This briefing provides an overview of the strategic direction of changes to the (NPPF) and specific proposed policies relevant to planning for health. This is not a comprehensive briefing on the wider spectrum of the wider determinants but it aims to allow the sector to have informed conversations with planning partners and stakeholders, and ensure that there is adequate and consistent public health response to the draft NPPF. This should be read in conjunction with the TCPA overall briefing published in March 2018[1].

TCPA recommends public health teams and health delivery partners discuss the implications of the draft NPPF with the planning team to ensure that the issues raised in this briefing and other issues relevant to local priorities are highlighted, clarified and, where relevant, feed into the local authority’s or wider organisation’s response. 

Strategic direction of changes

In its initial briefing, the TCPA has picked up on proposed wider changes to the local planning framework which will have implications on the extent to which health and wellbeing considerations can be taken into account. These appear to have gone under the radar of many planning organisations but the TCPA believes if such changes are adopted they will see a fundamental shift from the existing planning approach.

  1. The draft NPPF now only requires, as a minimum, a strategic priorities plan for a local authority area or jointly with other local authority areas (Para. 17). A list of strategic priorities is set out in Para. 20 and includes, primarily, physical infrastructure needs, such as community facilities for health, education (Para. 20 e), but not on health and wellbeing.
  2. A detailed Local Plan with local policies is no longer a requirement given the wording which says such policies “can be used” which implies a discretionary nature (Para 30). This is a change from the current NPPF which states that councils “should” produce a local plan. A local plan applies to a range of local development plans including site allocations, local design guidance or area action plans. The implication is that not having a Local Plan, any detailed guidance to support public health including bringing forward SPDs on specific issues would be a viable policy option for those local authorities struggling with resourcing.
  3. The draft NPPF emphasises efforts on pre-application engagement and frontloading by local planning authorities including with statutory and non-statutory consultees, which would capture the wider public health sector (Para. 41).
  4. Viability considerations are often one of the main barriers for securing wider community and social objectives such as health and wellbeing during the planning application process. Viability is now proposed to be primarily considered during the local plan-making stage (Para. 58 and draft PPG). This means public health teams should continue to set out detailed health and wellbeing requirements in local plans but would be subject to viability along with other policy requirements but once through the adoption process can be confident they won’t be challenged on a site by site basis.
  5. Proposed changes to the Section 106 developer contributions to allow pooling of Section 106 again which will benefit investment in local health infrastructure and services, and wider health and wellbeing measures, and help mitigate impact from the development, particularly in areas without a Community Infrastructure Levy (CIL). But this will require changes to secondary legislation before implementation. There is a proposed new mechanism - Strategic Infrastructure Tariff in areas with strategic (cross-boundary) planning powers and plans in place.


Health and wellbeing implications

When compared to the existing NPPF the draft NPPF retains and improves on references to health and wellbeing but in general there are no new health references. The following is a breakdown of the proposed policies:

  1. The planning system has a social objective to support strong, vibrant and healthy communities and to support communities’ health and social well-being (Para. 8). This was retained from the current NPPF.
  2. Section 8 is now about promoting healthy and safe communities, and pools previous health policies into Para. 92 and Para. 93. The answer to the question as to whether health is a material consideration is clearly evident by the wording set out in Para. 92. In particular this refers to planning policies and decisions which enable and support healthy lifestyles (Para. 92 c), which is the only new and additional policy and should be strongly supported).
  3. 92 c) also requires policy and decisions to address identified local health needs (Para 92 c). This refers to the Joint Strategic Needs Assessment (JSNA) and therefore JSNAs should provide the necessary evidence on the built and natural environments. Similarly needs around health and care, and health estates would come under this policy. But the wider policy text on working with health leads and organisations of the current NPPF has now been moved to the draft Planning Practice Guidance.
  4. 92 c) also requires policy and decisions to take into account and support the delivery of local health and wellbeing strategies (Para. 93 b) and was part of the Core Planning Principles of the current NPPF. This refers to the local Joint Health and Wellbeing Strategies, and therefore JHWBs should provide the necessary priorities and objectives including actions around the built and natural environments including the role of planning. Similarly strategies from CCGs and wider STPs around health and care, and health estates would come under this policy.
  5. Planning policies to assess the local need for open space, sport and recreation facilities (Para. 97) and Sport England have already provided planning guidance on just sport facilities.
  6. The draft NPPF continues to promote achieving well-designed places to create places that are safe, inclusive and accessible (Para. 126 f). it should be noted that achieving good design in Local Plans is already one of the few planning duties on local planning authorities, so this is nothing new.
  7. The draft NPPF requires consideration of design quality during early discussions and encourages use of tools to assess and improve design, with specific reference to ‘Building for Life’ principles (Para. 128). Achieving healthy environments should clearly be part of this consideration during the planning application process, and many councils have developed and incorporated planning-for-health checklists to action this. Another mechanism is incorporating health consideration into design codes which are often required as a planning condition for large-scale, multi-phase developments.
  8. The draft NPPF sets out requirement for the provision of affordable housing provision with exceptions for sites that are not ‘major’ sites. Reduced affordable housing should be sought in the development of vacant buildings being reused or redeveloped on brownfield land. (Para. 64)
  9. The draft NPPF strengthens the promotion of sustainable transport, in particular opportunities to promote walking and cycling through providing high-quality walking and cycling networks and support facilities (Para. 105 d). The current NPPF only seeks to give priority to pedestrian and cycle movements and minimise conflicts (current Para. 35).
  10. The draft NPPF continues policies on the natural environment but fails to reflect much of the work and recommendations of the Natural Capital Committee (see TCPA briefing).
  11. Planning policies and decisions to sustain and contribute towards compliance with relevant limit values or national objectives for pollutants, taking into account the presence of Air Quality Management Areas and Clean Air Zone (Para. 179).
  12. Other areas of the NPPF will have implications for health including, but not limited to impact from night time activities in encouraging residential in town centre areas (Para. 86) and optimisation of density in development (Para. 136 b).
  13. The draft NPPF is silent on many issues which public health teams are seeking to use to influence the planning system, including but not limited to:
    • use of health impact assessments;
    • prevent proliferation of unhealthy retail uses such as takeaway outlets and betting shops but could arguably be tackled under efforts to support a diverse retail offer and allow a suitable mix of uses (Para. 86 a);
    • housing and planning for an ageing population given recent research indicating the extent of local authorities failing to prioritise housing for older people In Local Plan and a 2017 legal duty[2] on the Secretary of State to provide guidance in this area; and
    • monitoring and evaluation of local policies on health through the Authority Monitoring Report.


Summary of transitional arrangements and wider issues

  1. Transitional arrangements will not apply and the draft NPPF will be given full weight once adopted in the summer. But the current Framework will apply to those Local Plans submitted for examination in public on or before the date which is six months after the date of the publication of the final NPPF.
  2. The current Planning Practice Guidance on health and wellbeing[3] (which have been afforded significant weight in various planning appeals and examinations in public decisions) will continue to be in force with one proposed update.
  3. As with the current NPPF, the final adopted NPPF may be a significantly different version following consultation feedback, however MHCLG will not be carrying out further consultation stages, so make sure you make your responses count.
  4. The NPPF is not only a national policy document but, in areas without a relevant local plan or policies are out of date, the NPPF will be used as part of planning decisions. It is important the NPPF is viewed also from this perspective particularly for those councils without or currently working through a Local Plan.
  5. The context in London with the London Plan may provide a limited cushion to soften the impact on the proposed Local Plan discretionary requirement. The draft new London Plan has set out detailed planning policies including on a healthy streets approach which borough Local Plans will need to be in general conformity with. Planning decisions are made in line with both the Local Plan and the London Plan, as well as being consistent with the NPPF. However the timescales for adopting the London Plan will not be until 2019 subject to the examination in public and there is no guarantee such health policies will be retained in their current form. The draft NPPF consultation closes in May, after which there will be no opportunity to influence the final adopted version. Therefore, the suggestion is to make a response on the merits or otherwise of the draft NPPF without relying on the current draft new London Plan.

 The TCPA has developed a guide for public health involvement in planning with the London Healthy High Streets group[4] which sets out opportunities for integrating health in the different stages of the planning process.

[1] TCPA, March 2018, Draft Revised National Planning Policy Framework. Briefing from the Town and Country Planning Association.

[2] Section 8 (2) Neighbourhood Planning Act 2017


[4] TCPA, Jukes, A., and Egbutah, C., 2015, Public Health in Planning Good Practice Guide,