The King's Fund – Creating healthy places: perspectives from NHS England’s Healthy New Towns programme
Our health and wellbeing is shaped by much more than just our health care. The places we live in affect our health in countless ways, including through the way a neighbourhood is designed, access to green spaces and the provision of good public transport. The social environment plays a key role too: strong social relationships or, conversely, stressful living conditions, can impact on our mental and physical health, and there is evidence that good urban design and planning can help to encourage positive social interactions and improve health.
Despite this awareness of the wider determinants of health, the joined-up thinking needed to create places that support and promote health can be challenging to bring about as a result of conflicting priorities and pressures. NHS England’s Healthy New Towns programme has sought to overcome this by bringing together the health sector, housing developers, local authority planning teams and local residents to design and build healthier communities.
This report features a collection of essays by the following authors: Emma Cariaga, Clare Gibbons, Hilary Hall, Irina Higginson, Amanda Hill-Dixon, Kevin McGeough, Joe McManners, Dan Northam Jones, Virginia Pearson, Rosie Rowe, Duncan Selbie, Julia Thrift and Louise Upton.
It is edited by Chris Naylor, Senior Fellow, at The King's Fund.
The Healthy New Towns programme
Taking advantage of the opportunity presented by the large number new housing developments taking place across England, the Healthy New Towns programme had three key aims:
- to shape new towns, neighbourhoods and communities to promote health and wellbeing, prevent illness and keep people living independently
- to radically rethink the delivery of health and care services and to support learning about new models of integrated care
- to spread learning and good practice to future developments and regeneration areas.
Ten demonstrator sites were chosen to receive funding and technical support over a three-year period. Key individuals from each site took part in learning collaboratives to support the exchange of knowledge and expertise across all sites. Sites were expected to work within a common framework set by the national programme, but in a way that suited the requirements of the local area.
Practical guidance capturing learning and insights from the demonstrator sites has been published in Putting health into place, aimed at anyone involved in the creation of new places, including planners, developers and their partners in local NHS organisations. The recommendations are also relevant for those working to improve existing places and communities.
Creating healthy places
Creating healthy places: perspectives from NHS England’s Healthy New Towns programme provides personal insights from those involved in the programme, illustrating how powerful a coherent local approach to improving population health can be. It highlights the importance of a number of themes, including the value of taking a place-based approach to population health, the need for specific action on health inequalities, the importance of working closely with communities and the potential to use new places as a test bed for integrated care.
The report concludes by highlighting that there is significant potential to improve population health through place-making and community development. It also stresses the need for the NHS to be closely involved in major housing developments and regeneration programmes in order to improve health and care outcomes.
- The places we live in have a profound impact on our health and wellbeing. Significant gains in population health can be achieved by working in partnership to improve the built, natural and social environments.
- NHS England’s Healthy New Towns programme has shown how large‑scale housing developments and regeneration projects can be used as an opportunity to test and deliver innovative approaches to population health and integrated care, aided by a strong focus on community development. Many of the lessons from the programme are also relevant to existing places.
- Creating healthier places requires closer working between the NHS, local authority planning teams, developers, public health professionals, voluntary sector organisations and communities themselves. In areas with two-tier local government, strong links between the NHS and district councils are important.
- The programme worked in part by acting as a connector and catalyst in local systems. Participating sites created a small team of people with an explicit responsibility for bringing partners together and facilitating dialogue across sectors. A key question is who should play this role outside of innovation programmes like Healthy New Towns.
- There needs to be concerted action on health inequalities as part of efforts to create healthy places, informed by data on the specific health needs of local communities. Health-promoting infrastructure, activities and opportunities need to be accessible to all, with a targeted focus on groups with the poorest health outcomes.
- New housing developments can be used as an opportunity to help bring about improvements in health and care for established communities in surrounding areas. Local partners should ensure that these people benefit as well as the new community.
- Place-based interventions can be designed to improve population health and strengthen community bonds simultaneously – for example, through group-based social activities in public spaces that encourage physical activity. This can be particularly helpful in new places where the community is still becoming established, but it is also applicable elsewhere.
- New places should be seen as an opportunity to redesign primary care so that GPs are part of a wider team that includes community health services, social care, mental health services, and local voluntary and community sector organisations. New premises that bring multiple services together on one site are one way of enabling this.
- In areas where major new housing developments are planned, NHS organisations need to know how and when to engage with planning processes in order to seize opportunities to secure funding for new health care infrastructure.
- Health leaders involved in strategic planning – for example, in sustainability and transformation partnerships or integrated care systems – need to be aware of any significant housing developments in their area. They should think proactively about how their plans will make the most of these developments and take the health needs of new and existing communities into account.
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