The latest legislative changes establish housing standards and other ‘general determinants of health’ as a means to address health through strategic authorities, spatial development strategies and local plan policies
Both the Planning and Infrastructure Act 2025 and the English Devolution and Community Empowerment Act 2026 contain clauses that create an opportunity to strengthen housing requirements – in both Spatial Development Strategies and Local Plan policies.
We have to look at both acts to understand the implications of the new health duty on strategic authorities, a duty that recognises housing standards as a key determinant of health.
The new strategic duty to promote health improvement and reduce health inequalities
The Devolution and Community Empowerment Act 2026, clause 45 indicates that all strategic authorities (combined authorities, combined county authorities, upper-tier county councils and unitary authorities) will have a new duty to promote health improvement and reduce health inequalities. This duty defines key determinants of health, including:
- housing standards,
- transport services and public safety;
- environmental factors, e.g. air quality and access to green space and bodies of water;
- employment prospects and any matters that affect levels of prosperity;
- access to public services;
- the use, or level of use, of tobacco, alcohol or other substances / matters that are or may be harmful to health;
- any other matters that are determinants of life expectancy or the state of health of persons generally,
The duty aligns with the Greater London Authority, who have been subject to a health improvement and inequalities duty under the GLA Act 1999.
Addressing the health duty through spatial development strategies
Each strategic planning authorities will be expected to prepare a spatial development strategy (SDS) for its area – modelling the approach applied in London over the last 20 years. An SDS must include policies on the use and development of land that are of strategic importance to the area – and this includes policies on housing and infrastructure requirements. Clause 58 of the Planning and Infrastructure Act states that strategic planning authorities must have regard to the effect of a draft SDS on:
- the health of persons in the strategy area;
- health inequalities between persons living in the strategy area;
- the achievement of sustainable development.
Strategic authorities will therefore need to consider how their spatial development plans will comply with the Health Duty in the Devolution Act. Furthermore, local plans within a strategic authority area must be in ‘general conformity’ with the SDS. This means SDS or Local Plan policies which address key health determinants, including housing and infrastructure requirements, must be written in a way that will contribute to meeting the health duty.
Building on existing good practice
The TCPA produced guidance for local planning authorities in England, collating adopted local plan policies which embed a strong approach towards Healthy Homes and healthy placemaking, and positively seek to promote health improvement.
In order to ensure compliance with the new duty, the TCPA would also recommend the application of Health Impact Assessment (HIA, e.g. Public Health Wales) or Health Equity Impact Assessment (HEIA, e.g. West Midlands Combined Authority bus transit HEIA). HIAs are vital to appraise, refine and monitor the impacts of SDS and Local Plan policies to the health of local people.
Although these legislative changes do not deliver the specific clarity that the TCPA and others have been seeking on Healthy Homes and placemaking, they do mean that health must be a central consideration by all strategic authorities going forward. Furthermore, the Planning Inspectorate should be cognisant of this new health duty when examining SDS and local development plans.
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The TCPA 2026 summer conference will explore why Spatial Development Strategies are returning, and how they can actively drive inclusive and sustainable growth – closing gaps between places, improving health outcomes, coordinating infrastructure, and shaping long‑term spatial investment. You can find out more and sign up here.
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Further links
- English Devolution and Community Empowerment Act 2026
- Planning and Infrastructure Act (2025)
- Factsheet: Strategic planning – GOV.UK
- Securing Healthy Homes at the local level – Town and Country Planning Association
- Planning for healthy places – a guide on embedding health in Local Plans and planning policy in England – Town and Country Planning Association
Image: Citizens House is an 11-home, genuinely and permanently affordable housing project in Sydenham, Lewisham – shorted in the 2026 Pineapple for Healthy Homes award.
