Five years after health responsibilities moved back into the hands of local government, the TCPA proposes to re-examine the challenges experienced by councils as they move from transition to implementation to innovation, integrating health and planning settings in localities, both formally and informally, in the planning process. The Five years on and reunited project includes a policy review of English councils’ local plans and Joint Health and Wellbeing Strategies (JHWSs) in line with National Planning Policy Framework (NPPF) requirements. This project aims to analyse the impact of local planning on public health in order to understand how local councils are making an impact integrating health and planning settings.

The final project report is expected in early-2019, but today we are able to analyse the first results of this English local plan research.

The methodology

Firstly, each criterion was created from the main guidelines established by the NPPF and was interpreted by central questions. After each criterion was correctly defined, it was necessary to look in the Local Plans of each council to see if they had considered these criteria.

There are 326 councils in England. For each council, Local Plans are named either named “Core Strategies”, “Local Development Documents” or simply “Local Plans”. All the Local Plans analysed date back from 2006 onwards. Sometimes, in cases where the plans weren’t yet adopted, we analysed their most recent document for the study. Thus, all England’s Local Plans were analysed in the same way, answering the central questions raised for each criterion.

In the same way, this was also done for the JHWS to determine whether these documents provide actions for planning.

Analysis of results

An analysis was done for each of the following questions:

  • Does the Local Plan or any policies reference to the health and wellbeing strategy or other health strategies?

The new NPPF requires councils to take into account and support the delivery of local strategies to improve health, social and cultural wellbeing, implying the use of the JHWS and other health strategies.

Only 22% of Local Plans make reference to a JHWS.

  • Do Local Plan policies require and promote good design, good placemaking, good quality in development, and do they refer to health and wellbeing as an outcome?

The NPPF requires that planning policies and decisions should ensure that developments create places that are safe, inclusive and accessible and which promote health and wellbeing, with a high standard of amenity for existing and future users. All councils have at least one policy about good design but half of them talk about public health.

  • Do Local Plan policies provide opportunities for active travel, active design, sustainable transport and a walking and cycling environment, and do they refer to health and wellbeing as an outcome/reason?

According to the new NPPF, transport issues should be considered from the earliest stages of plan-making and creating development proposals so that opportunities to promote walking, cycling and public transport use are identified and pursued; this can help to improve air quality and public health.

The results show that 74% of the policies make mention of an interest in more sustainable transport for the health of the population. Indeed, the NPPF text explicitly mentions the benefits of sustainable transport (e.g. walking and cycling) on health.

  • Do Local Plan policies provide opportunities and access to open space and play and recreation” areas, and do they refer to health and wellbeing as an outcome/reason?

According to the NPPF, access to open spaces and opportunities for physical activity and recreation make a significant contribution to the health and wellbeing of communities. That is why it is necessary for planning policies to be based on robust and up-to-date assessments of the need for open space, sport and recreation facilities and opportunities for new provision.

 All local authorities have at least one policy in terms of developing recreational green spaces, and 91% of them speak about the benefits they have in improving public health. Considerations in terms of development of green spaces to improve health are largely considered in England due to a strong promotion of green space in the country.

  • Do Local Plan policies set out provision of healthcare infrastructure?

According to the new NPPF, strategic policies should make sufficient provision for community facilities (such as health, education and cultural infrastructure). The results show that nearly all councils require provision of healthcare infrastructure and facilities. 

  • Do Local Plan evidence take into account local health needs by referring to the Joint Strategic Needs Assessment (JSNA)?

The JSNA is a document that examines the current and future health and care needs of populations to inform and guide the planning and implementation of health services. According to the NPPF, planning policies and decisions should aim to achieve healthy, inclusive and safe places which enable and support healthy lifestyles, especially where this would address identified local health and wellbeing needs and implies the JSNA.

The study shows that only 27% of Local Plans mention JSNAs to support their health recommendations while the rest of councils use demographic data in their texts without mentioning the JSNA itself.

  • What indicators are there in the monitoring chapter which can help monitor health impacts/ benefits?

According to the study, the indicators used are often the same. They mention the rate of green and open spaces, the percentage of obesity and the level of an inhabitant’s satisfaction regarding their living spaces or the rate of health services in the council.

  • Does the local plan have a policy or requirement for a Health Impact Assessment (HIA)?

A HIA helps decision-makers make choices about alternatives and possible improvements to prevent disease and actively promote better health. The Planning Practice Guidance maintains that a Health Impact Assessment may be a useful tool to use where there are expected to be significant impacts. According to the results, 30% of Local Plan refer to the use and requirement of HIA in planning applications.

  • Does the JHWS set out concrete planning commitments/priorities to address the wider determinants of health?

The JHWS’s objective is to improve the health and wellbeing outcomes of a local community and support health professionals and their partners by providing information on the population’s overall health.

52% of JHWS documents want to establish priorities and action plans in health. Most of these JHWS’s state the local authorities’’ will to ensure the development of active transport and to create a healthier environment by reducing the impact of fast food.



These first results of the Five years on and reunited project confirm the consideration of the NPPF recommendations by the English councils in terms of planning and sustainable development. The next step of the project will be to study the links between local Welsh plans and public health.

For more information about the project please contact [email protected]