sources of intelligence as the evidence base for policy making and decision making and ensure local plans and decisions reflect the issues set out.
- Consult Public Health on early Local Plan policy development and consider incorporating comments ahead of formal consultations. Work in partnership with Public Health on the development of policy documents such as Supplementary Planning Documents, Technical Advice Notes that relate to health and wellbeing including design guides and codes and Green and Blue Infrastructure Strategies.
- Include health and wellbeing related infrastructure within Infrastructure Delivery Plans and as appropriate in other strategies and plans such as Green and Blue Infrastructure Strategies. Involve PH in securing and allocating development contributions as appropriate.
- Ensure health and wellbeing is adequately incorporated into assessments of Local Plans for example a Sustainability Appraisal and/or undertake a separate HIA.
- Work towards requirement for a HIA for appropriate development in Local Plans and Local Validation Lists. Liaising with Public Health to assist in identifying appropriate trigger points for undertaking an assessment. Work with Public Health to develop an appropriate approach and process on implementing HIA including Quality Assurance. Specific working arrangements will be agreed and set out within detailed agreements between individual authorities and Public Health.
- Work with Public Health to establish a process for involving them in pre-application discussions for major developments above an agreed size threshold and/or agreed areas of deprivation. Specific working arrangements will be agreed and set out within detailed agreements between Public Health and individual authorities.
- Work with Public Health to establish a process for consulting them on planning applications for development and change of use or prior approval notification of developments where a potential public health impact is expected, or developments are above an agreed size threshold. Parameters and processes will be within existing processes, resources, and capacities wherever possible. Specific working arrangements will be agreed and set out within detailed agreements between Public Health and individual authorities.
Footnotes
- Public Health England. Spatial planning for health: evidence review. PHE publications, 2017.
- Strengthening the links between planning and health in England, 2020, Gemma McKinnon, Helen Pineo, Michael Chang, Laura Taylor-Green, Annalise Johns and Rachel Toms.