Officials from the National Health Service are aiming to involve themselves in the design of a series of new settlements, in a bid to make residents more healthy and plan for the support of ageing populations.
Developments at Barking Riverside and Ebbsfleet, Kent are among ten sites earmarked for the experiment.
Simon Stevens, head of NHS England, explained the thinking behind the approach: “As these new neighbourhoods and towns are built, we’ll kick ourselves if in 10 years’ time we look back having missed the opportunity to ‘design out’ the obesogenic environment, and ‘design in’ health and wellbeing,” he said.
“We want children to have places where they want to play with friends and can safely walk or cycle to school – rather than just exercising their fingers on video games. We want to see neighbourhoods and adaptable home designs that make it easier for older people to continue to live independently wherever possible. And we want new ways of providing new types of digitally-enabled local health services that share physical infrastructure and staff with schools and community groups.”
In a speech to the King’s Fund, Stevens named ten sites to come under the Healthy New Towns programme, which aims to design in health and modern care from the outset. During the last year, NHS England asked local authorities, housing associations and developers for projects that might fit the bill. “Our call for expressions of interest received an impressive number and range of applications, covering housing developments of different sizes, from smaller projects up to those over 10,000 units,” said the authority.
The approach calls for a mix of urban planning, architectural design and healthcare systems inputs. Communities will have an eye towards being more supportive of older people, as well as promoting overall preventive health measures.
In planning terms, the aspiration is to create walkable neighbourhoods, with “radically improved infrastructure for safe active travel” and better public transport links. Neighbourhoods will aim to encourage mixing of ages and backgrounds, with public spaces designed to encourage outdoor play and spaces to dwell and mix. The aspiration is also to make “smart” towns, with joined up and properly integrated public services.
There is also a wish to ensure better access to healthier food, perhaps restricting fast food outlets.
The genesis for the plan was an NHS five year planning document published in 2014, which acknowledged that the NHS was going to keep running short of cash, unless it focused on prevention, more joined up care, and greater efficiencies. Specifically, it noted: “New town developments and the refurbishment of some urban areas offer the opportunity to design
modern services from scratch, with fewer legacy constraints – integrating not only health and social care, but also other public services such as welfare, education and affordable housing.”
Drilling down, the approach aims to “go beyond existing good practice” with three core objectives: shaping neighbourhoods and communities that promote wellbeing and keep people independent; providing a testbed for radical new thinking about health and care services, free of legacy restrictions; and creating a model that can be learned from, and replicated elsewhere.
“Some of the UK’s 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,” said professor Kevin Fenton, national director for health and wellbeing at Public Health England. “The considerate design of spaces and places is critical to promote good health.”
The sites selected are a mix of those in planning, as well as some where development is under way.
At Ebbsfleet, the initative comes as the Ebbsfleet Development Corporation is just getting the project moving, with housebuilder Barratt completing the first homes. However, they have already been criticised by Dartford planning committee chairman Derek Hunnisett for being “standard off the peg stuff”. And concerns have been expressed that while a new masterplan is being drawn up, much of the land has already received outline consent and is in the hands of housing developers.
EDC chairman Michael Cassidy has welcomed the NHS approach: “This is an important milestone in the development of Ebbsfleet Garden City and we are delighted to be part of an initiative that will encourage healthy lifestyles in the twenty first century.”
“We look forward to working with NHS England as we drive forward our Garden City. Having this status is a positive move forward with all that it can bring in health care innovation in developing communities.”
LPA Perspective: The NHS is often accused of only being interested in people when they are ill, not in keeping them well. This initiative – clearly borne by thinking about the unsustainable health issues such as obesity and diabetes, coming over the hill – is to be welcomed.
The real challenge will be getting all the parties around the table to come up with something that really works. The NHS does not have funds to commit, only hoped-for savings. Cash-strapped local authorities likewise are looking for savings, albeit the use of smart town initiatives could help them considerably there.
Which then leaves the worrying prospect that the up front cost of these new, healthier communities will need to be borne by housing developers. And, as comments around Ebbsfleet point out, that is a real issue. Why would developers give over land to open spaces, attractive cycle and walking routes, unless they are obliged to, via section 106 or other agreements? Unless there is a swift replanning of developments already under way, the danger is that only lip service is paid to the fundamental planning issues that need to be addressed, to create neighbourhoods where people are happy to dwell outside their homes, and to move outside their cars.