Getting public health evidence into planning policy

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By Danielle Sinnett, Miriam Ricci, Janet Ige, Hannah Hickman, Adam Sheppard and Nick Croft (UWE), Michael Chang (PHE), Julia Thrift and Tim Emery (TCPA)

The Getting Research Into Practice 2 (GRIP2) project was commissioned by Public Health (PHE) England and delivered in collaboration with the Town and Country Planning Association. The project had two aims:

  1. To facilitate the implementation of health evidence set out in key PHE publications by directly engaging with local and regional policy makers, and practitioners across place-making professions and communities.
  2. To provide evidence-informed resources to assist local authorities in developing planning policies to improve health and wellbeing.

Following the publication of Spatial Planning for Health in 2017, PHE commissioned a further research project: Getting Research into Practice (GRIP). This sought to explore the use of the principles set out in Spatial Planning for Health, and the challenges of applying these in local planning policy and decision making. The findings informed the basis of this second phase of Getting Research into Practice (GRIP2).

What we did

We selected four locations to take part in the research and develop local resources from 39 Expressions of Interest. Workshops were then held in each of the selected locations, below, to understand how health evidence could be used in the development of planning policies, with a different focus:

  • Worcestershire: template Technical Research Paper on Planning for Ageing Well that could form the evidence base for new Supplementary Planning Documents (SPD).
  • Hull: template SPD on Healthy Places to address the considerable health inequalities.
  • North Yorkshire, York and East Riding (YNYER): framework for planning for health.
  • Gloucestershire: template to integrate health into neighbourhood plans.

The four workshops took place in November 2019 and each was attended by approximately 30 key representatives from across planning and public health, the relevant local authorities or county councils, and locally identified stakeholders. Workshops consisted of a series of short ‘scene setting’ presentations followed by short interactive workshops.

Written notes from workshop discussions and other background documentation from the local areas were then analysed using the qualitative data analysis software NVivo.

The notes and analysis were used to develop:

·         Framework for a healthy places supplementary planning document (SPD)

·         Developing a healthy planning principles framework

·         Guide to creating a technical research paper on ageing well

·         Guide to embedding health and wellbeing in neighbourhood plans

A suite of guidance to integrate health evidence into planning policies

Key findings and recommendations

We found that across the four locations examined there is a genuine recognition of the ongoing need to develop places that improve health and wellbeing outcomes and reduce health inequalities. However, integration and partnership working across the professions is key, and there are areas of good practice where this is already taking place. It was seen as crucial that all those involved in the planning and development process understand the importance of planning in tackling poor health and health inequalities, including central and local government planning policymakers, and those working in development management, private developers and their consultants.

Despite this, barriers remain related to a lack of leadership, experience, financial resources and capacity in local authorities. Participants were positive that these barriers could be overcome through, for example, increasing communication and joint working between planning and public health teams, learning from best practices and successes in other locations, making better use of the powers available to planners and including a wider range of voices and contributions in the local planning policy process.

There is also an opportunity to make more effective use of health evidence in local planning policy by improving stakeholders’ understanding of the types and sources of available evidence and their strengths and limitations.

The effective use of health evidence in practice, in turn, can further strengthen the case for healthy places at the local level, encouraging buy in from politicians and local communities.

The use of workshops was seen as a key engagement mechanism that helped to initiate and strengthen these local appetites for better integration.

The research report provides a series of recommendations, for example:

  • Tailored local evidence with specific objectives and audiences in mind could be provided to allow planning policies and decisions to be made more effectively and robustly.
  • All stakeholders could develop a shared understanding of the role of planning in improving population health and reducing health inequalities.
  • Make best use of public health evidence, including that generated by communities, to help planners use their powers more effectively.
  • Ensure that health inequalities, and their relationship with the built environment, are well understood and explained in planning policies.
  • Support the creation of an effective evidence base which can be applied within a planning context, including through monitoring and evaluation of planning policies.

The resources provided above provide detailed guidance towards achieving some of these recommendations and are a valuable resource for planning and public health teams.

The key to post COVID-19 recovery: community leadership

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By Robin Hambleton….

As well as causing appalling suffering and misery, the COVID-19 pandemic is opening up new possibilities for the future.  An uplifting feature of the way that communities have responded to the COVID-19 calamity has been the spectacular expansion of self-organising community groups working at neighbourhood, or village, level to help the vulnerable and the needy.

While researching my new book, Cities and communities beyond COVID-19. How local leadership can change our future for the better, I encountered many heart-warming stories of how local communities have responded with great imagination to the disruption of local food supply chains, taken steps to protect the most vulnerable in society, and engaged in all manner of creative, problem-solving activities at the local or hyper-local level.

My research suggests that cities and localities across the world now face four major challenges at once: 1) The COVID-19 health emergency, 2) A sharp, pandemic-induced economic downturn, 3) The climate change emergency, and 4) The disastrous growth of social, economic and racial inequality in many countries.

The good news is that many cities and localities are already developing and delivering progressive strategies that address these four challenges at one-and-the-same time.

An example of good civic leadership – Freiburg, Germany

The photographs in this piece are from one of the cities now leading the way in responding to current societal challenges.  Freiburg is, of course, very well known for pioneering high quality city planning and urban design. 

For example, the Academy of Urbanism joined with the City of Freiburg in publishing The Freiburg Charter for Sustainable Urbanism in 2011.The Academy wanted not just to recognise the achievements of civic leaders and city planners in Freiburg, but also to spread the word about their approach to an international audience.

What is not so well known is that Martin Horn, the young and energetic politician, who was elected as Mayor of Freiburg in 2018, is stepping up the progressive ambition of Freiburg’s policy making.  For example, he is insisting that, as well as meeting very high environmental standards, over 50% of new housing in the city must be affordable. Yes, that’s 50%. 

Detailed plans for Dietenbach, a new eco-friendly neighbourhood for 15,000 people, deliver on this objective.  Submitted to Freiburg City Council last month, these plans also provide open space, schools, sports facilities, day-care centres and local shopping opportunities.  

Meanwhile, the imaginative Freiburg holds together (Freiburg halt zusammen) digital network bundles together numerous citizen-oriented information services and activities for residents struggling with COVID-19 pressures.

Freiburg is just one of the progressive cities featured in my book.  Other cities discussed include Bristol, Copenhagen, Dunedin, Mexico City and Portland.

Children enjoying outdoor space in Vauban, Freiburg, Germany. (Source: the author).

Lessons for UK policy, practice and research

Three lessons for UK policy, practice and research emerge. 

First, the government’s 2020 White Paper, Planning for the Future, needs to be discarded as quickly as possible.  It contains proposals that will not just destroy effective approaches to local planning but also weaken councillor and citizen involvement in local decision-making.[i]   

The evidence from Freiburg, and other enlightened cities, demonstrates that high quality urban development designed to address the climate emergency, provide housing opportunities for the less well off in society, and build liveable communities requires more planning, not less.[ii]

Second, councillors in Freiburg, like all those in Germany, have the constitutional protection to do what they think is right for the people living in their locality.  German local authorities have, then, the freedom to do things differently.  This is not the case in the UK and it is essential to rebalance power within our country via a constitutional convention.  Comparative research can help to make the case for giving local power a major boost.

Third, researchers studying how to create sustainable cities and localities need to give much more attention to power relations.  Advancing our understanding of what needs to be done to co-create liveable cities and towns is vital.  However, just as important, research needs to explore how to bring about progressive change in society. 

What is the power system that is leading to unsustainable urban development?  How can this power system be changed?  What lessons can we learn from cities that are already delivering sustainable development?  These are the kinds of questions that deserve more active consideration by researchers studying modern urban, rural and regional development.

Robin Hambleton is Emeritus Professor of City Leadership at the University of the West of England, Bristol.

Film of book launch

Robin Hambleton’s new book, Cities and communities beyond COVID-19, was published in October 2020.  The book launch, organised by the Bristol Festival of Ideas, includes contributions from Marvin Rees, Mayor of Bristol, who has written a Foreword to the book, and Professor Sheila Foster, University of Georgetown, Washington DC.  This discussion, which was chaired by Andrew Kelly, Director of the Bristol Festival of Ideas, is available here: https://www.ideasfestival.co.uk/events/cities-and-communities-beyond-covid-19/


References

[i] Hambleton R. (2020) ‘Strong place-based leadership is instrumental in the battle against COVID-19’ The Planner, 19 October.

[ii] The key suggestion here is that public policy needs to advance caring in modern society – meaning caring for others and caring for the natural environment on which we all depend.  See Hambleton R. (2020) ‘COVID-19 opens a new political window’, Town and Country Planning, November/December, 89, 11/12, 366-370.

Talk of the Town

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by Nick Smith…

A lot has been written about Build, Build, Build[i] over the last couple of weeks and I share the same level of unease about some of the proposals. But we’ve been here before. Indeed, while you won’t have had the date marked in your calendar, last week marked the 5-year anniversary of when Fixing the Foundations[ii] was published. Back then, this plan for ‘creating a more prosperous’ nation, was penned by George Osbourne (as Chancellor of the Exchequer) and Sajid Javid (as Secretary of State for Business, Innovation and Skills). Chapter 9 ‘dealt’ with planning and some of the chapter’s sub-headings, including its promises for releasing land and increasing the urgency of planning, echo what has been said recently by Boris Johnson. Fortunately, the same level of derision was aired back in 2015, with the Guardian’s Oliver Wainwright[iii], for example, highlighting how the planned reform would give us the ‘slums of the future’. Oliver called for better public outcomes and it’s good that campaigning on this agenda has gained momentum since (with the TCPA’s pitch for a Healthy Homes Act being particularly noteworthy).

Chapter 15 of Fixing the Foundations also promised us a re-balancing of the UK’s economy. While some of the proposals in Build, Build, Build could be argued to support such a goal, the call for spreading prosperity was far stronger within the New Deal for Britain[iv] that Boris Johnson also launched a couple of weeks ago. Specifically, via a section on ‘investing in, and accelerating, infrastructure’, the New Deal provided an update on the Government’s Town Fund[v], a £3.6bn scheme that is intended to accelerate investment in town centres and high streets across England. The first tranche of money equates to an individual pot of about £500k-£1m per town but funding of up to £25m per town is ultimately expected from future waves of funding. At this time of gloominess this money cannot come quick enough. But what next? How will this money be spent and will projects be properly planned?

Before we focus on that, let’s remind ourselves on how the Towns Fund originated. Officially the fund emerged from a combination of two other initiatives that had been launched earlier in 2019, namely the Stronger Towns Fund and the Future High Streets Fund. The former had been introduced by Boris Johnson’s predecessor, Theresa May, with her launch speech targeting those towns with ‘glorious heritage, huge potential, and with bright futures ahead of them’. This same sentiment was pitched by Johnson himself when he launched the Towns Fund shortly after his election in July 2019. Whilst acknowledging that not everyone wanted to live in ‘our country’s great cities’, he promised to ‘start answering the pleas of some of our left behind towns’.

A formal prospectus for the Towns Fund was published in November 2019[vi]. The number of identified towns equate to a hundred, with Swindon, Bournemouth, Glastonbury, Bridgwater, Torquay, Truro, Camborne, St. Ives and Penzance representing the south west. Each of these towns has been funded to establish ‘Town Deal Boards’, authority-led partnerships that are intended to bring relevant stakeholders together. Once in place, each board is required to prepare their own ‘Town Investment Plan’ (TIP) which needs to present a vision for the town, and include action plans for delivering change over the short, medium and long term (although no specific timescales are defined).

A week before Build, Build, Build, the Government released further guidance on the Towns Fund and invited eligible towns to decide whether or not to submit their TIP by the end of July 2020 or in a later cohort, by either October 2020 or early 2021[vii]. Making such a submission will enable the towns to unlock funding. The funds continue to be justified on the basis of promoting local economic growth, but the latest document also acknowledges the impact of COVID-19 and the additional vulnerabilities and weaknesses that the pandemic has exposed across our towns. As for what the money can be spent upon, the guidance outlines six intervention themes. These include improvements to local transport, skills and enterprise infrastructure, as well as funding for the arts, culture and heritage. It will be interesting to see what comes forward given the breadth of possibilities. It is acknowledged that the fund can only go so far and the competitiveness of the programme feels somewhat wrong in these fragile times. It also remains unclear why certain towns were selected, while others were not, and I can’t help wondering what binds these places together. The guidance does talk about encouraging collaboration between the towns so I hope this joint learning is actioned. Although the further guidance mentions planning in a range of contexts, I hope planners are able to take a lead since in my view, the TIPS are essentially mini-local plans. But will they and how will the TIPs sync with plan-making and other local planning activities? By allowing planners to take a leading role, the Towns Fund can hopefully help to dispel recent narratives that have painted the planner as the ‘pantomime villain’ rather than as the un-locker of growth. I do hope the fund can fire-up some much-needed enthusiasm and creativity for pursuing a town-led ‘urban renaissance’ and I will certainly be interested in what is being planned to help bring our


[i] Prime Minister’s Office (2020) Build, Build, Build. Press Release. Available from: https://www.gov.uk/government/news/pm-build-build-build. Last accessed 06/07/2020

[ii] Department for Business, Innovation and Skills and HM Treasury (2015) Fixing the Foundations: Creating a More Prosperous Nation. Available from: https://www.gov.uk/government/publications/fixing-the-foundations-creating-a-more-prosperous-nation. Last accessed 06/07/2020

[iii] Wainwright, O. (2015) ‘Osborne’s planning reforms risk creating slums of the future’. The Guardian. 10 July. Available from: https://www.theguardian.com/artanddesign/architecture-design-blog/2015/jul/10/george-osborne-planning-reforms-risk-slums-house-building. Last accessed 06/07/2020

[iv] Prime Minister’s Office (2020) A New Deal for Britain. Press Release. Available from: https://www.gov.uk/government/news/pm-a-new-deal-for-britain. Last accessed 06/07/2020

[v] Ministry of Housing, Communities & Local Government[MHCLG] (2019) Town Fund Prospectus. Available from: https://www.gov.uk/government/publications/towns-fund-prospectus. Last accessed 06/07/2020

[vi] As above.

[vii] Ministry of Housing, Communities & Local Government[MHCLG] (2020) Town Fund: Further Guidance. Available from: https://www.gov.uk/government/publications/towns-fund-prospectus. Last accessed 06/07/2020