Introduction to Planning for Health for Public Health Professionals

Training Slides2015

Notes for Presenters1. 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. Making the case for planning for health2. What do we mean by Planning?3. National Policy Context for Health4. London Planning for Health 5. Local Planning for Health6. Development Management (Planning

Applications process)7. Planning mechanisms8. Further information and resources

1. Making the case for planning for health

Learning outcomes1. 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 millionThe 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 centThe increase in trade that has been reported when places are made more attractive for walking (Living Streets, 2013) 168:1The outcomes versus costs when modelling the health benefits of improving cycling infrastructure using ‘high-standard’ spatial planning (NICE, 2010) £7,000The 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 outcomes1. Understand the legal basis of the planning

system2. Appreciate the hierarchical nature of the

Planning System with its different levels3. Understand the structural links between the

Planning and Public Health Systems

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 Plan led system.

The London

Plan

TCPA, 2015

National Planning Policy Framework

Neighbourhood Plan

AREANeighbourhood Forums

Local Plan LOCAL

Local Planning Authority

NATIONALDCLG

Planning Practice Guidance

The Planning and Health Frameworks

Duty to

Cooperate

SUB-REGIONALGroups of Local Planning Authorities

Development Management

AREA/ SITEDeveloper/ Applicant

NATIONALDH and PHE

?

COUNTYUpper tier authorities/ HWBs

Health and Wellbeing Strategy

LOCALLower tier/ unitary authorities

AREAPublic health/ NHS providers

?

CCGs SUB-REGIONAL ?

Building Regulations BUILDINGDeveloper/ Applicant

National Policy Context for Health

Learning outcomes1. Recognise key policies in the National

Planning Policy Framework (NPPF)2. Identify key policies with relevance to Public

Health in the NPPF3. Be made aware where the national policy

guidance is located and how to access it.

• 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

National Health Guidance

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 DevelopmentA 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

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-beingNational Planning Policy Framework (NPPF 2012) Health and Wellbeing evidence in plan-making, Paragraph 171

The National Planning Policy Framework (2012)

http://planningguidance.planningportal.gov.uk Planning Practice Guidance (2014)• 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 outcomes1. Understand the Plan-Making process for a

Local Plan2. 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 healthTown 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 ReviewLocal 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 Outcomes1. 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?

Material considerations

The adopted Local

Development Plan

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 Tips1. 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 outcomes1. 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 ObligationsWhat 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

Examples1. Stockport sustainability checklist2. Wakefield health in planning checklist3. London HUDU checklist

Need more support and resources?

• Learning Outcomes1. 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