NHS 10 Year Plan - Summary for Built Environment Professionals

By Tony Beaman 

The 10 Year Health Plan sets out the Government’s plan for the NHS in England and is part of Government’s health mission. The plan is based on ‘three shifts’ in the way that health and care services are provided; hospital to community; analogue to digital, and sickness to prevention.

Hospital to community aims to deliver more care on people’s doorsteps and in their homes, and sickness to prevention seeks to create a healthier country through cross-societal action.

There are a number of actions in the plan which link to urban design thinking, and recognise the role that the environment has in enabling healthy activities:

The plan acknowledges that our health is shaped by the places we live and the wider social determinants

• There is a focus on ‘Neighbourhood health’ which is about bringing care closer to people’s homes (a principle which underpins 15-minute cities and compact cities).
• Proposals to better use the existing NHS estate and deliver more services on high-streets and out of town shopping centres.
• References the National Planning Policy Framework powers which can be used to block new fast-food outlets near schools.
• Tackling obesity and promoting physical activity – working with the DCMS on ‘place-based approach to physical activity’.
• Active travel – partnering with Active Travel England, local authorities and other government departments to identify simple changes that can substantially boost active travel rates to help spread this best practice and reduce physical inactivity.
• Improving peoples homes - The Department for Energy Security and Net Zero (DESNZ) and Department of Health and Social Care to work together to “help ensure more health-vulnerable households get the help they need to improve their homes”.

Relevant excerpts:

• From sickness to prevention “Our health is shaped by the places we live in. Whether because of the quality of the jobs available, the standard of the housing listed for rent, the price and availability of healthy food, or the extent of the mental health offer at the local school, good health can be easier or harder to maintain depending on factors as arbitrary as postcode. As the work of Professor Sir Michael Marmot among others has long shown, it is these social determinants that explain this country’s wide and widening health inequalities. The injustice is that the social determinants of ill health cluster in more deprived parts of the country”. p.58
• Neighbourhood health: “The neighbourhood health service is our alternative. It will bring care into local communities; convene professionals into patient-centred teams; end fragmentation and abolish the NHS default of ‘one size fits all’ care. It will transform access to general practice and prevent unnecessary hospital admissions. It will help reintegrate healthcare into the social fabric of places”. p.27

• Better using the exiting estate “Wherever possible, we will maximise value for money by repurposing poorly used, existing NHS and public sector estate”. p.36
• National Planning Policy Framework: “we will fulfil our manifesto commitments to restrict junk food advertising targeted at children, ban the sale of high-caffeine energy drinks to under-16-year-olds, and use our revised National Planning Policy Framework to give local councils stronger powers to block new fast-food outlets near schools”. p.63
• Promoting more physical activity: “Being physically active is good for physical and mental health and has a measurable positive impact on relieving NHS pressures, worth an estimated £10.5 billion in savings a year. Despite that, inactivity levels remain stubbornly high for adults and children, with huge inequalities across the country. Solving this challenge will require cross system join-up. The evidence is clear, where investment in physical activity is designed with local people, physical inactivity rates fall 2.5 percentage points more than otherwise without this reform. Working with the Department for Culture, Media and Sport (DCMS), we will move to a place based approach to physical activity across Government Departments: through £250 million of investment into 100 places by Sport England; at least £400 million of investment into local community sport facilities; new partnerships on school sport, and local health plans. DCMS will set out more detail on the strategy for physical activity in due course.” p.66
• “most physically active community each year” … The long-term aim is to have millions more  people moving and exercising regularly as part of their lifestyle, as well as showcasing communities with the best initiatives. We will partner with the Ministry of Housing,  Communities and Local Government (MHCLG) and the Department for Digital, Culture, Media and Sport (DCMS) to run a new bidding process, modelled on the UK City of Culture, to name the UK’s most physically active community each year. The scheme will showcase the exercise, sport and active transport initiatives in that community – to support public participation, spread best practice, and to crowd-in investment. p.66
• Active Travel “active travel is also an effective way to reduce emissions, while also supporting physical activity. In some parts of the country, there has been significant progress on active travel. In Cambridge, nearly 49% of journeys to work are made actively150, while at Kesgrave High School near Ipswich, as many as 86% of students walk or cycle to school every day151. We will partner with Active Travel England, local authorities and other government departments to identify simple changes that can substantially boost active travel rates to help spread this best practice and reduce physical inactivity”. p.67
• Air pollution “However, good progress on transport emissions is not enough to deliver the air quality improvements we need to see to protect everyone’s health. We will work with the Department for the Environment, Food and Rural Affairs (Defra) as they set out action on air pollution through the Environmental Improvement Plan review. This will set out policies and measures to reduce emissions, concentrations and population exposure to the most harmful pollutants, further steps to improve understanding of air pollution and activities to increase public engagement on air quality issues. We will explore ways to strengthen collaborations with the health community to improve awareness of and communications on the health impacts of air pollution”. p.6
• Improving people’s homes: “The government is also taking action to improve the standard of rented homes requiring social landlords to act promptly to fix housing hazards. This will initially focus on damp and mould, which can cause respiratory illness and other health problems. The Department for Energy Security and Net Zero (DESNZ) is also leading the development of an ambitious new Warm Homes plan and Fuel Poverty Strategy, backed by £13.2 billion of investment to help make homes warmer, more comfortable and energy-efficient. DESNZ will work with the Department of Health and Social Care to help ensure more health-vulnerable households get the help they need to improve their homes”. p.68