Town & Country Planning Journal – March-April 2024

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Town & Country Planning

The Journal of the

Town and Country Planning Association

ISSN 0040-9960 Published bi-monthly

March–April 2024 • Volume 93 • Number 2

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74 Nick Matthews –a celebration

76

Fiona Howie: Planning – an essential part of the solution

78 Time & Tide

Hugh Ellis and Celia Davis: Absolute zero

81

124

Robin Hickman: Controlling vehicle ownership and use

128 Design coding – it’s the law!

Special issue: Health and New Towns

86 Healthy New Towns

Sir Malcolm Grant on the background, impact and legacy of the NHS Healthy New Towns initiative

92 More than Playgrounds

Prof. Rhiannon Corcoran and Graham Marshall on how the built environment must take account of children's rights more effectively

100 Building a Healthy Britain

Katy Lock on the lessons that the design and management of the post-1945 New Towns teach us about how to promote healthy lifestyles in the next generation of New Towns and Garden Cities

106 Cumbernauld – a town with history

Tracy Lambert on the importance to sound mental health of incorporating nature into design

112

Healthy Place Shaping in Oxfordshire

Dr Rosie Rowe on how the NHS England Healthy New Towns programme is creating healthy, sustainable communities and reducing health inequalities

118 All's well that ends WELL

Andrew Sansom on how evidence-based frameworks help to drive a more holistic focus upon healthy buildings, localities and communities

Cover illustration by Clifford Harper.

Nick Matthews — a celebration

TCPA Chief Executive, Fiona Howie marked the close of Nick Matthews’ 35 years of service to the TCPA as Editor of this journal in the issue (November-December 2023). Space permits a further word:

The role of Editor has evolved alongside this journal since it was first released as The Garden City, in 1904 and then Garden Cities and Town Planning in 1908. The current moniker – Town & Country Planning – was adopted in 1932.

Throughout the busy years at the TCPA from 1930 to 1945, several distinguished editors supported the then Director, Frederic Osborn (known as ‘FJO’) as he threw himself into campaigning and the hard work that helped create the New Towns Act 1946 and the Town and Country Planning Act 1947. These significant pieces of legislation were part of the post World War II Attlee Government’s amazing new social and economic architecture for the UK. Osborn used this journal, as well as the BBC and newspapers, to help build the post war consensus for radical change. He was supported as Editor by the garden city advocate Elizabeth McAllister until 1947, and then Desmond Donnelly until 1949, after which time polymath FJO was simultaneously the TCPA’s Director, Editor, and sometimes also Treasurer.

By the time Hazel Evans became Managing Editor in 1969, town and country planning was a flourishing area of professional praxis, mostly in the

public sector. Several of the original New Towns were past their pioneer days, and major expansion schemes were underway. This journal recorded those achievements and became the vehicle for FJO’s fierce campaign against very high densities. There was now the brutal evidence of high rise estates – sometimes miles from work, family and friends – to expose the wickedness of the crammers of poor people into bleak places; in contrast with the wholesome life with mixed uses and green lower densities of the New Towns movement.

Colin Amery, later of The Financial Times and a saviour of Spitalfields, was Editor from 1970. The TCPA developed its focus on city regional planning and, as Editor and board member in 1972, Peter Self of the London School of Economics (LSE) ensured the topicality of the journal, followed quickly by Derek Diamond, also of the LSE, both serving with Barbara Hafter, who was the full time editorial anchor at the TCPA’s offices.

By 1979 Rob Cowan (later Editor of Roof and The Architect’s Journal) had moved across the room from his work in the TCPA’s Planning Aid Unit to become the Deputy Editor, and later Editor, and even more energetic contributor and illustrator. He changed the format from the pocketbook size enamoured by FJO to a size a little less than A4. Rob’s successors after his sparkling years included David Boyle, the radical historian and economist

(1984) from whom Nick Matthews was handed the reins, in 1989.

Nick had studied physics at the University of Leeds and came to the TCPA having worked on engineering and software publications. At the time Nick joined, the TCPA was reconstructing itself after some very painful years of financial hardship and management angst. The TCPA was refreshing the range and depth of its research and campaign staff who, while scant, drew strength from the TCPA’s Trustee Board and Policy Council and by forging alliances with complementary organisations. The huge output of reports, briefing documents, how-to manuals, and campaign position statements mostly fell to Nick to edit and have printed. This was in addition to the ‘day job’ of producing 10 editions of this journal each year, for which he is proud to have

cultivated a group of regular contributors as well as being keen to spot new talent.

Nick is a quiet man – not in the mould of the shouty propagandising editors that preceded him but of the other type: a one-man engine room that enabled the TCPA to be timely and authoritative in its printed word. What Nick has enabled the TCPA to deliver down the years has made a difference. He has our thanks and best wishes for the future from his base in – yes, of course – Letchworth Garden City.

Anonymous

Westholm Green, Letchworth Garden City

Historic England

on the agenda

TCPA Chief Executive Fiona Howie on key current issues in the policy landscape and the work of the TCPA

planning — an essential part of the solution

Despite the Prime Minister stating in January that it was his ‘working assumption’ the General Election would be in the second half of the year,1 the possibility of a May election has not been totally ruled out. I am conscious that everything might have changed again by the time this edition of the journal is published. Regardless of the final timing of when the country goes to the polls, we know political parties have been hard at work on their manifestos. So, the Association is pleased to have published its 2024 manifesto in January,2 which focuses upon what the next Government should commit to and take action on in its first 100 days in power.

Supporters of the Association’s work will be unsurprised by the overarching policy priorities set out in the manifesto. They focus upon net zero and climate resilience; the restoration of public trust in the system, and a need for a strong focus upon delivering affordable housing and healthy placeshaping. To achieve all of this, it then details six specific actions that a new Government should initiate within the first three months after the election:

• changing national planning policy to reflect ambitions on strategic housing delivery, zero carbon and health and wellbeing;

• tabling secondary legislation to return planning powers to local government;

• publishing a ministerial statement that draws upon the Scottish Government’s policy statement on public participation to signal of new approach to building genuine public trust;

• making changes to the focus of Homes England so that the agency plays a much stronger role in supporting local planning authorities in the strategic coordination of large-scale housing growth;

• establishing a task force that will lead the process of producing a National Spatial Strategy for England, and

• publishing a planning Green Paper to allow for full consultation on the new Government’s long term planning aspirations. This would include the ambition for a new statutory purpose for planning based upon the United Nations Sustainable Development Goals.3

There will of course be many more actions that

are needed – not least properly funding local councils, thereby enabling them to deliver a high quality planning service. This is one of the asks in the Royal Town Planning Institute’s ‘planifesto’4 that we very much support. However, we have identified the six actions above because we believe they could be delivered quickly, without a commitment to significant new spending, and would make an important difference.

Whilst we will promote these actions to all political parties, we have also published a more detailed contribution to the housing debate, to inform political thinking. As illustrated by speeches and debates during the 2023 political party conferences, we know there continues to be a cross-party consensus on the need for more homes. This included welcome commitments from Labour and the Liberal Democrats in relation to New Towns and Garden Cities respectively. However, as the Association has made clear,5 it is essential that any new programme learns the lessons from the past and from the current delivery of new, large-scale communities. Articles in this edition highlight lessons to be taken from seeking to revitalise Cumbernauld New Town and from the relatively recent NHS Healthy New Towns programme. The Association also has a wealth of knowledge that it is keen to share.6 Our Shared Future: A TCPA White Paper for Homes and Communities, 7 draws upon those lessons and knowledge, setting out the practical measures that are needed to deliver sustainable, affordable and ‘net zero’ communities.

Our Shared Future asserts that rather than being a problematic barrier to growth, town and country planning is an essential element in achieving it. A critical part of the planning system should be a National Spatial Strategy that supports and enables strategic growth nationally, through large-scale settlements, as well as local strategic growth and housing delivered through local plans. The current approach seeks to enable local strategic growth of between 1,500 and 10,000 homes, as demonstrated by members of the Association’s New Communities Group,8 but the system is complex and national Government needs to inspire confidence and deliver certainty if these long-term schemes are to be realised.

A central theme of Our Shared Future is that

on the agenda

whilst planning for housing is important, for too long the emphasis has been on speeding up decision making but without a corresponding emphasis on the effective delivery of permitted schemes to make sure those homes are actually built. As the executive summary states:

‘While investors, infrastructure providers and local government all have a contribution to this programme, the key responsibility for unlocking housing delivery sits squarely with national government. Its role is not to impose but rather to enable delivery by creating the preconditions for success. This includes the creation of a national spatial plan and a commitment to invest in the large-scale expansion of socially rented homes.’

I really hope manifesto writers and politicians read Our Shared Future with interest and take note! I am very aware that there is no cross sector consensus about what changes are necessary to enable the planning system to deliver the homes and communities needed. Consequently, we have endured what has felt like almost constant tweaks and reforms to planning policy and legislation over the last decade or more. We need reform, and this time we need to get it right.

• Fiona Howie is Chief Executive of the TCPA.

Notes

1 ‘Rishi Sunak indicates he will not call election until second half of 2024’. The Guardian, 4 Jan. 2024. https:// www.theguardian.com/politics/2024/jan/04/rishi-sunakhints-he-will-delay-calling-election-until-second-halfof-2024

2 100 Days to Rebuild Britain: The TCPA’s Vision for the Next Government. Town and Country Planning Association, Jan. 2024. https://www.tcpa.org.uk/ wp-content/uploads/2024/01/100-Days-to-RebuildBritain-Jan-2024-1.pdf

3 ‘The 17 Goals’. Webpage. United Nations Department of Economic and Social Affairs – Sustainable Development. https://sdgs.un.org/goals

4 RTPI Planifesto 2024. Webpage. Royal Town Planning Institute, 2024. https://www.rtpi.org.uk/new/ourcampaigns/rtpi-planifesto-2024/

5 See for example F Howie: ‘End of An Era’. Town & Country Planning, 2023, Vol. 92, Nov.-Dec., pp.362-363

6 See for example K Lock, H Ellis: New Towns – The rise, fall, and rebirth, 1st Edn., Riba Publishing, 2020.

7 Our Shared Future – a TCPA White Paper for Homes and Communities. Town and Country Planning Association, Jan. 2024. https://www.tcpa.org.uk/ wp-content/uploads/2024/01/TCPA-White-Paper-OURSHARED-FUTURE_160124.pdf

8 See https://www.tcpa.org.uk/areas-of-work/gardencities-and-new-towns/new-communities-group/ for information about the Group and its members

The TCPA’s vision is for homes, places and communities in which everyone can thrive. Its mission is to challenge, inspire and support people to create healthy, sustainable and resilient places that are fair for everyone.

Informed by the Garden City Principles, the TCPA’s strategic priorities are to:

Work to secure a good home for everyone in inclusive, resilient and prosperous communities, which support people to live healthier lives.

Empower people to have real influence over decisions about their environments and to secure social justice within and between communities.

Support new and transform existing places to be adaptable to current and future challenges, including the climate crisis.

TCPA membership

The benefits of TCPA membership include:

• a subscription to Town & Country Planning;

• discounted fees for TCPA events and conferences;

• opportunities to become involved in policy-making;

• a monthly e-bulletin; and

• access to the members’ area on the TCPA website.

Contact the Membership Officer, David White t: (0)20 7930 8903 e: membership@tcpa.org.uk w: www.tcpa.org.uk

TCPA policy and projects

Follow the TCPA’s policy and project work on Twitter, @theTCPA and on the TCPA website, at www.tcpa.org.uk

• Affordable housing

• Community participation in planning

• Garden Cities and New Towns

• Healthy Homes Act campaign

• Healthy place-making

• New Communities Group

• Parks and green infrastructure

• Planning reform

• Planning for climate change

absolute zero

We have used this column many times to share the deep frustration caused by outdated, complex and contradictory policy from national government on planning for net zero homes in England.¹ The poor quality of national planning policy has thwarted attempts by local authorities to take credible and innovative action on climate change by using local plan policies to secure the delivery of energy efficient, genuinely net zero² new development.³

It is therefore quite staggering to find ourselves in a position where Government has made the situation even worse by publishing, on 13 December 2023, a written ministerial statement (WMS) entitled ‘Planning – Local Energy Efficiency Standards Update’. This WMS seeks to curtail the use of policies that use energy based metrics designed to significantly reduce greenhouse gas emissions by specifying fabric efficiency standards and deliver highly energy efficient buildings to evidence and develop similar policy approaches for their local areas.⁴

Three local authorities (Bath and North East Somerset, Cornwall and Central Lincolnshire) have successfully adopted such policies and others (we think as many as 70) have invested considerable expertise and resources in building an evidence base that supports the introduction of similar policies for their localities.

The TCPA is profoundly disappointed by the technical limitations that this WMS places upon those local authorities seeking to secure genuinely net zero new development. The WMS reflects the breadth of failure of Government to deliver meaningfully on net zero, which is a woeful indictment and unforgiveable in the context of the climate emergency we are now facing.

Despite this, we want to use this column to speak to practitioners, particularly those in local government, urging them not to ‘down tools’, and to carefully consider the implications of the WMS.

Now is not the time to cast aside those policies that we urgently need in order to face up to the climate emergency.

There are two strong reasons for this:

The weight of the WMS should not be exaggerated

The new WMS should be given the same weight as a statement of national policy. This means that the WMS is subservient to primary legislation and cannot lawfully be interpreted in a way that ignores any statutory duty placed upon local authorities, or that undermines the powers granted to local authorities through primary legislation, including the primacy of the adopted development plan.

The WMS is a powerful material consideration, but like any other material consideration, the amount of weight to be given to it is entirely a matter for the decision maker, subject to the test of Wednesbury reasonableness and a coherent explanation as to why a different approach is appropriate in any particular case.

There are two legislative requirements that local authorities should consider in relation to the relative weight to be given to the WMS when balanced against the rationale and evidence supporting net zero buildings policies:

• Article 15C(6) of Schedule 7 to the Levelling Up and Regeneration Act 2023 amends Article 19 of the Planning and Compulsory Purchase Act 2004, requiring that:

‘The local plan must be designed to secure that the use and development of land in the local planning authority’s area contribute to the mitigation of, and adaptation to, climate change.’

This obligation – first introduced in the Planning Act 2008 alongside the Climate Change Act 2008 – makes clear that local plans must contribute to the national carbon budget of 78% carbon reduction by 2035 and the target of achieving net zero by 2050.

Local plans must produce robust evidence to demonstrate compliance with this legal requirement. For many local authorities, the evidence base indicates that achieving net zero buildings at the earliest viable opportunity is a fundamental aspect of a credible net zero pathway, and planning has a legitimate role in seeking to close the gap between

Hugh Ellis and Celia Davis advocate for development plan policies in England that support the delivery of ‘genuinely net zero new development’

building regulations and the net zero requirement. This is also in line with advice from the Climate Change Committee, which advocates for ‘all new homes to be genuinely zero carbon’ by 2025.5

• Article 1(1)(c) of The Planning and Energy Act 2008 empowers local planning authorities to: ‘include policies imposing reasonable requirements [i.e. subject to a viability test] for… development in their area to comply with energy efficiency standards that exceed the energy requirements of building regulations.’

Government has recently confirmed that it has no intention of amending this Act, both through its response in January 2021 to the Future Homes Standard consultation6 and in correspondence with Bath and North East Somerset Council during the examination of its Local Plan Partial Update in 2022.7 This primary legislation is more powerful than the WMS, which cannot negate statute.

There is no doubt that the WMS puts local authorities in a difficult position, and we believe that it creates a contradictory position between the legal requirements placed upon local authorities for carbon reduction on the one hand and policy obligations on the other.

The WMS could be found to be unlawful

This contradiction between the WMS and legislation constitutes a clear ground for legal challenge. The TCPA is aware of at least one current pre-action protocol letter challenging the lawfulness of the WMS and understands that this is likely to proceed to a legal challenge. Although a judicial review of the WMS will take time, the uncertainty should give local authorities pause to reflect and consider the best strategy for taking forward local plan policies.

Local authorities must continue to develop policy based upon robust, carbon literate evidence. We think that local authorities progressing policies that set energy requirements that exceed current and planned building regulations can consider three broad options:

1) Continue with the preferred policy approach

The WMS has three inherent weaknesses that should embolden local authorities to stand firm on policy development, particularly if the evidence base clearly supports this approach:

a) the status of the WMS as a material consideration needs to be weighed against legal obligations relating to plan making;

Aiming for net zero carbon Building

b) the WMS may be subject to legal challenge, and

c) a general election may result in changes to national policy on this issue.

All of these factors mean that circumstances may be very different in 12 months’ time, and local authorities should be prepared to take forward strong policies that support greenhouse gases emissions reduction and net zero.

2) The Planning and Energy Act 2008 empowers local authorities in England to set reasonable requirements for renewable and low carbon energy use in development.8 They could consider framing net zero policies for renewable energy requirements – essentially using a Merton-type rule9 to require development to meet its own energy demands from renewable sources. This would require local plans to demonstrate land availability for renewables, but also incentivise high standards of energy efficiency in buildings. This is because lowering energy demand would reduce the land take required for renewable or low carbon energy generation. This may be a less efficient route to securing net zero buildings, but is potentially less risky because the powers set out in the Planning and Energy Act 2008 are unqualified, and are not restricted by the WMS.

3) A third option is to align the policy approach with the WMS and to set a percentage based uplift of the Target Emissions Rate (TER). This approach has been proposed by Lancaster City Council. Examination correspondence with the local plan Inspector about whether the proposed policies comply with the WMS is ongoing.10 However, this policy approach is likely to be less effective in securing greenhouse gases emissions reduction because, firstly, it fails to take account of unregulated energy and, secondly, is vulnerable to the ‘performance gap’, which means the operational greenhouse gases emissions of a building are significantly higher than initially anticipated at the design stage, when equipment would have been assessed against the manufacturers’ published energy efficiency performance specifications.

The TCPA will go on working with partners both to continue to support local authorities and update our guidance and advice about planning for climate change. Our most important message is that despite the dead hand of national planning policy, local authorities must continue innovating to deliver

on the vital challenge of the climate crisis.

• Dr Hugh Ellis is Director of Policy and Celia Davis is a Projects and Policy Manager at the TCPA. The views expressed are personal.

Notes

1 See for example H Ellis and C Davis: ‘Government must grasp the potential of planning to help address climate change’. Town & Country Planning, 2023, Vol. 92, Jul.-Aug., 221-223

2 Net zero buildings are defined here as addressing total energy use in a building and aligning with the climate targets

3 See for example our previous statement on this issue, available here: https://www.tcpa.org.uk/wp-content/ uploads/2023/03/20220714-climate-statement-W-Ox-2. docx

4 The Written Ministerial Statement is published here: https://questions-statements.parliament.uk/writtenstatements/detail/2023-12-13/hlws120

5 L Marix Evans: Local Authorities and the Sixth Carbon Budget. Climate Change Committee, Dec. 2020. Available to download here: https://www.theccc.org.uk/ publication/local-authorities-and-the-sixth-carbon-budget/

6 The Future Homes Standard: 2019 Consultation on Changes to Part L (Conservation of Fuel and Power) and Part F (Ventilation) of the Building Regulations for New Dwellings. Summary of Responses Received and Government Response. Executive summary section (chapter 2), Ministry of Housing, Communities and Local Government, Jan. 2021. http://assets.publishing. service.gov.uk/government/uploads/system/uploads/ attachment_data/file/956094/Government_response_to_ Future_Homes_Standard_ consultation.pdf

7 Exam 10: Policy SCR6: Note on the Setting of Local Energy Efficiency [sic] Standards For New Build Development. Bath & North East Somerset Council, July 2022. https://beta.bathnes.gov.uk/sites/default/ files/EXAM%2010%20Note%20on%20Local%20 Energy%20Efficiency%20Targets%20FINAL.pdf

8 Planning and Energy Act 2008. §1. UK Government. 13 Nov. 2008. https://www.legislation.gov.uk/ ukpga/2008/21/section/1

9 See: https://en.wikipedia.org/wiki/Merton_Rule 10 EX/INS/12. Climate Emergency Local Plan Review Examination. Examination news and updates. Lancaster City Council. 30 Jan. 2024. https://www. lancaster.gov.uk/planning/planning-policy/local-planexamination

Editor’s Note: The phrase ‘net zero’ relates principally to reductions in the operational emissions of carbon dioxide gas. However, human activity is causing a rise in the atmospheric concentration of other greenhouse gases also. Article 24(1) of the Climate Change Act 2008 identifies the following as ‘targeted green-house gases’: carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons and sulphur hexafluoride. Other gases, such as nitrogen trifluoride, may be added to this list in the future.

off the fence

and to invest in major New Town

new strategy, new towns

In this General Election year the Labour Party has announced a commitment to prepare a National Spatial Strategy for England and to create some major new towns. On the hustings these questions might be asked …

Why has Labour agreed to having a National Spatial Strategy (NSS) for England?

England is adrift without an NSS. There is no context for big strategic decisions, or for the National Policy Statements by which Government makes pronouncements on bits of strategic policy of its choosing, making a sprinkle or a scatter rather than a mosaic.1

The absence of context cultivates silo thinking by officials, ministers and their SPADs (unaccountable paid political advisors). They find themselves wonderfully free to unveil policies and initiatives to grab a headline, confident that by the time we’ve worked out its usefulness, or it has an unforeseen consequence, the politician would no longer have responsibility or could claim to have been misled. Or our national consciousness will have been distracted by something else.

The absence of context can provide ‘smoke and mirrors’ cover for project creep or project mismanagement in Government departments, their diaspora of agencies and sponsored organisations. The horrific mess of procurement that is HS2 – both route and specification – enabled the flourish by Prime Minister Sunak of announcing (in Manchester) the ‘abandonment’ of HS2 from Birmingham to Manchester. In fact, all he has wisely done (unless there is deception by smoke and mirrors) is to implement the Integrated Rail Plan for the North and Midlands produced by the Department of Transport in 2021, when Boris Johnson was Prime Minister.2

The unmoderated pronouncements of the Environment Agency3 and ‘executive nondepartmental body’ Natural England – an

empowered pressure group these days, also sponsored by the Department for Environment, Food and Rural Affairs (Defra)4 have huge impact. The processes of obtaining planning permission and the making of statutory development plans are directly slowed down, made more expensive, and made harder for the public to follow because of their pronouncements.

Privatised utility companies of all types, and public transport undertakings (outside London), enjoy the absence of a NSS, holding out their hands for cash for everything which is ‘unprofitable’ for them. Such businesses rarely engage seriously with statutory plan-making processes, feigning surprise when major new developments come forward for planning permission.

Some types of entrepreneur see opportunity in the present chaos, but for wise ones the advantage of strategic planning is that it helps de-risk major investments by providing spatial focus and context. Is this place a rising star? If it is ailing, is there high-level cross-party Government support? Is this place going to be connected – to power; transport networks; to broadband; drone delivery networks; to other population and economic growth areas? Or, is its lack of connectivity – dark skies; deep country (not country-as-city-hinterland)⁴ a special attraction, with a uniquely different, value?

Being adrift with no NSS makes everyone unhappy; causes immense waste of public and private resources; increases disrespect for Government and its broken-spirited civil service, and diminishes the spirit and purpose of local planning authorities. Oh dear!

What a NSS look like – what would it contain?

A NSS sets out a broad design for the governed space. It starts with helping us all understand the real social, economic and environmental geography of now. Strategic policies which flow from that will need words but should ideally be capable of memorable graphic representation. It used to be

David Lock probes the Labour Party’s commitment to prepare a National Spatial Strategy for England

projects

said that the best strategic spatial plans could be drawn on a restaurant napkin, in conversation. Those were the days of the Copenhagen metropolitan area ‘finger plan’,6 for example.

England would not be venturing into the unknown. Wales and Scotland are way down the road. Scotland’s NSS briskly reached its current edition in 2023 and is now branded National Planning Framework 4.⁷ The supporting documents; the production and consultation processes; the tightly constrained scrutiny by the Scottish Parliament, and the issues raised are readily accessible.

do the skills for graphic presentation. The challenge is to ensure that there is a focused client for the work, and here officials (with all due respect) need experienced professional help.

In the 1960s the Ministry of Housing and Local Government established the Planning Advisory Group (PAG) to make recommendations for the reform of the planning system.10 We need a similar group with a similar brief right now, but that is not the subject here. This is not the right way to procure a NSS for England, because it outsources the task and allows Government to wriggle away.

Better to assemble a small expert advisory group to assist officials in the process of procurement, hands on, in real time.

Why should strategic scale New Towns be an inevitable part of the NSS?

The NSS for Wales has now been updated and rebranded as Future Wales – the National Plan 2040 8 Again, the supporting documentation is readily accessible through the Welsh Parliament.

How could we produce it quickly and cost effectively?

As the TCPA argue in its most recent White Paper:

‘Government should establish a task force to begin urgent work on a National Spatial Framework drawing on the approach of the Welsh Assembly Government and aiming to produce preliminary results for consultation within six months.’ 9

The data exists and the analytical skills exist, as

The NSS for England would, as part of its output, identify those propitious areas (towns and cities and their hinterlands) in decline, that should be chosen as targets for enhancement and re-invigoration through long term mixed-use urban development and strategic economic development. The objective would be to create a social and economic engine where one is currently spluttering or missing.

As to propitious areas for major New Towns that would not require grants to attract investment, as the TCPA White Paper puts it:

‘Our current planning system has led to a great deal of poorly located, poorly designed and therefore extremely controversial housing developments scattered across districts in high demand areas. Agreeing to deal with housing growth pressures in one strategic location over the long term, should free the local authority from any requirements to deliver five-year land supply and the housing

National Spatial Strategy for Scotland

National Spatial Strategy for Wales

Senedd Cymru

Scottish Government

delivery test outside the phased delivery of strategic designations.

This puts the local authority back in control of its own future and free to meet other local needs where they arise. In short, while the designation of one strategic site is a major political risk it removes the constant aggravation of deeply unpopular speculative housing proposals.’11

How big should these major New Towns be?

In the writer’s experience, locations with a potential population capacity of between 250,000 to 500,000 people should be selected. The lower of these figures was the, now exceeded, planned capacity of Milton Keynes in 1967. The higher figure is that outlined by the National Infrastructure Commission study of 2018 as the target size for an enlarged Milton Keynes as part of a Cambridge-Milton Keynes-Oxford Arc.12 At such a scale, major New Towns are proven to act as strategic growth points that deliver across several political and economic cycles.

The TCPA White Paper posits a minimum of 35,000 homes (about 80,000 people),13 which is nearly three times Ebenezer Howard’s Garden City invention, at 30,000 people. Remember, however, that Howard argued for a cluster of Garden Cities that together would form a networked metropolitan region of some 500,000 people.14

Smaller New Towns have struggled to achieve the strategic impact hoped of them, and will rarely be able to secure the commitment of the mix of city builders required to apply themselves and their families to the task: the engineers, planners, architects, builders, social development professionals and more. To ‘live the dream’ in the New Town one is working on is a fabulous and daunting experience; gleaning direct practical experience of life in the emerging place one is helping to shape, and seeing the consequences of actions taken.

By committing to a New Town on this scale, governments inherit and pass on political commitment at the highest level. That endorsement is crucial in attracting inward investment from the private sector. Little New Towns can be sacrificed in fleeting political games. Well-chosen locations for strategic scale growth need to demonstrate success very early, and be too strong to fail.

How do we make major New Towns happen?

The TCPA is clear that new town development corporations (NTDCs) remain the most effective route to delivery. ‘Locally-led NTDC’s’ were introduced in 2018 to give local authorities the power to try delivering strategic scale growth

themselves,15 but this was a political sleight of hand – the legislation shifts the entire financial and political responsibility for delivery to the local level, as if a local planning authority (LPA) has a long term political horizon; the necessary skills and mind-set, and nothing else to do!

While LPAs must play a strong role in the governance of NTDCs, national Government must take financial and political responsibility if the confidence of the public and other investors is to be secured over the long term.

Ministerial responsibility for development corporations creates a strong platform from which to unlock cross departmental spending and to advocate for the necessary infrastructure delivery. LPAs have enough to do in service delivery, without trying to finance and manage the development of strategic scale New Towns.

How could we afford them?

The New Towns Acts empowers a NTDC to acquire the necessary land close to its existing use value (EUV).

The Myers case16 established the legal precedent by which (until it is overturned by reform) an existing landowner can seek to prove that land subject to a compulsory purchase order (CPO) would have been developed in the near future anyway, so its value is actually much higher than the EUV, which might be garden land, grazing or some type of agricultural use. Nevertheless, this ‘hope value’ would be reduced due to infrastructure and other planning agreement costs, which would correspondingly reduce the CPO price for the NTDC.

Why not leave it to the private sector to build the major New Towns?

In 1946, the Reith Committee considered submissions to this effect and reported as follows:

‘We have carefully considered the employment of private enterprise as a possible agency. While it is desirable to provide every opportunity for private development, we have come to the conclusion that in an undertaking of so far reaching and special a character as the creation of a new town, ordinary commercial enterprise would be inappropriate. Apart from the risks involved, both in matters of finance and in execution, such a policy would of necessity result in the creation of a private monopoly. And even to the promoters themselves, we believe that the controls which the public interest would demand would render such a project unattractive.’17

Today, if there is a landowner and/or developer with strategic scale ownership in the location chosen

by due planning process, who wishes to work in partnership with the NTDC, the case for participation might be argued. The added value of incorporating such an interest whilst protecting the public interest would need to be worked through in detail, and the case made. NTDCs are empowered to raise finance from the private sector, rather than only from HM Treasury at 2% above LIBOR (London Inter Bank Offered Rate), but sharing the development task itself on a major project extending over several decades – and when the criteria for success is not just profit – would cut new ground.

• David Lock CBE is Strategic Planning Adviser at David Lock Associates. He is a Vice-President and former Chair of the TCPA and was employed by Milton Keynes NTDC. He was a consultant to the London Docklands, Merseyside and Black Country UDCs, and was a Board member of Ebbsfleet UDC. All views expressed are personal.

Notes

1 ‘National Policy Statements for energy infrastructure’. Website. Department for Energy Security and Net Zero. 17 Jan. 2024. https://www.gov.uk/government/ collections/national-policy-statements-for-energyinfrastructure

2 Integrated Rail Plan for the North and Midlands. CP 490, Department for Transport. 2021. https://assets. publishing.service.gov.uk/media/

62389f1ae90e07799cd3de47/integrated-rail-plan-forthe-north-and-midlands-web-version.pdf

3 In the writer’s view, too wide an area of policy was migrated from the old Department of the Environment to Defra. A panoply of work has been published by the Environment Agency, pressing its sponsor, Defra, to declare new policies in areas such as flood risk, pollution, and food supply – all of which directly affect land use. The research programmes and policy consequences are out of synchronisation with policy making in other parts of Government and can have much wider effects than Defra alone. See: https://www. gov.uk/search/research-and-statistics?content_store_ document_type=research&order=updated-newest&org anisations%5B%5D=environmentagency&page=2&parent=environment-agency

4 Wander into these corridors: https://www.gov.uk/ government/organisations/natural-england

5 I am grateful to Robin Bryer – contributor to this Journal and to TCPA events in the 1970s - for reminding me recently that not all “countryside” is “hinterland of a city or town”. Even on our small island, a great deal of countryside has an independent life.

6 ‘Finger Plan’. Webpage. Wikipedia, 4 Aug. 2021. https:// en.wikipedia.org/wiki/Finger_Plan

7 National Planning Framework 4. Scottish Government, Riaghaltas na h-Alba, 13 Feb. 2023. https://www.gov. scot/publications/national-planning-framework-4/

8 Future Wales: the national plan 2040. Llywodraeth Cymru, Welsh Government, 24 Feb. 2021. https://www. gov.wales/sites/default/files/publications/2021-02/ future-wales-the-national-plan-2040.pdf

9 Our Shared Future – a TCPA White Paper for Homes and Communities. Town and Country Planning Association, Jan. 2024, p.23 [electronic]. https://www. tcpa.org.uk/wp-content/uploads/2024/01/TCPA-WhitePaper-OUR-SHARED-FUTURE_160124.pdf

10 The future of Development Plans – Report of the Planning Advisory Group. HMSO, 1965.

11 Our Shared Future – a TCPA White Paper for Homes and Communities. Town and Country Planning Association, Jan. 2024, pp. 25-26 [electronic]. https:// www.tcpa.org.uk/wp-content/uploads/2024/01/ TCPA-White-Paper-OUR-SHARED-FUTURE_160124.pdf

12 Partnering For Prosperity: A new deal for the Cambridge-Milton Keynes-Oxford Arc. National Infrastructure Commission, 17 Nov. 2017, p.36. https:// nic.org.uk/app/uploads/Partnering-for-Prosperty.pdf

13 Our Shared Future – a TCPA White Paper for Homes and Communities. Town and Country Planning Association, Jan. 2024, p.15 [electronic]. https://www. tcpa.org.uk/wp-content/uploads/2024/01/TCPA-WhitePaper-OUR-SHARED-FUTURE_160124.pdf

14 E Howard: Garden Cities of Tomorrow. Swan Sonnenschein & Co. Ltd., 1902, Chapter XII, pp.128-140. Transcribed electronically by Project Gutenberg, 29 Jun. 2014. https://www.gutenberg.org/ files/46134/46134-h/46134-h.htm

15 The New Towns Act 1981 (Local Authority Oversight) Regulations 2018 (SI 2018 No. 891), 23 Jul. 2018. https:// www.legislation.gov.uk/uksi/2018/891/contents/made

16 Bernard Myers v Milton Keynes Development Corporation. [1974] EWCA Civ J0503-2, 3 May 1974. For summary, see: https://www.gov.uk/guidance/landcompensation-manual-section-2-compensation-forland-taken/practice-note-2-5-determining-the-extent-ofthe-scheme

17 JCW Reith: Interim Report Of The New Towns Committee, Ministry of Town and Country Planning, Cmd. 6759, HMSO, March 1946.

Mary Riley

Mary Riley was a pioneer in the field of town and country planning and the first woman to be appointed a County Planning Officer in England and Wales. She was born in Liverpool on 4 July 1922 to Edith and Tom Burns. Tom was a purser in the merchant marine. It was a musical household and Mary was taken to a concert at St George’s Hall at the age of six, afterwards shaking hands with Sergei Rachmaninoff.

Mary excelled at Holly Lodge High School, choosing the London School of Economics (LSE) to read geography. The LSE was dispersed to Cambridge because of the blitz. Living in Liverpool through the depression and then witnessing the blitz on the port, sparked her interest in seeking ways to reduce social and economic inequalities and rebuild for a fairer society.

Coming down in 1943 she reported for war work and was directed to the Scientific Reserve based at St Andrews House in Edinburgh. Post war, she took the civil service exams, coming third from top in the country and joined the regional office in Birmingham working on social and economic planning for the West Midlands. Mary spotted exciting prospects in the newly created local planning authorities and in 1949 was successful in her application to be Assistant County Planning Officer for Staffordshire County Council, leading their research team.

In 1973 she was appointed County Planning Officer for Staffordshire. Both councillors and staff valued her approachability combined with her sharp intellect and inquiring mind. As chief officer she led the team that enabled Staffordshire to be the first English county to adopt a new structure plan in 1974, providing a long term strategic development plan for the county.

Mary chose to support the TCPA joining the executive in the 1970’s and then being elected the

first woman Chair in 1983.

It was with her active support that the TCPA launched the first national Planning Aid service to give voice to communities affected by top-down planning decisions. It was on her watch that the neighbourhood planning unit was spun out of the TCPA and, with the help of the Housing Association’s Charitable Trust, the Neighbourhood Initiatives Foundation was launched to promote Planning for Real, with Tony Gibson at the helm. Mary was a founder trustee and served as a Board member for over 20 years.

Mary married Dennis Riley who predeceased her and then Desmond Matthews who survives her aged 100. She was a committed Anglican and in both her private and professional life was a formidable force for good.

Edith Mary Riley. Town and country planner. Born Liverpool 4 July 1922. Died Stafford 21 January 2024.

Graeme Bell OBE

Taking planning to the people – Mary Riley launches the Mobile Planning Aid Unit

TCPA

healthy new towns

Sir Malcolm Grant explains how the relative autonomy enjoyed by NHS England liberated it from the political interference that had prevented the NHS from addressing public health and social care policy and how this change in governance gave birth to the NHS Healthy New Towns initiative. How have the Healthy New Towns contributed to our growing awareness of the inter-relationships between home, place, space, community and health?

The NHS is a truly remarkable institution – almost unique worldwide because of the way in which it provides universal healthcare free at the point of clinical need. It pools the risk of healthcare costs across the entire population through a progressive model of taxation. Of course, healthcare is provided in some form in every country in the world, with a wide range of price and coverage. However, the distinctiveness of the NHS lies not only in its lack of a charging mechanism, but that it is an entire system in itself. This gives it many advantages, not all of which have yet been realised in practice. For example, it has so far failed to capitalise on the remarkable bank of data accumulated over decades, with its latent ability to not only to understand better the causes and nature of ill health, but to anticipate its trends and advance new treatments. This potential was demonstrated under emergency conditions during the COVID-19 pandemic, when regulations were relaxed to allow real-time exchange of data across the country to determine the most effective clinical interventions. We know that data science holds the keys to the development of much more accurate diagnoses and personalised therapies; artificial intelligence is already enabling extraordinary new discoveries using health data from across the world.

Progress within the policy-political world of the NHS is, however, much bumpier. Whilst the status of the NHS as a national system allows us in theory to plan for more effective prevention of ill-health and to gradually pivot away from being a national sickness service focused on urgent care and chronic disease, the barriers to progress seem at times insurmountable. The ambition to shift healthcare investment into prevention rather than cure is common to every system in the world but is the least successful aspect of healthcare system design globally. True, there have been some great successes, the most noteworthy being the steady reduction over several

decades in adult smoking levels, with a correspondingly clear and demonstrable reduction in cardiovascular disease. This has been achieved through a mix of interventions including public education campaigns, steep increases in tobacco pricing, restrictions upon advertising and sales and bans on indoor smoking.

The politics of health prevention are, though, complex. The spectre of the ‘nanny state’ is an obvious target for the libertarian right and a real constraint on action in any political sphere. Yet, all the data demonstrates two undeniable facts: firstly, that although life expectancy has been rising steadily for several decades, at least up until now, the increase in healthy life expectancy has not. That means that increasing numbers of the population every year are living with chronic disease, often with multiple co-morbidities in older age. For some it is almost as if it is not the length of living that has been extended, but the length of dying. Secondly, the data demonstrate the clear relationship between health and wealth, increasingly so as the wealth inequality gap continues to widen. Poverty imposes stresses, the consequences of which are seen every day in every hospital, every GP consulting room and every morgue. Poverty also has the most dramatically negative impact upon the next generation – today’s children born into disadvantage are experiencing heightened dental decay, mental ill-health, obesity and even unprecedented exposure to infectious disease as a consequence of many parents rejecting childhood vaccinations.

This is or should be the central stuff of contemporary politics. We might reasonably have expected it to be a mainstay of the grandly entitled Levelling Up and Regeneration Act 2023, but it is not. Of the 39 references to ‘health’ in the 530 pages of this Act, fully a third (13) relate to revoking the powers of the Health and Safety Executive in relation to building safety. This is despite the remarkable campaign led

by the TCPA to incorporate into the Act a set of 11 legally binding ‘healthy homes’ principles. This approach to legislation illustrates a phenomenon from which the NHS has also suffered over its 75-year life, which is the fascination of the political classes with dramatic upheavals of the institutional structures that deliver public services, with all the disruption that inevitably follows. These upheavals are at the expense of the careful development of substantive principles and achievable targets to guide long-term, strategic delivery that the services themselves need in order to succeed.

There have been several government-sponsored external reviews of the NHS in the past that have urged much more investment into prevention. Derek Wanless chaired a landmark review in 20021 in which he identified, under his ‘fully engaged’ option, the extent to which the call upon public spend could be mitigated by focusing on public health measures. He followed it up with a further report in 2004,2 looking at what needed to be done if the ‘fully engaged’ option was to be realised. Its 21 recommendations include targets for reduction of smoking, alcohol consumption and obesity, a focus on behavioural psychology, and an apparently revolutionary precept that ‘the right of the individual to choose their own lifestyle must be balanced against any adverse impacts those choices have on the quality of life of others.’3

Tragically, Wanless is today almost entirely forgotten. We should not be surprised. It is wholly understandable that, in the day-to-day life of a healthcare system, the saving of lives and offering relief from pain and distress, often with immediate and visible results, will be the greater priority. There is a political reflection of this. As investment in the NHS has increased, albeit erratically since 2004, so investment in public health and social care has been slashed and the relevant functions divided between different delivery bodies and across Whitehall. The dysfunctionality of this was to become all too apparent in the nation’s response to the COVID-19 pandemic.

Back in 2015 the board of NHS England had no direct remit in public health or social care, yet we were acutely conscious that successful delivery of these services was fundamental to our own remit. Previously, the formulation of NHS strategy had been government-led and imposed top-down. NHS England was different from its predecessors, however, in that it had, certainly in theory, significant autonomy. It had been set up in 2013 under the Lansley reforms, which sought explicitly to liberate the NHS from political interference. It was to have full competence to fund and oversee health care commissioning within a framework of government strategy. As it transpired, almost inevitably, that government had neither the talent nor the patience for strategy. It was obsessed with delivery and with

Badgerswood Surgery, Whitehill & Bordon: modernising the way people access healthcare was an objective of the Healthy New Towns project

©Mike Ellis Photography / NHS England

public expenditure. So, curiously, the balance shifted.

In particular, and not without controversy, the NHS England board stepped into the strategy vacuum and in 2015 published its Five Year Forward View 4 This showed the NHS to be capable of thinking as a system, taking a view across the whole spectrum of health, and not just the sharp end of treatment and intervention. It embraced the interests of the other arms-length government bodies responsible for areas such as public health, health education, health system improvement and economic regulation. It set out a clear vision and the steps to be taken through commissioning and other methods to address the multiple weaknesses in institutional structures and organisation. It promoted ‘vanguards’ to explore how better to align primary, secondary and tertiary care; mental and physical ill-health; and healthcare and social care, laying the early foundations for the integrated care systems and boards promoted by The NHS Long Term Plan5 and later given statutory authority.

It recognised that many if not most of the factors impinging upon the health of the population actually lie outside the remit of the NHS itself. One such is the relationship between health and housing, which was clearly recognised in 1947.6 The legislation that created the NHS7 and that which created a national land use planning system8 were twin ventures into radical social reform. Yet, by the 2010s the link had all but disappeared at the national level, where the silos presided over by government departments allowed little effective cross-over. So, the Five Year Forward View was bold in attempting to rewrite the status quo and in seeking a more comprehensive approach. It provided authority and headroom for experimentation.

One of the proposed experiments was the idea of healthy new towns.9 This would be the first time

that the NHS had stepped into the planning arena. Our challenge was to excite the interest of the planning and construction industries in this concept. It was not to be a simplistic leap into architectural determinism, but a desire to lend the weight of the NHS behind those who could produce added value in housing construction by paying better attention to the health of those who would occupy it. We were not envisaging the NHS taking on a role as provider or regulator, but of working through partnerships with industry, local government and regulators to build opportunities for long-term improvement.

With modest investment and a small team at NHS England we launched, through a competitive process, ten demonstrator sites (out of over 100 applicants) across a variety of development types and geographic locations. Some were small-scale additions to existing settlements; others, such as Ebbsfleet in Kent, involved huge long-term projects; yet others were engaged with surplus defence land being brought forward for development. In total, over 70,000 new homes fell within the programme.

The project was run nationally by us but was in fact led by partnerships with local government and other actors on the ground. We launched a network of developers and housing associations, recognising their capacity to shape places for better health for the future. We wished to provide a national focal point for healthy place-making, and to learn from shared experience. The experiment should not only lead to 70,000 exemplars of a fresh approach to the relationship between planning and health, but also create a wider legacy by influencing future government policy. This was to prove a greater struggle than it should have, but building on the experience, with our partners we developed a series of publications, Putting Health into Place, and proposed a quality mark by which to assess new developments.10

Today, a Home Quality Mark* has been developed under the BREEAM schemes.11 It has three central performance indicators relating to running costs, health and well-being and environmental footprint. The well-being indicator draws upon issues such as good daylighting, air quality, access to amenity and levels of thermal comfort. It reflects how the home is likely to impact the health of the occupants and their well-being, including the quality of living space, recreational space, security and access and space. It was developed with support from several local authorities, the Royal Town Planning Institute and the TCPA.

There have also been successive revisions to the National Planning Policy Framework (NPPF). Its 2012 iteration recognised that the planning system could play an important role in facilitating social interaction and in creating healthy, inclusive communities. It spoke about choice of school (§72), of high-quality

'Edible Ebbsfleet' was an initiative to help tackle poor diets, part of the Ebbsfleet Healthy New Town project

©Mike Ellis Photography / NHS England

Special issue: health and new towns

open spaces (§73) and of protecting public rights of way and access (§75).12

By 2019, the NPPF had come to incorporate an overall requirement to aim to achieve healthy, inclusive and safe places, which could promote social interaction, could be safe and accessible and enable and support healthy lifestyles (§91).13 Emphasis had come to be placed on the provision of safe and accessible green infrastructure, sports facilities, local shops, access to healthier food, allotments and layouts that encourage walking and cycling (§91c)); and likewise upon high-quality open spaces and opportunities for sport and physical activity (§96). It also reinforced earlier guidance on the designation of land as Local Green Space (§§99-101 and footnote 6 to §11b)i. and §11d)i.).

We may count all of these as necessary but modest advances at the national policy level. Perhaps public consciousness has been raised as a result of the Healthy New Towns experiment, even as its direct impact has faded since its end-date of 2019. Moreover, despite the cessation since then of NHS funding, several of the demonstrator sites continue to promote the ideals of the experiment.

One such is Bicester garden town, always a front-runner because of the enthusiasm, competence and commitment of the local authority and the engagement of the local population.14

Context is all. There are several qualifiers. Good quality housing is but one of the many variables that have an impact on human health, but it goes hand in hand with all other environmental impacts –pollution, traffic, lack of safety, lack of local amenities and open space. The planning system has the tools to rebalance these impacts, but although human

health has long been a material consideration in making planning decisions, it has often been more of a wallpaper feature than one of primary focus.

‘although human health has long been a material consideration in making planning decisions, it has often been more of a wallpaper feature than one of primary focus’

Kids playing in Hogmoor Inclosure, part of Whitehill & Bordon Healthy New Town

©Mike Ellis Photography / NHS England

Creating cycling routes was one way the Healthy New Towns supported communities to become more active

©Mike Ellis Photography / NHS England

Special issue: health and new towns

and their impact is unlikely to have the reach to directly affect the most economically deprived communities. However, to focus on healthy new settlements is to take the first step towards embedding health-promoting innovation at the earliest stage of future housing provision. Given the extent to which, in the modern world, the growing burden of disease is associated with lifestyle, it is vital to better understand the extent to which our neighbourhoods, towns and cities have a restrictive impact on people‘s choices and chances to lead healthier and more active lives. It is a sobering fact that UK schoolchildren are amongst the least active in the world and amongst the most overweight or obese.

‘It is a sobering fact that UK schoolchildren are amongst the least active in the world and amongst the most overweight or obese’

Indeed, it is noteworthy that despite having very different models of healthcare provision, the United

Kingdom and the United States of America ranked surprisingly poorly in global tables15 comparing the impact in terms of morbidity and mortality of the COVID-19 pandemic.16 This reflects hardly at all on the quality of their respective healthcare systems, but upon the fragility of the underlying health of the populations in two of the wealthiest countries in the world: upon poor diet, lack of exercise, poor education, rising inequality and poor life chances.

It is clearly a multifactorial political problem. There is no silver bullet. Improvement in the quality of the health of a population requires action on many fronts, of which housing quality is clearly an important starting point. Hence the importance of the NHS and its Healthy New Towns initiative. If it has succeeded in raising consciousness of the issue within the development community, in creating a market advantage for them, and in deepening the understanding within national planning policy guidance, then it might be judged a success, albeit as an incremental contributor rather than a fundamental change-maker. It is too early to tell what its longterm impact may yet be, but it is clear that no progress at all will be made without similar joinedup thinking being embedded within healthcare, all forms of social provision and market intervention.

Healthcare systems across the world are in crisis,

Community based healthy eating initiatives, such as this one in Bicester, were set up by several Healthy New Towns

©Mike Ellis Photography / NHS England

Special issue: health and new towns

as costs continue to rise significantly ahead of inflation and GDP growth as a consequence of the need to respond to the complex diseases of an unhealthy ageing population within a context of increasingly expensive pharmaceutical and technological innovations. In times of sluggish economic growth, healthcare expenditure is squeezing out other much needed public investment. The premium for securing better prevention of ill health has never been higher.

In England, the new statutory integrated care systems,17 with their focus upon prevention, better outcomes and reducing health inequalities, represent an important structural step in breaking down the barriers. They derive from the same strategy package as the NHS Healthy New Towns initiative and they represent a realisation that the long-term survival of the NHS in anything like its present form depends upon conditions beyond its immediate grasp, including engagement with the planning system in order to better address the physical and social determinants of health. The NHS Healthy New Towns programme has been an important step, both symbolically and on the ground, in that direction.

• Sir Malcolm Grant CBE was the independent chair of the Board of NHS England from 2011 to 2018. He was previously President and Provost of University College London, and before then Professor of Land Economy at the University of Cambridge. For 23 years he was editor of the Planning Encyclopedia. He is an honorary life member of the Royal Institute of Chartered Surveyors, the Royal Town Planning Institute and the Town and Country Planning Association. He's a Vice President of the TCPA. All views expressed are personal.

Notes

1 D Wanless: Securing our Future Health: Taking a Long-term View: final report. HM Treasury, 17 Apr. 2002. https://web.archive.org/web/20071003045037/ http://www.hm-treasury.gov.uk/Consultations_and_ Legislation/wanless/consult_wanless_final.cfm

2 D Wanless: Securing Good Health for the Whole Population. HM Treasury, 25 Feb. 2004. https:// webarchive.nationalarchives.gov.uk/ukgwa/+/http:// www.hm-treasury.gov.uk/consultations_and_ legislation/wanless/consult_wanless04_final.cfm

3 D Wanless, J Appleby, A Harrison, D Patel: Our Future Health Secured? A Review of NHS Funding and Performance. King’s Fund. 11 Sep. 2007, p.261 https:// www.kingsfund.org.uk/publications/our-future-healthsecured

4 Five Year Forward View. NHS, Oct. 2014. https://www. england.nhs.uk/wp-content/uploads/2014/10/5yfv-web. pdf

5 The NHS Long Term Plan. Version 1.2 with corrections. NHS, Aug. 2019. https://www.longtermplan.nhs.uk/ wp-content/uploads/2019/08/nhs-long-term-planversion-1.2.pdf

6 ‘1948–1957: Establishing the National Health Service’. Webpage. Nuffield Trust, 2024. https://www. nuffieldtrust.org.uk/chapter/1948-1957-establishing-thenational-health-service

7 National Health Service Act 1946, available here: https://www.legislation.gov.uk/ukpga/1946/81/pdfs/ ukpga_19460081_en.pdf

8 Town and Country Planning Act 1947, available here: https://www.legislation.gov.uk/ukpga/1947/51/pdfs/ ukpga_19470051_en.pdf

9 Putting Health into Place: Introducing NHS England’s Healthy New Towns programme. NHS England, 20 Sep. 2018. https://www.england.nhs.uk/wp-content/ uploads/2018/09/putting-health-into-place-v4.pdf

10 ‘Healthy New Towns’. Webpage. NHS England, 2024. https://www.england.nhs.uk/ourwork/innovation/ healthy-new-towns/

11 T Taylor, H Pineo: Briefing Paper: Health and wellbeing in BREEAM. Building Research Establishment Ltd, 2015. https://tools.breeam.com/filelibrary/Briefing%20 Papers/99427-BREEAM-Health---Wellbeing-Briefing.pdf

12 National Planning Policy Framework. National Archives, 27 Mar. 2012. https://webarchive.nationalarchives.gov. uk/ukgwa/20180608095821/https://www.gov.uk/ government/publications/national-planning-policyframework--2

13 National Planning Policy Framework. National Archives, 19 Jun. 2019. https://webarchive.nationalarchives.gov. uk/ukgwa/20210708211349/https://www.gov.uk/ government/publications/national-planning-policyframework--2

14 ‘Bicester Garden Town’. Webpage. Cherwell District Council, 2024. https://www.cherwell.gov.uk/info/260/ bicester-garden-town

15 ‘COVID-19 pandemic death rates by country’. Webpage. Wikipedia®, 6 Nov. 2023. https://en.wikipedia.org/wiki/ COVID-19_pandemic_death_rates_by_country

16 S Matta, KK Chopra, VK Arora: ‘Morbidity and mortality trends of Covid 19 in top 10 countries’. Indian Journal of Tuberculosis, 2020, Vol. 64 (4), 167-172. https://www. ncbi.nlm.nih.gov/pmc/articles/PMC7543896/

17 A Charles: ‘Integrated care systems explained: making sense of systems, places and neighbourhoods’. Online explainer. The King’s Fund, 19 Aug. 2022. https://www. kingsfund.org.uk/publications/integrated-care-systemsexplained

Editor’s Note:

* The most recent Home Quality Mark technical standards may be downloaded without charge after submitting your details using the online form located here: https://bregroup.com/products/home-qualitymark/resources/

more than playgrounds and sports pitches: supporting children and young people’s wellbeing in our villages, towns and cities

Prof. Rhiannon Corcoran, and Graham Marshall present a critical analysis of research conducted in Halton Lea, Runcorn – one of the NHS Healthy New Towns demonstrator sites – in the context of ensuring

that the planning system takes into account the need to accommodate free play in the built environment and to ensure that children and young people are heard and feel that they matter

Introduction

‘A child-focused built environment policy could transform children’s lives, health and wellbeing ... effective low cost policies could be enacted almost immediately.’ 1

The needs of children in the built and living environment are a hot topic this year. On 16 January 2024 Royal Assent was granted to the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024,2 which includes the right to be listened to and have a say3 and the right to play.4 Also in January, the Levelling Up, Housing and Communities (LUHC) select committee received evidence on children, young people and the built environment.5

These are big moves that ought to herald significant changes in their wake. Scotland’s new Act alongside the now well-established Well-being of Future

Generations (Wales) Act 20156 puts the devolved nations at the vanguard of safeguarding the wellbeing of children and young people, leaving England trailing rather woefully behind.

However, if the presentations of the expert panels to the LUHC select committee are anything to go by, children’s needs in England’s cities, towns, villages and more rural areas will now be taken more seriously, making way for more formal consideration of how the built environment can support these needs. Medical, psychological, human geographical and planning expertise was represented across the panels with their contributions combined in a robust and convincing manner. It demonstrated young people’s poverty of access to places and spaces that are essential to support adequate physical, cognitive, social and emotional development, through free play, exposure to bugs, and the

togetherness of peers.

Inevitably, some evidence stood out. For example, the current National Planning Policy Framework (published December 2023) mentions children only twice and no consultation with children and young people took place during its preparation. We heard how free play engages the richness of challenge, risk and uncertainty to support development in a way that organised or supervised play, such as happens during breaks in school or in clubs and sports, does not. We heard about the importance of incidental spaces that can easily accommodate everyday play experiences in neighbourhoods, close to home.

Yet, we heard how these spaces are being sacrificed to increased urban densification and to make provision for cars and motorists’ needs.

We heard how those in less provisioned or more remote areas needed good quality reliable public transport and/or safe active travel options to enable them to reach outdoor spaces. We heard how navigation through ‘hostile environments’ to get to spaces where children and young people can play and hang out was a worrying issue for children, young people and their parents. There was mention of teenagers needing to hang around in children’s playgrounds because they had nowhere else to go, and how this acted as a barrier to the use of these places by the younger children for whom they are intended.

Finally, the inequality of access to adequate outdoor space was stressed. Race, gender and disability were referred to as key determinants of this space and place inequity. Within this, the poor understanding and therefore inadequate provision of spaces for girls and young women was stressed,

leaving 50% of our population of children and young people severely under-served and at enormous, potentially irrevocable, disadvantage from the earliest of ages.

In short, the experts at the select committee provided reliable evidence that it is hard for the, so far unhearing, Government to ignore.7 Optimistically, we might assume that things will change for the better for England’s future generations. Change that will benefit young people by providing what they require in their living environments need not even require a steer away from the dominant emphasis upon local and national economic factors. After all, the health and wellbeing of our children and young people is the font of a thriving future economy.

There is a wider context within which a focus on children’s and young people’s needs in the built environment sits and that is the growing call to consider health and wellbeing in all policies (HIAP). HIAP itself stems from the understanding that much of our capacity to stay healthy and well rests, not with us as individuals, but rather with so-called social or wider determinants of health as expressed in the influential ‘rainbow’ model of health, which acknowledges the importance of the living environment.8 Also foundational is the well-established public health evidence highlighting the importance of the early years for future health and wellbeing,9 the need to take a life course approach to improving health and wellbeing10, 11 and the focus upon addressing inequality gaps in health and wellbeing.12, 13

What children need

There are two matters that deserve the fullest attention in attempts to redress the obvious omissions in built environment policy on the needs of children

Public freeplay area in Helsinki, Finland

Markus Mattila

and young people. These are the need to play and to be heard, both now enshrined in law in Scotland through the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024.

As we heard in the LUHC select committee evidence, play – particularly free play – is essential to the development of mental and physical wellbeing. Taking many forms, play features throughout the human life course where it changes in nature as we mature. However, it is in many people’s minds definitive of what it means to be young. All young social mammals play14 and they all play outside during times and within spaces where it feels safe to do so. This stresses play’s evolutionary significance, as does the fact that contact with the germs and organisms that exist in the outside world is critical to an individual’s long-term fight against inflammatory, allergic and autoimmune diseases.15, 16

It seems, therefore, that although many parents and carers fear giving their children free rein outdoors, it is actually less safe to restrict children to indoor play within controlled environments because lack of access to outdoor play has serious long term health and wellbeing consequences.

According to Gray,17 free play has two defining characteristics: it is self-chosen and self-directed and it is done for its own sake, being ‘intrinsically motivated’. Gray also emphasises that generally play is social in form, needing two or more individuals to come together and agree to play and then to negotiate the principles, rules and roles of the play. It is therefore a cooperative, prosocial activity requiring skills such as awareness of non-verbal cues, turn-taking, negotiation, compromise and creativity.

Play therefore provides the opportunity to learn, build and apply these skills within behaviour that is its own reward. As free play needs a safe space for it to happen, the living environment of children and young people needs to provide that safety. Furthermore, society needs to facilitate this kind of play beyond the break times in the school playground by enabling the time for children and young people to engage in this seemingly frivolous yet critically important activity. Increasingly, young people’s time seems taken up with homework, hobbies and formal activities, completely usurping real time to play. Furthermore, for some time and increasingly, parental notions of risk have curtailed children and young people’s ability to play independently outdoors.18

The decline in time and opportunity for children and young people to engage in free play tracks the increased prevalence of children and young people’s mental health issues over decades in the United States.19 Several studies support the thesis that decline in play opportunity is a key determinant of increased child and adolescent common mental health problems. One particular study stands out.20

It compared five-year-olds who lived in an area where children were allowed to play unsupervised outdoors with five-year-olds who lived in similar areas where unsupervised play outdoors was not allowed for reasons of perceived risk. The children who could play freely and unsupervised outdoors spent about twice as much time outdoors; were more active; had more friends, and enjoyed better motor and social skills than those who were not allowed to pay out by themselves. Moreover, the provision of playgrounds, no matter their quality and upkeep, were no substitute for incidental or ‘door step’ play areas (neighbourhood streets for example) because the latter afforded more creative play that could be supported by equipment and resources brought from home. In short, children allowed to play out are better equipped for later life. Finland stands out as facilitating this particularly well.21

The predominantly cross-sectional research studies into wellbeing and the built environment, often using existing data within epidemiological designs, are most frequently focused upon access and use of green space. There seems little adequate consideration of other, potentially confounding, characteristics of the environment such as surrounding hostile grey space and noise and air pollution, which are well known to impact health and wellbeing. Furthermore, with truly ‘public’ realm shrinking over recent decades, that which does exist in the form of green space is increasingly contested, potentially making children, and more likely teenagers, feel unwelcome.22

Yet the importance of incidental neighbourhood spaces is acknowledged as a facilitator of children and young peoples’ outdoor activity. A recent review of evidence23 reveals little convincing evidence of the impact of the urban public realm upon adolescent wellbeing and mental health. However, as convinced as many others are of the importance of the living environment in supporting wellbeing, this lack of convincing evidence may be due to the complex pathways between the living environment and wellbeing. There is therefore a need for better data and for theories drawn from diverse disciplines with overlapping interest in this area of study. Here, qualitative material collected from children and young people about their locality and how it meets their needs is invaluable as a source of rich and context-specific data. Given that modern-day planning policy seems to have failed to engage with children and young people, research and creative methods that can facilitate the hearing of their voices are desperately needed.

Indeed, being listened to and heard is the second topic in need of redress mentioned above and which Scotland has now legislated for. Having a sense of empowerment and control over what happens in your neighbourhood through joint decision-making, for example, has been shown to positively impact

Special issue: health and new towns

wellbeing of communities providing involvement is meaningful and power imbalances are addressed.24

When we are seen and heard and when our points of view are taken seriously and our perspectives recognised, we feel significant and we begin to feel that we matter within our communities. The failure of the UK planning system to engage with young people about their living environments can only send out signals that they don’t matter, that their views are insignificant and their contributions not worthwhile. Mattering and the psychology behind feeling that we don’t matter is an area of growing interest in the field of mental health and wellbeing.25

Its significance extends wherever Arnstein’s ladder of citizen participation has been influential.26 It was to address the feeling that the community didn’t matter that Jane Jacobs began her crusade in New York against 1950s urban planning policy – a story that catalysed participatory movements in built environment practice.27 Indeed, the evidence suggests that positive wellbeing impacts of interventions in place occur only when the community were meaningfully involved in the decision-making process.28 Given that children and young people are seldom heard while at the same time suffering unprecedented poor mental health, it is critical that children and young people’s views about their living environment are heard in research and acted on in practice. This has been emphasised by The Royal College of Paediatricians, which has stated: ‘paediatricians cannot be any clearer on this point; child health is in crisis and rampant health inequalities can no longer be ignored’. 29

NHS Healthy New Towns – Halton Lea, Runcorn

One of the three core objectives of the NHS Healthy New Towns programme, was to: ‘develop new and more effective ways of shaping new towns, neighbourhoods and strong communities that promote health and wellbeing, prevent illness and keep people independent’.

It seemed to provide a unique opportunity, backed by a respected and cherished national institution, to both hear from communities and to prioritise the needs of children within ten new sites appearing across the country. However, since launching its final publications,30 the programme has staggered due to changes within the NHS and lack of capacity to support this prevention-focused initiative. The scheme seems fairly typical of NHS pilots in general in terms of failure of ‘locking in the benefits or spreading the learning more widely’. 31

In short, the ambitions of the programme have been, at best, only partly realised. Some of the ten demonstrator sites – those with more of a head start – established leadership, collaboration and support structures prior to the programme have continued to progress (e.g. Ebbsfleet, Kent), whilst the ambitions of other places have stagnated. There is a clear need for sustained national leadership for such collaborative, place-based opportunities.31 Perhaps new cross-sector vigour generated by the bow wave of evidence provided to the LUHC select committee will stimulate such leadership, through calls for a minister for children, for example?

The authors sat on the publications steering

Geodesic dome three-dimensional consultation device used by Prosocial Place to engage with young people in Halton

University of Liverpool Special issue: health and new towns

group of NHS Healthy New Towns that provided a unique opportunity to oversee the work going on through the course of the programme. More significantly, in the current context of the LUHC select committee topic, we were also involved in the community focused work that took place in 2017 to shape the plans of one of these demonstrator sites, Halton Lea in Runcorn. The town’s vision is expressed in NHS Healthy New Town documentation as:

‘In response to the (NHS) Five Year Forward View to improve local health and integrate health and social care, we are building a connected Healthy New Town – connected by its people; connected by its aspirations; connected by its environment; connected by technology and connected by place. The development at Halton Lea, Runcorn, has the potential to regenerate the area into a thriving community hub, with new opportunities for social and community activities, healthy retail provision and integrated housing, health and social care provision. Our ‘One Halton’ model of care and support is focused on enhancing services in the community and ensuring easy access to those services. We are focusing on developing a health and wellbeing ecosystem, with people at the heart of it, and an infrastructure that supports wellbeing and health.’ 32

Summary and Discussion of Findings

During July 2017 as part of Halton Lea’s NHS Healthy New Town programme, three half-day workshops took place to hear the views of 73 local young people who attended one secondary and one primary school in the area.

The findings demonstrate how much children and young people need from their built environment over and above any blanket allocation of playgrounds and sports pitches. In the data there is a mature sense of what places and spaces can and should afford the whole community, across life course, gender and race. These ranged from ideas consistent with notions of free play,17 most obviously expressed by the primary school pupils, all the way to the prioritisation of equitable environments and inclusive access, emphasised most by the secondary school students. For this next generation of adults, all of these matters are considered necessary to support their own wellbeing and that of others.

In responses that emphasise the coming together of community across age we see a desire to fix generational culture gaps. This seems, in part, a response intended to address the perceived judgment and disapproval of young people by older generations, while hanging around with mates in the places and spaces that they were able to access (a concern expressed by groups of young people in other areas we have worked as well).

Fresh start island engagement tool used by Prosocial Place to consult young people in Halton

University of Liverpool

This acknowledgement of being misunderstood by adults who fear antisocial behaviours and interactions is a sensitive and sophisticated response to address the issue as they see it. It is notable however, that the children and young people we engaged here also expressed fears about gangs of older kids taking over spaces not designed with them in mind. Just as the LUHC select committee evidence7 stressed, teenagers feel unwelcome and displaced in the built environment, where they seemingly quite rightly detect disapproval from adults while being forced to ‘hang around’ in play spaces that are not meant for them and which do not meet their needs.

There was a keen awareness amongst secondary school students of the ‘social determinants’ of wellbeing,8 honed through the experience of growing up in a disadvantaged area. Cultural norms; poverty; homelessness; drugs, and gang culture were all referred to as barriers to deriving benefit from the living environment. Inequities of access, income and housing were all mentioned within a distressing narrative of place stigma, where young people are judged unfairly because of where they come from.33

All of the young people were enthused by being asked for their opinions about where they live. It is saddening that Halton Lea’s bid for Healthy New Town status has floundered somewhat, although the vision statement is consistent with the views expressed by its children and young people and so should be represented and carried forward in the plans of the town in the coming years. The thinking of the children and young people demonstrated an

astute awareness of the need to be heard within decision-making, as well as emphasising the lack of suitable, safe and affordable infrastructure and services that could enable them to enjoy the outdoor neighbourhood environment.

The evidence gathered during the workshops successfully represented the views of the 73 children and young people involved. Whilst we can only assume that the group was representative of the population of the area, we can be sure that fuller, more extensive engagement would have engendered greater confidence in data sufficiency or saturation. In terms of methodology, the mix of discursive and creative techniques aligned with the notions of free play and seemed to work well when promoting the translation of health and wellbeing thinking into three dimensional representations of them in the form of place.

However, translating the views of children and young people into real world place-making and/or place-keeping practice is a step further still. Some suggest that change to address concerns about the limitations placed on children’s freedoms is likely to be most successful if it comes from within communities where shared concerns, philosophes and objectives can be cooperatively supported, making a better neighbourhood for everyone.34 Calls for playstreets and for the reduction of motor vehicle speed limits to 20 miles per hour in built up areas – a change already made in Wales in 2023 – 35 are part of such grassroots initiatives. However, mindful of the apparent neglect amongst

Special issue: health and new towns

NHS England's Healthy New Towns project aimed to involve a wide range of people in shaping plans

Mike Ellis Photography / NHS England

Special issue: health and new towns

professionals to engage with children and young people, systemic and nationwide change can only come about when the whole sector agrees to prioritise children’s needs and rights in the built environment.

If the country’s children and young people really do matter, then it is essential that the way that public realm, its amenities and resources are designed and stewarded is geared towards meeting their needs. These needs, as shown here, go well beyond the provision of formal play spaces, which can only ever be considered the bare minimum because they do not support independence and are often inaccessible for various reasons beyond any young person’s control.

The failure of empowered adults to address these matters has long-term consequences for the physical and mental health of today’s children and young people. If practitioners of the built and living environments do not now feel moved to support the thorough development of key socio-cognitive skills through appropriate changes to the living environment, then it can only be assumed that England’s children and young people do not matter sufficiently to the nation.

• Rhiannon Corcoran is Professor of Psychology and Public Mental Health at the Institute of Population Health, University of Liverpool and Co-Director of Prosocial Place. The views expressed are personal.

• Graham Marshall is Co-Director of Prosocial Place and Honorary Senior Research Fellow at the Institute of Population Health, University of Liverpool. All views expressed are personal.

Notes

1 S Laville: ‘Children suffering due to lack of outdoor play, UK charities warn’. Webpage. The Guardian. 23 Jan. 2024. https://www.theguardian.com/society/2024/ jan/23/children-suffering-due-to-lack-of-outdoor-playuk-charities-warn

2 See: https://www.legislation.gov.uk/asp/2024/1/ contents/enacted

3 Ibid. Article 12 1. of Part 1 of the Schedule

4 Ibid. Article 31 1. of Part 1 of the Schedule

5 ‘Children, young people and the built environment inquiry – Levelling-Up Committee publishes evidence ahead of opening evidence session’. Webpage. UK Parliament. 19 Jan. 2024 https://committees.parliament. uk/committee/17/levelling-up-housing-andcommunities-committee/news/199504/levelling-up_ committee_publishes_evidence_ahead_of_opening_ evidence_session/

6 See: https://www.legislation.gov.uk/anaw/2015/2/ contents/enacted

7 Levelling Up, Housing and Communities Committee Oral evidence: Children, young people and the built environment, HC 94, 24 Jan. 2024. https://committees. parliament.uk/oralevidence/14157/default/

8 G Dahlgren, M Whitehead: Policies and Strategies to Promote Social Equity in Health – Background document to WHO – Strategy paper for Europe. Institute for

Future Studies. Stockholm, Sweden. Sep. 1991. Available for download at: https://www.researchgate. net/publication/5095964_Policies_and_strategies_to_ promote_social_equity_in_health_Background_ document_to_WHO_-_Strategy_paper_for_Europe

9 C Tickell: The Early Years: Foundations for life, health and learning – An Independent Report on the Early Years Foundation Stage to Her Majesty’s Government. Department for Education. 30 Mar. 2011 https://assets. publishing.service.gov.uk/ media/5a7ac0ec40f0b66a2fc02915/DFE-00177-2011.pdf

10 S Hatch, FA Huppert, R Abbott, T Croudace, G Ploubidis, M Wadsworth, M Richards, D Kuh: ‘A Life Course Approach to Well-Being’. In J Haworth, G Hart (eds.): Well-Being – Individual, Community and Social Perspectives. Palgrave Macmillan, 2007, pp.187-205. https://doi.org/10.1057/9780230287624_11

11 O Douglas, M Lennon, M Scott: ‘Green space benefits for health and well-being: A life-course approach for urban planning, design and management’. Cities, Jun. 2017, Vol 66, 53-62. https://doi.org/10.1016/j. cities.2017.03.011.

12 LJ Thomson, R Gordon-Nesbitt, E Elsden, HJ Chatterjee: ‘The role of cultural, community and natural assets in addressing societal and structural health inequalities in the UK: future research priorities’. International Journal for Equity in Health, 2021, Vol. 20, 249. https://doi.org/10.1186/s12939-021-01590-4

13 S Lewis, C Bambra, A Barnes, M Collins, M Egan, E Halliday, L Orton, R Ponsford, K Powell, S Salway, A Townsend, M Whitehead, J Poppay: ‘Reframing “participation” and “inclusion” in public health policy and practice to address health inequalities: Evidence from a major resident-led neighbourhood improvement initiative’. Health and Social Care in the Community, 2019, Vol. 27 (1), 199-206. https://doi. org/10.1111/hsc.12640

14 LL Sharpe: ‘Fun, fur, and future fitness: The evolution of play in mammals’. In PK Smith, JL Roopnarine (eds.): The Cambridge Handbook of Play: Developmental and disciplinary perspectives Cambridge University Press, 2019, pp.49-66.

15 T Zuo, MA Kamm, J-F Colombel, SW Ng: ‘Urbanization and the gut microbiota in health and inflammatory bowel disease’. Nature Reviews, gastroenterology and heptology, Jul. 2018, Vol. 15, 440-452. https://doi. org/10.1038/s41575-018-0003-z

16 H Sbihi, RCT Boutin, C Cutler, M Suen, BB Finlay, SE Turvey: ‘Thinking bigger: How early-life environmental exposures shape the gut microbiome and influence the development of asthma and allergic disease. Allergy, Nov. 2019, Vol. 74 (11), 2103-2115. https://doi.org/10.1111/ all.13812

17 P Gray: ‘Play is nature’s way of teaching cooperation: a reply to ‘Building a cooperative child: evidence and lessons cross-culturally’ by Tanya Broesch and Erin Robbins’. Global Discourse, 18 Oct. 2023, Vol. 13 (3, 4), 442-446. https://bristoluniversitypressdigital.com/view/ journals/gd/13/3-4/article-p442.xml

18 A Jerebine, M Mohebbi, N Lander, ELJ Eyre, MJ Duncan, LM Barnett: ‘Playing it safe: The relationship between parental attitudes to risk and injury, and children’s adventurous play and physical activity’. Psychology of Sport and Exercise, Jan. 2024, Vol. 70, art. 102536. https://doi.org/10.1016/j. psychsport.2023.102536

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19 P Gray, DF Lancy, DF Bjorklund: ‘Decline in Independent Activity as a Cause of Decline in Children’s Mental Wellbeing: Summary of Evidence’. Journal of Pediatrics, 23 Feb. 2023, Vol. 260 (2), art. 113352. https:// www.researchgate.net/publication/368794518_Decline_ in_Independent_Activity_as_a_Cause_of_Decline_in_ Children%27s_Mental_Wellbeing_Summary_of_the_ Evidence

20 M Hüttenmoser: ‘Children and their living surroundings: Empirical investigations into the significance of living surroundings for the everyday life and development of children’. Children's Environments, Dec. 1995, Vol. 12 (4), 403-413. https://www.jstor.org/ stable/41514991

21 B Shaw, M Bicket, B Elliott, B Fagan-Watson, E Mocca, M Hillerman: Children’s independent mobility: an international comparison and recommendations for action. Policy Studies Institute, Jul. 2015. https:// westminsterresearch.westminster.ac.uk/

22 G Jack: ‘Place Matters: The Significance of Place Attachments for Children’s Wellbeing’. The British Journal of Social Work, Apr. 2010, Vol. 40 (3), 755-771. https://doi.org/10.1093/bjsw/bcn142

23 P Fleckney, R Bentley: ‘The urban public realm and adolescent mental health and wellbeing: A systematic review’. Social Science and Medicine, Sep. 2021, Vol. 284, art. 114242. https://doi.org/10.1016/j. socscimed.2021.114242

24 A Pennington, M Watkins, A-M Bagnall, J South, R Corcoran: A systematic review of evidence on the impacts of joint decision-making on community wellbeing – Technical report. What Works Centre for Wellbeing, London. Aug. 2018. https:// whatworkswellbeing.org/wp-content/uploads/2020/01/ full-report-joint-decision-making-wellbeingNovember2018-1.pdf

25 GL Flett: The Psychology of Mattering. Understanding the Human Need to be Significant. Academic Press, 1 Jun. 2018.

26 SR Arnstein: ‘A Ladder of Citizen Participation’. Journal of the American Institute of Planners, 1969, Vol. 35 (4), 216-224. Full text available to download at: https:// www.nebraskachildren.org/file_download/872e8b2f826f-4eb8-94e4-0aa3ca7efc49

27 J Jacobs: The Death and Life of Great American Cities. First Vintage Books edition Dec. 1992. Copyright J Jacobs 1989. Full text available at: http://www. petkovstudio.com/bg/wp-content/uploads/2017/03/ The-Death-and-Life-of-Great-American-Cities_JaneJacobs-Complete-book.pdf

28 A-M Bagnall, J South, K Southby, S Di Martino, G Pilkington, B Mitchell, A Pennington, R Corcoran: ‘ A systematic review of interventions in community infrastructure (places and spaces) to boost social relations and community wellbeing’. Journal of Epidemiology and Community Health, 2019, Vol. 73 (A73-A74). https://whatworkswellbeing.org/wp-content/ uploads/2023/01/Places-and-Spaces-Review-Refresh-31Jan-2023-final-with-logos.pdf

29 S Laville, Children suffering due to lack of outdoor play, UK charities warn’. Webpage. The Guardian. 23 Jan. 2024. https://www.theguardian.com/society/2024/ jan/23/children-suffering-due-to-lack-of-outdoor-playukcharities-warn

30 ‘Healthy New Towns’. Webpage. NHS England, 2024. https://www.england.nhs.uk/ourwork/innovation/ healthy-new-towns/

31 C Naylor: ‘Healthy New Towns four years on: the legacy of a national innovation programme’. Blog. The Kings Fund, 3 May 2023. https://www.kingsfund.org.uk/ blog/2023/05/healthy-new-towns-four-years-legacynational-innovation-programme

32 ‘Halton Lea, Runcorn’. Webpage. NHS England. 2024. https://www.england.nhs.uk/ourwork/innovation/ healthy-new-towns/demonstrator-sites/halton-learuncorn/

33 E Halliday, J Popay, R Anderson de Cuevas, P Wheeler: ‘The elephant in the room? Why spatial stigma does not receive the public health attention it deserves’. Journal of Public Health (Oxford). 28 Feb. 2020, Vol. 42 (1), 38-43. Full text available at: https://core.ac.uk/ download/pdf/196588772.pdf

34 M Lanza: Playborhood – turn your neighborhood into a place for play. Free Play Press. Copyright Mike Lanza, 2012. Full text available at: https://archive.org/details/ playborhoodturny0000lanz/page/n1/mode/2up

35 ‘Wales’ 20mph speed limit: How has the first month gone?’. Webpage. BBC News. 17 Oct. 2023. https:// www.bbc.co.uk/news/uk-wales-67064306

Formal play spaces can only ever be considered the bare minimum

building a healthy britain

How should the promotion of healthy lifestyles in the design and management of the post 1945 New Towns influence the delivery of the next generation of New Towns and Garden Cities? Katy Lock explains

When reading the New Towns Act 1946 in Parliament, Minister of Town and Country Planning, Lewis Silkin, set the ambition for the New Towns to: ‘combine… the friendly spirit of the former slum with the vastly improved health conditions of the new estate, but it must be a broadened spirit, embracing all classes of society…a new type of citizen, a healthy, selfrespecting, dignified person with a sense of beauty, culture and civic pride.’ 1

It’s difficult to imagine a minister today giving such a passionate speech recognising the ‘wider determinants’ of health and wellbeing and their pivotal role in creating healthy, thriving places. It’s a vision for homes and communities that we need now, more than ever.

For 125 years the TCPA has emphasised the importance of embedding health and wellbeing within placemaking – a core aspect of the Garden City Principles.2 A strong financial and moral case for this continued focus today is supported by a wealth of evidence showing how the quality of our homes and neighbourhoods directly and indirectly impacts both our mental and physical health. It is estimated that poor quality homes alone cost the National Health Service (NHS) £1.4 billion every year.3 Meanwhile, the disconnect between planning and health persists, with governments consistently failing to put health at the centre of planning policy and legislation.4

As the general election approaches, both the Liberal Democrats and Labour Party have committed

to building new Garden Cities or New Towns if they get into power, presenting an opportunity for ambitious, healthy new settlements. This provides an opportunity to reunite planning and health in the creation of new communities. With that in mind, what can we learn from the New Towns programme about planning for healthy new towns today?

The New Towns Act 1946 was part of a post-war settlement that included the Town and Country Planning Act 1947 and the foundation of the welfare state. A programme of new settlements, and the foundation of the NHS5 were key to creating a healthier new future for the nation – a project the Garden City movement had laid the foundations for half a century earlier.

In 1938, Dr Norman Macfadyen,6 Letchworth’s first resident doctor and its first medical officer of health, was arguing that the ‘inevitable strain of life can be eased by good housing conditions, good working conditions, good opportunity for the enjoyment of leisure, freedom for proper rest, with the proper opportunity for fresh food’.7 The New Towns were upscaled in their size and ambition from the Garden Cities, with an entirely different delivery model, one led by government and underpinned by long-term public sector loans, but the legacy of the Garden City ethos for healthy places remained – a proposition supported by modernism, which was also to have a huge influence on the New Towns.

Lewis Silkin, MP

© National Portrait Gallery

Designing healthy places

The design ethos of the New Towns was to create socially balanced communities that integrated employment, homes and social life to provide opportunities for all. Whilst each New Town is distinct, and some later development corporations intentionally sought to break the mould in respect of design, there are some common New Town design characteristics which intentionally promoted healthy lifestyles.8 The zoning of industrial and residential areas would distance residents from the polluting noise, smells and traffic of industry. Pedestrians and vehicles were often separated into different networks allowing people to move freely and safely from place to place; with underpasses and overpasses making it unnecessary to cross busy roads. Excellent pedestrian and cycle links would encourage people to walk to work or to local services. Homes were provided in neighbourhood units, served by local centres, with key amenities a short walking distance from homes. The landscapeled approach to master-planning, a key legacy of the Garden City movement, meant networks of green infrastructure, from formal parks and gardens to green verges and ancient woodland would provide identity and provide residents with access to nature, and separate pedestrian and transport routes.

The development corporations also put a huge emphasis on community development and space for community facilities and the arts. This meant locating community facilities within a short walking distance of homes and using multifunctional spaces (a school doubling up as a community centre in the evening, for example). The corporations encouraged participation in the arts and had officers tasked specifically with welcoming new residents and setting out opportunities for social activities. There is some debate about whether the ‘new town blues’ (isolation felt by some early residents, particularly those who were not working) was real or manufactured by the media, but these measures were designed to improve mental health and wellbeing and foster a positive social life, an early form of social prescribing. It was important that facilities were established early on, with homes converted to community buildings to welcome the earliest residents.

Healthcare provision

The story in relation to healthcare provision and medical services in the New Towns is more complex. A 1966 conference of the Office of Health Economics and College of General Practitioners discussed in detail what went wrong with medical provision in the early New Towns, calling it a ‘major missed opportunity’ 9

Frank Schaeffer’s 1970 account of the New Towns story10 provides some insight. He notes that the

Reith Committee on the New Towns had assumed that health centres would be built in the New Towns – a general requirement, imposed by §21 of the National Health Service Act 1946. Most of the New Towns reserved land for this purpose at the outset, but it appears that, for the early New Towns, they did not materialise. It also took many years for maternity services to be provided in the early New Towns, despite many having some of the highest birth rates in the country because they attracted young families. There were at least two notable exceptions – in Harlow and Corby – where the Nuffield Provincial Hospitals Trust stepped in. It financed a diagnostics centre at Corby and invested significantly in a series of health centres and an industrial health service at Harlow.

Health innovation in Harlow

Just over ten years after its 1947 designation, Harlow Development Corporation officers were promoting the town as a possible blueprint for the future of healthcare.11 Thanks to the Nuffield Provincial Hospitals Trust, in 1952 Harlow’s Mark Hall neighbourhood became home to a temporary health centre, located in two converted houses on the estate. Providing a range of services in close proximity to residents, the success of the pilot led to the Trust financing the building and equipping of several permanent centres, providing complete medical cover for the whole town, short of full hospital care. The first three opened in 1955.

The Trust also provided funding for the Corporation to co-operate with the industrialists in providing a headquarters for the Harlow Industrial Health Service. This experiment in co-operative medical care for medium-sized and small factories was run by a not-for-profit association with a widely representative council. It was staffed by industrial nursing sisters and the general practitioners of the town, so they could look after their patients not only in their homes and at their surgeries in the health centres, but also in the local authority clinics and at work.

By the time of the later New Towns, such as Milton Keynes, the focus upon healthcare provision had evolved. The Plan for Milton Keynes (1970) outlined how proposals for the development of health services in the new city ‘represent an important step forward in the organisation of medical care’ 12 The plan advocated continuity of care through an integrated team bringing together all the professions and

Special issue: health and new towns

institutions concerned with health services in the new city, including the Development Corporation, through a Health Services Liaison Committee. The joint working party of the group co-ordinated reports and recommendations on buildings, finance and the development of particular services. Health centres would be provided in the local centres providing primary medical care, alongside a range of services from child, student and mental health to ‘care of the elderly and physically handicapped and environmental health’. A district general hospital was planned to service the sub-region as a whole, but by the middle of the 1970s there was still no local hospital. A campaign under the banner ‘Milton Keynes is Dying for a Hospital’ was started. This resulted in the building of Milton Keynes Hospital, which officially opened in 1984.13

It is unfortunate that the early innovations in architecture and design that materialised in the New Towns did not extend more widely to modern healthcare provision; particularly given the contemporary exploration of new ways of preventing ill-health through projects such as the Pioneer Health Centre in Peckham, which used observation of real families in a social setting to identify the crucial role played by the environment in promoting health.14 It appears that opportunities for imaginative experiment and built in research were lost due to ‘a lack of foresight, poor communication, and liaison between lay and medical professionals’ – issues familiar to those labouring to unite health and planning today.11

In recent years the TCPA has worked with both Harlow and Milton Keynes in developing their health and wellbeing strategies, which will inform their expansion and renewal. Harlow remained a focus for healthcare when Public Health England announced in 2020 that it would locate itself there.15

The New Towns today

Today, the New Towns provide homes for over 2.8 million people and exhibit a range of successes and failures, including as they do both the fastestgrowing and most successful places yet also some of the most deprived communities in the UK.16

The New Towns have clear positive legacies of green infrastructure, accessibility (by road, bicycle, and foot), social housing, community development, built heritage and architectural interest, innovation, and a spirit of ‘going for growth’; but what impact has this legacy had on health? The TCPA has not yet explored this in detail, but our work with New Town local authorities provides some clues.

Census data from 2011 suggested that the (self-declared) ‘general health’ of residents in the New Towns was broadly consistent with UK averages, but of course the detailed picture is more complex.17 Whilst pockets of deprivation in the New Towns are

Craiglinn Underpass, Cumbernauld – before, during and after its transformation. The council used public art and worked with local pupils to change the physical appearance and perception of its underpasses.

Special issue: health and new towns

due mainly to wider social and economic policy, there are aspects of the legacy of their design and delivery that present challenges to people leading healthy lifestyles today. In many New Towns, the ease of movement for vehicles afforded by their layout, the generous provision of parking in town centres, and issues with public transport all tend to discourage active travel (i.e. walking, wheeling and cycling). Combined with the rising popularity of driving over the decades, this has made the private car the most convenient mode of transport for many New Town residents.

The build quality of the housing estates varied as a ‘push for the new’ introduced experimental housing designs with varying degrees of success. Whilst some have become celebrated for their longevity and architectural interest, the use of cheap materials and experimental designs in some early homes meant leaky flat roofs and poor insulation for residents from the offset. Building all at once and at speed has also led to the need for whole estate renewal, a costly burden for local authorities. Key active travel design elements, such as pedestrian underpasses connecting town centres to parks and gardens, are in some New Towns a positive deterrent to walkability due to poor maintenance and fear of crime.

One of the most visible and enduring legacies of the New Towns is their green infrastructure.

These assets provide important resources for renewal and climate resilience for many New Towns, but for others a valuable resource has become a maintenance burden. For those places where expensive regeneration schemes are yet to be secured, a lack of stewardship of the public realm contributes to negative perceptions, including of personal safety, which may prevent the use of certain routes and spaces. In addition, generous industrial land allocations and town centre offices have made the New Towns vulnerable to the exploitation of expansions to permitted development rights (PDR). Places such as Harlow are home to some of the most shocking examples of conversion to unhealthy homes using PDR.18

Conceptualisation of Public Health England’s plans for Harlow, 2020

Entrance to Addison House Group Practice and Clinic Centre, Harlow, 1959

There is a huge opportunity in the creative renewal of existing New Towns. Using their legacy as a catalyst for renewal and making design features work positively for people could allow them to become exemplars of good public health and sustainability. Some authorities are already exploring this possibility. Active travel features such as narrow underpasses are being made to feel safer and therefore more usable by innovative arts projects, which use light and public art to make them more attractive.8 Peterborough benefits from a land stewardship scheme, which focuses upon the protection and restoration of natural resources through cooperation between private landowners and the community at large.19 Towns like Cumbernauld are using their strong landscape design to encourage people to venture outdoors as part of measures to address health inequalities.20 Our work in Peterlee has explored opportunities for greening the public realm and repurposing of green infrastructure in relation to food and biodiversity to improve health and wellbeing.21

An opportunity not to be missed

It is clear that the New Towns succeeded in providing decent homes and jobs for millions of people in places which enabled healthy lifestyles. Design and maintenance challenges are not unique to the New Towns, but it is evident that the common legacy challenges around town centres, the (mis) management of the public realm, ageing infrastructure and fragmented land ownership resulting from the dispersal of assets when the development corporations were wound up have impacted negatively upon opportunities for maintenance and renewal.

In relation to health and healthcare, some core messages emerge:

• The importance of high ambition and a strong, clear vision for healthier places and innovation, with political buy-in;

• Adopt a holistic approach which combines designing for healthy lifestyles, a commitment to high standards of design and maintenance, and provision for community development as part of a strategy for long-term stewardship;

• Design places flexibly to allow for healthcare technology;

• Commit to and deliver the coordination of healthcare provision across sectors and between authorities, and;

• Recognise the crucial role of monitoring, evidence and research.

The TCPA’s research about reuniting health and planning, and initiatives such as the NHS Healthy New Towns programme have sought to recapture the sense of innovation in relation to healthcare in new communities. Its findings are explored in

detail elsewhere in this edition of Town & Country Planning

Our Shared Future – a TCPA White Paper for Homes and Communities 22 outlines how a new programme of New Towns could learn the lessons from the past to create places which are exemplars of health and sustainability. As we wait for the election year to unfold, here’s to avoiding missed opportunities and hoping that the UK government can recapture the ambition of the post-1945 New Towns programme and seizes the opportunity to ensure that those delivering new settlements are ‘daring and courageous in their efforts to discover the best way of living’ 23

• Katy Lock MRTPI is Director – Communities (FJ Osborn Fellow) at the TCPA.

Notes

1 New Towns Bill. HC Deb 8 May 1946, vol. 422, col. 1091. https://api.parliament.uk/historic-hansard/ commons/1946/may/08/new-towns-bill

2 See: https://www.tcpa.org.uk/garden-city-principles/

3 Healthy Homes Principles – what’s the evidence? Town & Country Planning Association, Jun. 2023, p.1 https:// www.tcpa.org.uk/wp-content/uploads/2023/02/ HH-principles-and-evidence-2.pdf (see also ‘BRE report finds poor housing is costing NHS £1.4bn a year’. Webpage. Building Research Establishment Ltd, 9 Nov. 2021. https://bregroup.com/press-releases/bre-reportfinds-poor-housing-is-costing-nhs-1-4bn-a-year/)

4 The Levelling Up and Regeneration Act: neither effective nor democratic. Blog. Town & Country Planning Association, 30 Nov. 2023. https://www.tcpa. org.uk/the-levelling-up-and-regeneration-act-neithereffective-nor-democratic/

5 National Health Service Act, 1946. https://www. legislation.gov.uk/ukpga/Geo6/9-10/81/enacted

6 Obituary: Norman Macfayen MB DPH. British Medical Journal, 1959, 2:1105, 21 Nov. 1959 https://www.bmj. com/content/2/5159/1105.1

7 N Macfadyen: Health and Garden Cities. In Town & Country Planning, Tomorrow Series Paper 14, Mar. 2013, p.7 https://www.tcpa.org.uk/wp-content/ uploads/2021/11/Health__Garden_Cities_TSP.pdf

8 See Lock K and Ellis H: New Towns – The rise, fall, and rebirth, 1st Edn., RIBA Publishing, 2020

9 J Beatson Hird: ‘Failures and hopes in medical care. The Provision of General Medical Care in New Towns’. In J Fry, J McKenzie (eds.): Proceedings of a symposium. Office of Health Economics. In Town & Country Planning, 1967, Aug.-Sep., p.429. https:// archive.tcpa.org.uk/archive/journals/1960-1969/1967/ july-september-48/1605149-tcpa-journal-no-8-9-augustseptember-page-0047?q=health%20new%20towns

10 F Schaffer: The New Town Story, MacGibbon & Kee, 1970

11 SJ Lake Taylor: ‘The Health Centres of Harlow’. Town & Country Planning, 1959, Jan., 17-20 https://archive.tcpa. org.uk/archive/journals/1950-1959/1959/january-march37/1541961?q=health%20new%20towns

12 Llewelyn-Davies Weeks Forestier-Walker & Bor. The Plan for Milton Keynes Volume One. Milton Keynes Development Corporation, Mar. 1970, p.61 https://www. theplanformiltonkeynes.co.uk/the-plan

13 ‘Our History’. Webpage. Milton Keynes University Hospital NHS Foundation Trust. 19 Aug. 2021. https:// www.mkuh.nhs.uk/about-us/our-history#:~:text=A%20 campaign%20under%20the%20banner,was%20 officially%20opened%20in%201984

14 ‘The Peckham Experiment’. Webpage. The Pioneer Health Foundation, 3 Feb. 2017 https://thephf.org/ peckhamexperiment

15 ‘About PHE Harlow’. Webpage. Public Health England. 17 Jul. 2020 https://www.gov.uk/government/ publications/phe-harlow-science-hub-proposals/ phe-harlow-science-hub-proposals

16 ‘A New Future for New Towns – Lessons from the TCPA New Towns Network Including Five-Minute Fact Sheets’, Town & Country Planning Association. Aug. 2021, pp.4, 11 https://www.tcpa.org.uk/wp-content/ uploads/2021/11/nfnt_final004-1.pdf

17 Ibid., p.10

18 ‘These are homes photobook’. Webpage. Town & Country Planning Association. Provocation paper, Feb. 2023. https://www.tcpa.org.uk/resources/these-arehomes-photobook/

19 ‘Peterborough County Stewardship’. Webpage. Peterborough County Stewardship, 2023. https://www. peterboroughcountystewardship.org/about-us

20 ‘Cumbernauld Living Landscape’. Webpage. Scottish Wildlife Trust, 2024. https:// cumbernauldlivinglandscape.org.uk/

21 ‘Peterlee: The Place to…Bee – A new future for Peterlee – Prospectus, December 2003’. Town & Country Planning Association, Dec. 2023 https://www.tcpa.org. uk/wp-content/uploads/2023/12/TCPA-PeterleeProspectus-23.pdf

22 Our Shared Future – a TCPA White Paper for Homes and Communities. Town & Country Planning Association, Jan. 2024. https://www.tcpa.org.uk/wp-content/ uploads/2024/01/TCPA-White-Paper-OUR-SHAREDFUTURE_160124.pdf

23 New Towns Bill. HC Deb 8 May 1946, vol. 422, col. 1090. https://api.parliament.uk/historic-hansard/ commons/1946/may/08/new-towns-bill

How municipal greenspace in Peterlee might be repurposed for food, biodiversity and leisure

TCPA

Cumbernauld — a town with history

Failure to work with nature and incorporate nature into design

will

result in a continual cycle of biodiversity loss and poor mental health, warns

Tracy Lambert

Cumbernauld was designated as a New Town on 9 December 1955 and was built to support approximately 70,000 residents.1 Building began in the 1950s on the top of one of the town’s hills, a location that became the town centre with some architecture that has not stood up well to the test of time.

The residential neighbourhoods of Kildrum, Carbrain and Seafar were also built in the 1950s. Abronhill, Ravenswood, Greenfaulds and Cumbernauld Village would see expansion in the 1960s, and by the end of the 1970s Condorrat and Westfield were complete. The last council-built area of Eastfield was completed in the 1980s and the remaining residential neighbourhoods on the north side of the M80 motorway, were constructed by private developers until about 2021.

Interestingly though, Cumbernauld may have been a settlement from as early as 81CE, possibly associated with the succession of forts built along the Antonine Wall.2 Now a UNESCO World Heritage Site, the wall was built by the Romans to confine the Picts to the north and marks the northernmost frontier of the Roman Empire. In the following centuries, kings and queens would visit ‘Commernalde’, one of the largest

castles in Europe,3 to enjoy hunting and other royal pursuits.4 Many people think that the town didn’t exist until the 1950s, but we have a deep and sometimes dark history here.

I was a child of eight when I moved to Cumbernauld from the east end of Glasgow. Leaving the old, cramped tenements behind with their shared gardens and middens and moving to a place with your own back and front door, gardens and wide-open fields with very little housing surrounding you; at the time was an incredible adventure. I would wander within a four- to five-mile radius, along farm tracks and through woodlands searching for butterflies and following rabbits and birds along hedgerows trying to find their homes.

It was a childhood wrapped up in the bliss that was nature, but as the town developed, we began to lose more and more of those open fields. My wanderings were reduced because I now had to navigate my way through other housing schemes which somewhat burst my exploring bubble. I felt less safe as more people migrated to the area; the environment around me was becoming cramped. My path and line of sight now had to navigate the twists and turns of housing developments and people I didn’t know. My exploration zone had receded to approximately half a mile.

Bringing the landscape to life

The feeling and acknowledgment of reduced space for movement is something that drives me in my role with Cumbernauld Living Landscape.5 This partnership initiative is led by the Scottish Wildlife Trust, which manages four wildlife reserves in the town and is, together with North Lanarkshire Council, the largest landowners of greenspace in Cumbernauld. Other partners are The Conservation Volunteers, who bring expertise in working with communities; Sanctuary Scotland, which is the largest social housing landlord in the area; and the James Hutton Institute, which

Cumbernauld Town Centre

©

CC Interbeat

contributes expertise in monitoring and evaluation.

I have been with the Living Landscape since its launch in 2013, most recently as Project Manager for the Creating Natural Connections project, funded through the National Lottery Heritage Fund. This project recently came to an end after delivering landscape scale change through the restoration and enhancement of urban peatbogs, woodland and wildflower meadows. This conservation work linked together with three distinct areas of engagement:

• education and training for outdoor learning;

• taking action for the environment through volunteering, and

• improving mental health.

What we found is that each of these streams of work have contributed to improving people’s mental

health. Path works not only meant that people could avoid getting their feet wet and muddy, but also helped to reduce the risk to visitors of trips and falls when walking around our parks and reserves. By paying attention to the routes that people wanted to take, rather than the ones already provided, we determined that there was demand for a path linking a reserve to an old blaes pitch.6 The residents had been asking for a path for years and it was well received when our project delivered it.

Alongside the path is a drain for runoff with wildflower seeds sown on the freshly excavated soils. One issue that we see with access routes is the path becoming overgrown with vegetation – mainly grasses which require regular mowing. Sowing wildflowers reduces the grass sward, attracts pollinators and increases species composition. The wildflowers require only one cut per year with the risings removed through cut and lift regimes, which are essential to ensure the habitat stays species rich. Decomposing vegetation returns high levels of nitrogen back to soils. Removing the cuttings prevents the build-up of nitrogen, which prevents wildflowers from thriving. The wildflower buffer also reduces the need for intense spraying with glyphosate. A win-win-win for landowners, visitors to the area and pollinators.

Restoring habitat

Habitat restoration, particularly of woodland, divided the opinion of residents during this project, with some people angry because we were removing trees. It’s human nature to feel an emotional connection to

The Launch of Cumbernauld Living Landscape 2013

Clearing invasive dogwood

© Scottish Wildlife Trust

© Tracey Lambert, Scottish Wildlife Trust

Special issue: health and new towns

trees and an instinctive reaction to object to them being felled. However, there are many cases where this is the right thing to do. Many of the trees planted in the 1950s were non-native species that support very little wildlife. Amid a biodiversity crisis, it’s essential that we make all trees work for nature as well as for people. Replanting with native species of tree is therefore a very positive action to take.

Throughout our project, we selectively thinned non-native species, some of which were diseased or storm damaged. By planting native broadleaf species in between the remaining trees, we have created a

varied age structure and have left some open glades to create a mosaic of habitats. This variety of habitats will increase the biodiversity and resilience of the area, as well as providing people with a space to visit and enjoy, thereby bringing health and wellbeing benefits too.

In total, we have planted over 13,000 native broadleaf trees in Cumbernauld, as well as restoring three urban peatbogs and managed over four hectares of wildflower meadows. The project has also encouraged residents to get involved by volunteering to clear scrub on peatbogs, plant trees and scythe wildflower meadows.

An intrinsic link

We know through extensive studies that increasing biodiversity helps improve people’s wellbeing7 and we know that increased urbanisation brings challenges for biodiversity and for maintaining good mental health.8 It is possible to strike a successful balance between the two, but this thinking must start at concept stage and be enforced throughout project design and delivery.

All too often we see developers stating that they will incorporate existing greenspace and woodland into their designs, only to change their minds due to costs or having to cut down the woodland to gain access for construction. Whilst promises of supplementary tree planting are positive, it takes

Ravenswood Local Nature Reserve link to Red Blaes pitch

Winter is a wonderful time for a Wild Ways Well walk

© Duncan Clark, Scottish Wildlife Trust

© Paul Barclay, The Conservation Volunteers

centuries for a woodland to fully mature and be able to support the wealth of native wildlife that depends on it. The new National Planning Framework 4 has the potential to greatly improve nature’s standing in developments, if it is properly implemented.9

The loss of greenspace in Cumbernauld is becoming a concern. Ten years ago, a mapping exercise was conducted to examine how much greenspace there was within the Living Landscape boundary. This included woodlands, parks, reserves, gardens and farmland. We found that the town was 50% green, making it one of the greenest towns in Scotland. Since 2012, approximately ten new housing sites have been or are in the process of being built out – two of which are in the South Cumbernauld Community Growth Area10 – with the potential to add up to an additional 2,000 new homes.

We still need to establish the impact that these developments will have on the remaining green spaces in the town , but it is estimated that we have lost approximately 15% of it. This loss of greenspace has a huge effect upon the health and wellbeing of the residents of the town. Some individuals have vocalised their discontent at the number of new developments being permitted, but many others will be affected insidiously because of the increasing disconnect with nature brought about by having fewer greenspaces to enjoy.

Wild Ways Well

Our final method of improving health and wellbeing was to engage residents in activities that would encourage them to get outside, explore their surroundings, learn about the local habitats and wildlife and subtly take them out of their comfort zones. We achieved this through education, volunteering and the green health and wellbeing programme known as Wild Ways Well.11 While each of the engagement streams contributed to improving health and wellbeing, Wild Ways Well focused solely on mental health.

Programme sessions include a walk, an activity and some social time. Participants meet at a predetermined location in an open space or close to the town centre for familiarity and convenience. The walk then heads off to a reserve or nearby woodland – places that can take people out of their comfort zones.

Comments from participants indicated that they would not normally walk to or through such sites due to concerns about personal safety. When we investigate these concerns, we find that the greenspaces are in fact safe, leading to the conclusion that this feeling of threat is a societal perception. Nevertheless, it’s a perception that coalesces into the belief that greenspaces are unsafe and this begins to haunt greenspaces, creating a culture of fear around using them.

Broadwood community planting day

© Vass Media

To counter this, routes through greenspaces should have a good line of sight and the foliage chosen to line the routes should be native, low maintenance and preferably slow growing. Planting near paths and housing is better with a cascading edge, with smaller species closer to paths and larger species further back. This allows more light to penetrate the walking route and creates a sense of openness, whilst still biologically diverse and supportive of local wildlife.

This cascading edge idea has been trialled by the Scottish Wildlife Trust’s Reserves Manager for Cumbernauld to great effect. Residents have commented that they feel safer when trees are not going to fall close to their houses during the increasingly frequent storms that we are experiencing, and they are happy to have more light in their gardens and homes. Conversely, there are areas outside of reserves in the town where the trees are now taller than the flats they grow next to, putting main living rooms in near constant shade. Residents have been asking for the trees to be reduced in height for years, but to no effect because the trees are healthy and are considered to contribute to good human mental health.

There is a balance required in all things but there is no reason why this cannot be achieved through forethought and good design. Creating good quality design in New Towns is imperative if residents are to be healthy and happy and if communities are to thrive without negatively impacting upon biodiversity. Failure to work with nature and incorporate nature into design will result in the continual cycle of biodiversity loss and poor mental health. We have the knowledge to achieve so much more for the benefit of all.

The following are lessons we learned during the years of Cumbernauld Living Landscape and should be of interest to other practitioners:

Access

• Engagement and inclusion are vitally important. For access, talk to people in the locality to understand their frustrations and how they might be addressed by good quality design that will stand the test of time. The feeling of stewardship gives confidence and a feeling of being part of a welcoming community always contributes to good mental health.

• Where are the clear routes that people are using but that do not constitute formal paths? Do these desire lines better define these routes in comparison with the formal paths network?

• Desire lines often become routine walking routes, but they begin to fragment habitat and cause endless destruction of often sensitive areas. Working with the public should help define the routes that are important to them whilst allowing for the protection of habitat through engagement.

• ‘Ground truth’ the area – how do you feel walking that route and would you walk it at 11:00pm? If not, why not?

• Try to create a buffer between paths and

vegetation. This overgrowth issue is one which crops up time and time again for us. Messy, unkempt routes put people off from engaging in active travel because they think it is neglected and possibly unsafe. A large part of this is education and steering people away from the Victorian ideal of having everything in neat rows. The continual maintenance is extremely labour intensive and costly, too.

Habitats

• Work with nature not against it, include it in engagement.

• The right tree in the right place; don’t plant trees next to houses, think of the canopy spread of the tree; the target of its fall at maturity, and the spread of the roots that could damage underground infrastructure and lift paving slabs. This is a huge worry for residents.

• Make greenspaces accessible to all from day one. Include cycle lanes and paths wide enough for prams, wheelchairs and cycles in the design. Retain hedges, meadows and trees. Everyone should be able to access good quality greenspace within a 5-10 minute walk of their home.

• Make greenspaces within development accessible for the people who will maintain them. Could machinery easily be moved in when required? It is all too easy for an area to become neglected if the mower cannot get in to cut the verges or an arborist cannot gain access to undertake emergency tree works. These works are necessary to show residents that greenspaces are being looked after. Without access to them, they will degrade.

• Add a buffer between homes and greenspaces. Prevent residents from inserting gates into their garden fence to allow informal access to reserves (specified in title deeds preferably). All too often damage to greenspaces happens as a direct result of the use of a back garden gate. Prevent this at the concept, design and planning stages. This should prevent the spread of invasive species and the degradation of habitat that reduces biodiversity.

Engagement

• Give people agency to make decisions about design and listen to them. All too often, residents are asked their opinions only to have them ignored. There are some comments which are within reason and not impossible to achieve.

• Engage with the nearby landowners. Current planning conditions only require consultation with the landowner if there is an existing dwelling. We have found to everyone’s cost that failure to engage with landowners delays projects and causes difficult issues which take time to resolve.

• Engagement is a requirement of planning and

should be the first port of call. Set up a sustainable form of citizen stewardship, ideally built around an existing community group with allied objectives.

Biodiversity

• Support native biodiversity and plant native species as a priority. Non-native double headed flowering plants and trees do not support pollinators; they simply cannot get into them. Non-native trees offer little for our native wildlife and in some cases cause disease or create toxic soils.

• Create a mosaic of habitats; give nature and people a variety of habitats at the right scale for both to thrive. Higher biodiversity delivers improved mental health.

• The current UK government list of native trees12 is incompatible with conditions in Scotland. If working in Scotland, specify planting schemes that utilise native Scottish species13 to support our native biodiversity.

• Better connectivity for wildlife increases biodiversity. For example, provide hedgehog and amphibian tunnels under roadways for safe migration. Incorporate bird boxes and swift bricks into new build homes as a standard planning condition. For many, the influx of swifts is the herald of spring. People notice this, and it lifts their spirits up. Swifts have been declining and this is such an easy fix.

• Tracy Lambert is Project Manager for the Cumbernauld Living Landscape Creating Natural Connections project. All views expressed are personal.

Notes

1 Cumbernauld, North Lanarkshire – ‘Mark One’ New Town – Designated 9 December 1955. Town and Country Planning Association, 2023. https://www.tcpa. org.uk/wp-content/uploads/2021/11/Cumbernauld.pdf

2 PC Tacitus: The Germany and the Agricola of Tacitus – The Oxford Translation Revised, with Notes. ‘The Life of Cnaeus Julius Agricola’, §23, ftnt 99. Transcribed electronically by Project Gutenberg, 17 May 2013. https://www.gutenberg.org/files/7524/7524-h/7524-h.htm

3 ‘Cumbernauld Castle’. Webpage. Wikipedia. 15 Feb. 2023

https://en.wikipedia.org/wiki/Cumbernauld_Castle

4 ‘Elizabeth: January 1562’. In J Bain (ed.), Calendar of State Papers, Scotland: Volume 1, 1547-63. 1898, pp. 584-599. British History Online (subscription required). https://www.british-history.ac.uk/cal-state-papers/ scotland/vol1/pp584-599

5 ‘Cumbernauld Living Landscape’. Webpage. Scottish Wildlife Trust. 2024. https:// cumbernauldlivinglandscape.org.uk/

6 A type of sports field surfaced with crushed slate or granite, commonly used in Scotland for playing football and hockey.

7 M Hedin, A Hahs, L Mata, K Lee: ‘Connecting Biodiversity With Mental Health and Wellbeing – A Review of Methods and Disciplinary Perspectives’. Frontiers in Ecology and Evolution, Vol. 10-2022, 24 May 2022. https://www.frontiersin.org/articles/10.3389/ fevo.2022.865727/full

8 MR Marselle, DE Bowler, J Watzema, D Eichenberg, T Kirsten, A Bonn: ‘Urban street tree biodiversity and antidepressant prescriptions’. Scientific Reports, 31 Dec. 2020, Vol. 10, pp.1-11. https://www.nature.com/ articles/s41598-020-79924-5

9 National Planning Framework 4. Scottish Government. 13 Feb. 2023. https://www.gov.scot/publications/ national-planning-framework-4/

10 South Cumbernauld Community Growth Area. Strategic Development Framework. Supplementary Planning Guidance. North Lanarkshire Council. Approved 15 Jun. 2016. https://www.northlanarkshire. gov.uk/sites/default/files/2020-09/South%20 Cumbernauld%20CGA%20Strategic%20 Development%20Framework.pdf

11 ‘Wild Ways Well’. Webpage. NatureScot/NàdarAlba. 4 Oct. 2023. https://www.nature.scot/funding-andprojects/green-infrastructure-strategic-intervention/ projects/gi-community-engagement-fund-projects/ wild-ways-well

12 See: https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_data/ file/952066/Appendix_2_-_Species_list_-_Controlled_ and_Voluntary_-_updated_January_2021.pdf

13 G Patterson, D Nelson, P Robertson, J Tullis: Scotland’s Native Woodlands – Results from the Native Woodland Survey of Scotland. Forestry Commission Scotland, Jan. 2014, Annex 1 – Tree and shrub species native to Scotland, p.87. https://forestry.gov.scot/publications/74scotland-s-native-woodlands-results-from-the-nativewoodland-survey-of-scotland/download

Broadwood Loch

© Vass Media

healthy place shaping in Oxfordshire: our experience of shaping healthy communities

Dr Rosie Rowe discusses how, as part of the NHS England Healthy New Towns programme, ‘healthy place shaping’ is creating healthy, sustainable communities and reducing stark health inequalities across Oxfordshire

It is now eight years since, in March 2016, it was announced that two sites in Oxfordshire – the market town of Bicester, and Barton on the urban fringe of Oxford – had been selected as two of the ten demonstrator sites1 for NHS England’s Healthy New Towns programme. This initiative aimed to put health at the heart of new neighbourhoods and towns by future-proofing new communities for the health and care challenges of this new century – obesity, dementia, and new models of digital health – by designing in health and modern care from the outset. In common with all other demonstrator sites, Bicester’s Eco Town (Elmsbrook) and Barton Park were at an early stage of development, either still developing a master plan or starting to bring forward the first phase of new homes. They both sought to create an exemplary built environment and establish

vibrant communities that promote healthy, sustainable lifestyles for all ages. Although the NHS initiative was branded as an innovation programme, to many observers it may have seemed like little more than good placemaking, seeking to fulfil a long-standing purpose of good planning, namely the maintenance and improvement of public health2. However, our experience of developing healthy place shaping in Oxfordshire, firstly through the NHS pilot and then by seeking to embed this approach across the county, has shown that it constitutes a wider approach, which delivers benefits not only to residents living in new development, but also to the existing population.

Healthy place shaping (HPS) in Oxfordshire has been ambitious in its vision, scale and scope right from the outset. We define HPS as a systems-wide approach, which aims to create sustainable, well

Built environment natural play area and SUDS, Barton Park

Oxfordshire County Council

designed, thriving communities where it is easy to be healthy and which provide a sense of belonging, identity and community. In practice our ambition is to create communities where healthy behaviours are easy, fun and affordable – where being active, eating healthy food, and being a good neighbour are part of normal daily life. Designing-in healthy living to shape the built environment so that it promotes health and wellbeing, prevents illness and keeps people independent is one of three strands to healthy place shaping. The other two strands are essential to

ensure that HPS addresses existing health challenges and inequalities in local communities. The second strand: community activation involves working with locally based people, community organisations, businesses and schools to engage them in developing places, facilities and activities which create health. This strand is essential to ensure that people reap the benefits of a health enabling environment. The third strand: new models of care involves re-shaping health, wellbeing and care services, and the infrastructure which supports them, with the aim of preventing future poor health and a decline in wellbeing.

Our experience in Oxfordshire is that, whilst each strand of HPS is important, the greatest benefit to health and wellbeing is generated when all three strands interact. This is exemplified by our experience of delivering interactive wayfinding. Use of wayfinding and walking trails to promote walkable neighbourhoods is a recognised feature of good urban design but how do you ensure that people who are most inactive actually use them? Health data can identify ‘least active’ neighbourhoods where such trails would be beneficial. However, community activation means that routes can be co-designed with local people, including their location and appearance and the nature of lines and signs. Testing them out with the support of local community groups helps to engage target populations that need to become more active. Local GPs can encourage patients to use the trails for their health benefits and this demonstrates the importance of linking health services into these initiatives.

Zoo trails wayfinding map, Kidlington

Oxfordshire County Council

Oxfordshire County Council

Wayfinding cues for the ‘lion trail’, Kidlington

Special issue: health and new towns

The resulting benefits, not only to wellbeing but also in terms of promoting community connection and a sense of belonging, have been significant. An external evaluation of the social return on investment of interactive wayfinding in Kidlington found that, for every £1 invested, £18 of wellbeing was generated –an excellent return – showing how cost effective this intervention can be. Qualitative data such as the following shows the impact on family lives:

‘I am writing to you to give amazing feedback on your new health walks in Kidlington. My daughter is usually extremely lazy, to the extent that she would want to catch the bus a couple stops but already she wants to walk, scoot and cycle everywhere. It’s a MASSIVE thumbs up from us!’

This example highlights two key aspects of HPS that are critical to its success. Firstly, it needs to take

Box 1

The Marmot Principles

• Give every child the best start in life;

• Enable all children, young people and adults to maximise their capabilities and have control over their lives;

• Create fair employment and good work for all;

• Ensure a healthy standard of living for all;

• Create and develop healthy and sustainable places and communities, and

• Strengthen the role and impact of ill health prevention.

a place-based approach and, secondly, it must involve a wide range of partners, extending well beyond planners and others working in statutory services.

With both demonstrator sites, we were clear from the outset of the Healthy New Town programme that this work could not be limited to the red lines of development sites, it needed to take a whole place approach. In Bicester this meant considering the health needs of the entire population of 30,000 (2016). In Barton this involved ensuring that new development addressed the deep health inequalities in the neighbouring community, which is one of the 20% most deprived in England. By applying HPS to existing Oxfordshire communities, as well as new development, we have been able to use it as a mechanism for addressing health inequalities and key health challenges in the existing local population as well as promoting good health and well-being for new residents. By working with existing place based partnerships we have been able to engage a much wider range of stakeholders. Town and parish councillors, local businesses, schools and nurseries, community and voluntary sector organisations – all playing a key role

Box 2

Healthy Place Shaping Principles

• Place based approach: agreeing with local people the natural scope of any place-based action is fundamental – in some places a neighbourhood or ward level action may make more sense rather than a whole town.

• Partnership working: all key partners with an influence over aspects of the system that needs to change must be actively involved and have effective working relationships.

• Local engagement and ownership: a sense of local ownership is critical to engagement and success, and early investment in this is vital. Co-production needs to be embedded from the outset to ensure local engagement.

• Asset based approach: focusing on the assets of a place, both physical and social, so that you recognise and build on the strengths of communities.

• Focus upon reducing health inequalities: proportionate universalism means that initiatives can be community wide but with greater resource being made available for those with greater need.

• Alignment of purpose with existing priorities: alignment with local priorities, as well as wider national priorities and targets, promotes both engagement of key partners and progress in the development and implementation of HPS.

• System leadership: HPS can act as a system connector and coordinator. Taking a system perspective promotes collaboration and ensures that decision making has involved system-wide perspectives. This leadership role has been supported by investment in network infrastructure.

• Programme management: sufficient, dedicated time and resource for senior-level leadership and management is vital, as is dedicated project office time.

• Dedicated and flexible funding: a recent evaluation identified that HPS is a cost effective approach to prevention, but some dedicated resources are needed to support the delivery of initiatives in a place. A certain degree of flexibility in the use of this funding is needed to enable plans and priorities to change as required, including in response to changes in the system.

• Evaluability: a clear evaluation plan needs to be developed in the early stages of any programme of activity with learning informing its delivery in an iterative way.

Special issue: health and new towns

as they are deeply invested in the success of their local communities. They bring to place-shaping different assets, skills, and resources that can extend the reach of place shaping initiatives and ensure that they are effective. In this way HPS can act as a catalyst for bringing organisations as well as individuals together with the shared aim of creating a healthy place. It also helps residents to realise that growth can benefit existing communities, not only those living in new development.

This wide engagement is also needed to address the complex system of interrelated factors that shape people’s health. The basic building blocks of health – education, work, food, transport, access to nature, the bonds of family, friends and community networks – account for 80%3 of our health and wellbeing. Weaknesses in this system have contributed to persistent and worsening inequality across the UK.

This was brought sharply into focus by the impact of the COVID-19 pandemic and was made even more acute by the subsequent cost of living crisis. In 2010, the Marmot review4 identified that poor health does not arise by chance and is not simply linked to genetic make-up, unhealthy lifestyles and a lack of access to medical care. Although these factors are important, the greatest contributors to poor health are the differing social, environmental and economic conditions of local communities and their places. The review sets out six policy objectives5, reproduced in Box 1, that contribute to a healthy environment and that address unfair and unjust inequalities in health.

Wider place-based partnership working is needed to collectively address these wider determinants of health in order to achieve these policy goals, thereby cementing into place, through healthy place shaping, the basic building blocks of health in places of greatest need.

In 2019, system leaders from across health, care and local government came together at the end of the NHS pilot and decided that HPS must not only be sustained in the two demonstrator sites but also scaled up across Oxfordshire. This strong, ongoing political and strategic support has been critical in terms of ensuring that HPS delivers its impact both ‘on the ground’ in communities as well as being embedded in professional praxis such that it becomes

an established way of working that influences policy, strategy and future development in the long term.

One of the weaknesses of the NHS pilot programme was its short time frame, which reflected neither the longer-term development cycle nor the extent to which time is required to deliver measurable reductions in health inequalities. The evaluation of the pilot programme identified ten key principles which formed the HPS approach and which have subsequently been applied to HPS programmes in different communities. These are summarised in Box 2.

The learning from HPS has also informed health policy and planning policy. At a county level, Oxfordshire’s Health & Wellbeing Board Strategy 2024-30 6 and the Local Transport and Connectivity Plan 2022-50 7 have identified creating healthy communities as a strategic priority and is reflected in policy requirements. At a district level, Oxfordshire’s emerging and adopted Local Plans contain priorities which directly relate to healthy place shaping principles and include a range of policies and proposals that will support the creation of healthy communities. Public health and planning policy officers have worked together in Oxfordshire to identify a set of planning policies which will support the creation of healthy environments. These are identified in Box 3.

Of particular importance is that district and city policies have identified the need for a health impact assessment (HIA) to be made for all strategic or major development proposals. The HIA identifies and takes account of the health status and needs in the area and provides information about how development should improve health and wellbeing. We have produced a local Health Impact Assessment Toolkit8 and Guidance Note9 to support planners and developers to undertake and assess the quality of HIAs, with their use being endorsed by all the constituent local planning authorities in 2021. The relationships developed between health and planning over the last eight years mean that we have generated a range of resources10 that provide guidance to planners on health issues. In turn, planners support us to influence the content of planning applications at an early stage to ensure that proposals create a health promoting environment. This includes providing guidance to developers on the type of health data they need to consider when undertaking HIAs, which is updated on an annual basis as part of the Oxfordshire Joint Strategic Needs Assessment11

So, what has been the impact of HPS? Although health outcomes at the population level can take many years to change, particularly when poor health is multi-generational, we have identified a series of indicators that will show whether HPS is having a positive impact on issues such as levels of loneliness/ isolation, sense of community connection, strength of the community and voluntary sector, as well as some

Oxfordshire County Council

Community social ride

Special issue: health and new towns

Box 3

HPS Planning Policy Principles

Major development, urban extensions and regeneration schemes must contribute towards shaping healthy communities by demonstrating that they adhere to the following principles to deliver high quality sustainable places.

Development must:

• address the existing and projected health and wellbeing needs of an area, including addressing health inequalities, avoiding and mitigating any adverse health and sustainability impacts.

• design in opportunities for people to be more active and to improve air quality.

• enable good mental wellbeing through reducing social isolation and loneliness by encouraging social community infrastructure and opportunities for people to meet and connect with one another.

• enable easy access (within 10 minutes of where people live) to nature-rich green spaces to enable connection with nature, to promote physical and mental health and wellbeing and to deliver multiple benefits for people, place and the environment.

• mitigate and adapt to climate change.

• provide diversity in the residential offer that improves accessibility, affordability, offers high quality design, and promotes inter-generational connectivity and lifetime neighbourhoods.

• provide adaptable homes with adequate amenities/room sizes and thermal/sound insulation which can accommodate change and support independent living.

• make it easier for people to make healthier food choices by promoting access to fresh, healthy and locally sourced food, and by avoiding over-concentration of hot-food

behavioural factors such as healthy eating and physical activity. A recent independent evaluation found that scaling HPS across Oxfordshire has had many positive impacts; has been well-received by the community and has been associated with positive behaviour change likely to influence health and wellbeing. It is a good use of public funds because its implementation is not resource intensive. The common purpose to deliver on HPS using a system wide approach has positively influenced public policy in ways that are likely to influence health and wellbeing in the long term. However, it also recognises limitations. For example, planning applications approved eight or ten years ago are now bringing

takeaways, restricting their proximity so that they are up to 600m walking distance of schools, town centres or other facilities where children, young people, and families gather.

• enable inclusive social, environmental and economic growth which supports local employment and other meaningful activity.

• consider existing community assets that could be enhanced to help promote health and support the provision of multi-functional community facilities and co-location of services at appropriate geographical level.

• be designed to allow universal accessibility, making it easier for everyone to maintain their independence throughout their life course.

• encourage and support the provision of sport and leisure facilities to help communities live active lives.

• ensure that development is appropriately phased with health promoting infrastructure, such as footpaths and cycle paths, provided in the first phase so that people are supported to adopt healthier day-to-day lifestyle habits when they move into new developments.

• recognise that residents in neighbouring communities need to be actively engaged in the design of major developments so that they are better integrated with existing communities, enhance their sense of place and promote community cohesion. Developers need at the earliest stage of housing delivery to provide community development support for place based social activities that encourage good physical and mental health for local people and promote social connectivity.

• work with local stakeholders to co-produce communities which people value because they have character and a local distinctiveness, which are attractive places to live and work, which promote a sense of identity, and where people feel safe and comfortable.

forward development that is not health enabling and the quality of the existing housing stock means that many of Oxfordshire’s residents do not enjoy a safe, warm, secure home. Healthy place shaping is a key mechanism for creating healthy, sustainable communities and reducing the stark health inequalities in Oxfordshire but we need to continue to invest time and resource if these connections between health and planning are to generate the benefits to health and well-being that our residents need.

• Dr Rosie Rowe PhD MSc (Econ) MA is Head of Healthy Place Shaping at Oxfordshire County Council. All views expressed are personal.

Special issue: health and new towns

Notes

1 See https://www.england.nhs.uk/ourwork/innovation/ healthy-new-towns/demonstrator-sites/

2 See https://ukhsa.blog.gov.uk/2017/07/06/improvingpeoples-health-through-spatial-planning/

3 CM Hood, KP Gennuso, GR Swain, and BB Catlin: ‘County health rankings: Relationships between determinant factors and health outcomes’. American Journal of Preventive Medicine, February 2016, Vol. 50 Issue 2, pp.129-135. https://doi.org/10.1016/j. amepre.2015.08.024

4 M Marmot, J Allen, P Goldblatt, T Boyce, D McNeish, M Grady, I Geddes: Fair Society, Healthy Lives: The Marmot Review; Strategic Review of Health Inequalities in England post-2010. February 2010, p.16. https://www.instituteofhealthequity.org/resourcesreports/fair-society-healthy-lives-the-marmot-review

5 Ibid, p.15

6 See Health and wellbeing strategy 2024-2030 | Let’s Talk Oxfordshire https://letstalk.oxfordshire.gov.uk/ health-wellbeing

7 See Local Transport and Connectivity Plan | Oxfordshire County Council https://www.oxfordshire. gov.uk/residents/roads-and-transport/connectingoxfordshire/ltcp

8 See https://futureoxfordshirepartnership.org/projects/ oxfordshire-health-impact-assessment-toolkit/

9 See https://futureoxfordshirepartnership.org/wpcontent/uploads/2021/01/Briefing-Note-for-LocalPlanning-Authorities_Feb-23-update.pdf

10 See https://www.oxfordshire.gov.uk/residents/ social-and-health-care/public-health-and-wellbeing/ healthy-place-shaping/built-and-natural

11 See https://insight.oxfordshire.gov.uk/cms/healthyplace-shaping

Oxfordshire County Council

Community launch of the ‘zoo trails’, Kidlington

Oxfordshire County Council

Built environment community growing space, Elmsbrook, Bicester

all’s well that ends WELL

Evidence-based frameworks such as WELL are becoming an increasingly influential design tool at multiple scales – buildings, neighbourhoods, and communities – to drive a more holistic focus on health, says

Andrew Sansom

Post World War II Britain has largely been a period of rising living standards for working families. Supported by the shift to a service-based economy, the declining incidence of industrial disease, and medical advances, life expectancy broadly has moved steadily upwards. Since 2010, however, progress has stalled – indeed, in a recent study,¹ the Institute of Health Equity found that between 2014 and 2017, healthy lives lived had stagnated for men, and fallen for women. The upshot is that as people live more of their later years in poor health and with multi-morbidities, healthcare services are becoming increasingly stretched.

One response from governments and health agencies has been to focus upon upstream societal factors, including healthy housing and financial support, to shape downstream factors, such as smoking and poor diets. This focus on wider health determinants is a reminder of the role of the built environment in shaping health. Several voluntary standards have emerged that underline the health credentials of new developments and communities, reinforcing the link between health and the financial worth of building projects.2

This year marks the tenth anniversary of the launch of the WELL Building Standard, a performance-based system for measuring, certifying, and monitoring features of the built environment that impact health and wellbeing. Now delivered by the International Well Building Institute (IWBI), and currently on its second iteration (WELL v2), the standard addresses myriad aspects of design, operations, and strategy, with more than 100 features grouped under ten core concepts: air; water; nourishment; light; movement; thermal comfort; sound; materials; mind; and community. Each concept considers factors that impact wellness, and each feature is informed by scientific evidence and industry data. The verification process involves the review of proposals at the design stage. At project completion stage, outcomes are validated through on-site inspections and testing, with a final score awarded. More details on the

certification and rating process can be found on the IWBI website.3

Behavioural influence

Certain WELL concepts sit outside the traditional realm of the designer or planner, but by edging into areas of behavioural design, the impact upon health can be elevated. The concept of nourishment is one example. Ann Marie Aguilar, senior vice-president, EMEA (Europe, Middle East and Africa region) at the IWBI, has suggested that designers should liaise with catering consultants to explore healthier food and drink options, and encourage consultants to be transparent about the food they serve to clients and tenants.

‘Nutrition is something architects and engineers are not typically responsible for in a building, yet it has a huge impact on people’s health,’ Aguilar noted. ‘Mindful eating, or healthier food choices, should be designed in, not thought about afterwards.’ 4

In 2016, University of Twente researcher Elizabeth Nelson and property firm CBRE undertook a study to explore workplace health opportunities for strengthening worker potential. A healthier office environment was designed for employees, who were tested daily on their mental effort and energy levels, comparing them with a control group. After a twomonth baseline measurement, the project began modifying employees’ environments with a different focus each month – adding plants to workspaces; changing lighting; offering nutritious snacks; and encouraging physical and mindful activities. All changes were designed to help employees become more focused at work.

‘We were studying consultants, who are the number-two most stressed and burned-out industry behind doctors,’ Nelson explained, in a talk at the 2017 Healthy City Design Congress. ‘What we saw with the control group was that they were heading towards a dangerous area [of mental exertion]. They were at a point that wasn’t sustainable. We saw that

the test group not only avoided this [pre burned-out stage] but actually improved in a number of areas.’ 5

On extrinsic motivation, the healthy test group increased up to 17% over the baseline, and the control group decreased in motivation. There was another unexpected effect – participants continued with healthy behaviours outside of work. ‘The research proved to be infectious’, Nelson said. ‘Participants not only drank more water at the office, they also opted for water with fruit rather than soft drinks or coffee even when at home... The healthy adaptations influenced their time spent at the office but also their free time.’ 6

To help shape healthier communities using behavioural cues, urban planners should look to such real-life studies and healthy building frameworks like WELL. One might see an infectious effect here, too, if those experiencing healthier workplaces also demand that health is designed into their housing, neighbourhoods and towns.

Community focus

The growth of standards, tools and frameworks in the built environment arena helps to advance professional understanding of planning healthy places.7 Using the WELL Building Standard as a foundation, the WELL Community Standard aims to impact the health of individuals throughout public spaces.

To meet the WELL Community Standard,8 projects must meet at least two of the following conditions:

• planned daytime or night-time population of 500 people or more;

• planned total floor area of 50,000 square metres or more;

• planned total building count of ten or more;

• total land area of two hectares or more.

Since the Community Standard is also designed for mixed-use developments, projects must also include at least two of the following:

• multi-family residential – at least one building with five or more dwellings;

• office and/or retail – at least one space employing at least five people;

• public recreational and/or leisure use. At least 0.4 of a hectare in total. Accessible from dawn to dusk and comprising one or more spaces, each of at least 0.02 of a hectare.

In a 2017 paper, experts from engineering services company Stantec noted how WELL had begun pairing with established ‘green’ standards, such as LEED and BREEAM, to promote healthier built environments. They highlighted how the world’s first WELL Platinumcertified building, CBRE’s Los Angeles headquarters, ‘exemplifies this with active seating, exposed stairs, indoor plants, and workplaces with ample views and natural light’. 9

This had an impact, too, at the masterplanning

level. ‘At the urban scale, the first WELL Community is currently being planned in Tampa, Florida to scale these strategies up for multiple buildings and shared public spaces,’ they said.‘This marks a shift in our thinking about buildings and cities as interchangeably responsible for impacting health in all aspects of life, including work, play and living.’ 9

In September 2023, that project, Water Street Tampa, was finally realised, achieving WELL Community Standard certification for implementing health-conscious and community-focused elements throughout the neighbourhood. Aspects included improving walkability with double-wide sidewalks and streetlevel experiences; monitoring air quality; fostering community engagement through public art and free events; increasing access to drinking water through water stations; increasing access to healthy foods via farmers’ markets; introducing bike lanes and free fitness classes; incorporating native landscaping; and limiting light and noise pollution.10

Standards in unison

Speaking at the 2017 Healthy City Design Congress, Alan Fogarty, a partner at engineering firm Cundall, also emphasised tackling health and wellbeing and sustainability in unison. ‘There’s no point talking about healthy buildings if the outside isn’t, and at this moment, we do have a lot of issues in regard to sustainability,’ he said.11

In 2015, the firm had to decide whether to renew its occupancy agreement at its London Hatton Garden offices or relocate near to St Paul’s. Air quality and chemical composition had been regularly monitored at the existing office, but Fogarty saw the appeal in relocating across town if it meant customising a space to raise the bar on wellness through WELL. There were some challenges, however, particularly in meeting an American-based standard in the UK and ensuring flexibility.

‘Furniture suppliers couldn’t tell whether they met the standards, so the most straightforward thing was to have a local joiner make all the desks, cupboards, etc.,’ said Fogarty. So, except for some chairs procured from Spain, all desks and tables were custom-built.12

An internal report on introducing potted plants highlighted a large decline in CO₂ concentrations, and an increased air exchange rate of almost 11%.

Heron apartment interior, Water Street, Tampa, Florida

Achieved formaldehyde levels were less than a hundredth of the threshold for WELL, and ozone levels around a tenth of the permissible limit.

Fogarty’s team were also able to provide drinking water at high purity levels, with improved taste and appearance known to encourage increased water consumption by staff and to reduce reliance upon bottled water.

Visitors appreciated the office’s open planes, soft light and calming sounds – for example, the birdsong soundscape playing in reception; a planted wall that reduced ventilation by 11%; and reflective coatings that brought in ‘30% more daylight’ than a standard floorplan.

For Cundall, its WELL investment amounted to about €200 per person in 2018 – a small price to pay to avoid the potential losses associated with recruitment and retention. Indeed, Cundall London demonstrated a return-on-investment from WELL status within just three months, based solely on reductions in sick leave and attrition.

A post-occupancy staff survey highlighted improvements across several metrics, with more employees agreeing that the new workplace promoted the company’s values and a sense of community; provided an enjoyable environment; and enhanced perceived wellbeing and productivity.

Sustainability, equity and inclusion

Whilst the crossovers of sustainability and human health between standards are positive factors, there are caveats. According to urban planning academic Dr Helen Pineo, it’s important to assess whether built environment standards sufficiently address notions of sustainability, equity and inclusion, in addition to how far they deter those with local knowledge from helping to shape new development. Pineo noted that while these standards can influence healthy development at multiple scales and motivate those taking design decisions to opt for healthier or greener materials, they also risk preserving a static view that remains overly focused upon the health of the occupants of a building to the point where the health of communities, ecosystems or the planet are neglected.13

‘There are likely to be trade-offs if a healthy built environment standard is prioritised over a sustainability standard and these tensions require further research,’ Pineo reasoned. ‘A multi-scalar perspective of health impacts is needed to ensure that new buildings are supportive of health in terms of sustainability, equity and inclusion.’ 13

through a proposed amendment, led by Lord Nigel Crisp, to the Levelling Up and Regeneration Bill.

On sustainability, the TCPA’s Healthy Homes principles call for all new homes to secure radical reductions in carbon emissions in line with the Climate Change Act 2008. Furthermore, all new homes must demonstrate how they will be resilient to a changing climate over their lifetime.

Inclusivity is referenced in the Healthy Homes principles by the need for the design of all new homes and their surroundings to be inclusive, accessible and adaptable, and to meet the needs of all. They should also be built in places that prioritise and provide access to sustainable transport and walkable services, including green infrastructure and play space.

Equity is covered, too, with all new homes being built to be secure – designing out crime – and to be free from unacceptable and intrusive noise and light pollution. This principle aligns with the ‘Sound’ and ‘Light’ elements of the ten concepts of the WELL Community Standard, whereby projects should:

• facilitate noise exposure assessment with planning for acoustics, techniques to reduce sound propagation, and hearing health education, and

• help maintain levels of illumination for roads and walkways, including strategies for limiting light pollution, light trespass, glare, and discomfort.

Other commonalities between the WELL Community Standard and the Healthy Homes principles relate to air, movement, and thermal comfort.

The link between decent building and housing standards and human health is also relevant to social justice. Living in poor-quality homes can literally be a death sentence, as highlighted by the tragic case of two-year-old Awaab Ishak, who died in December 2020 from a severe respiratory condition caused by exposure to mould in his Rochdale home.15

Disappointingly, in late October 2023, the TCPA amendment to the Levelling Up Bill failed to win sufficient parliamentary support, albeit by a narrow margin. Government spokesperson Earl Howe observed that while there is consensus in Whitehall regarding the importance of the quality of homes, the Government disagrees that further legislation is necessary.

Countering that many policies are not mandatory and that the amendment sought to put health and wellbeing at the heart of planning, Lord Crisp said:

‘My point is simply that this is nowhere in planning, and the idea that the built environment should not in some way promote health, safety and wellbeing seems extraordinary. It is equally extraordinary that in this entire Levelling Up Bill, there is no reference to the climate crisis, as we have just heard, or indeed to the public health crisis.’ 16 Special

These aspects of sustainability, equity and inclusion, along with more traditional building standard and human wellbeing elements, such as thermal comfort and access to natural light, are also evident in the Healthy Homes principles,14 which underpin the TCPA campaign to promote healthy homes – initially through a Healthy Homes Bill and subsequently

WELL for residential

Increasingly, health is becoming a non-negotiable factor when purchasing a home. According to a November 2020 report from the US-based New Home Trends Institute, 57% of homeowners valued health and wellbeing over energy savings, and 69% placed greater priority on physical and mental health than they did in the year before the pandemic.17

In addition to the WELL Building Standard and WELL Community Standard, the IWBI has just launched its WELL for Residential programme, which offers more than 100 strategies to create homes that prioritise resident health, comfort and wellbeing.18 Twenty-five pilot participants have committed to implementing WELL for Residential across nearly 30,000 residences.

In November 2023, London real estate developer City Sanctuary Developments became an early adopter of WELL for Residential with its Albion Court project. City Sanctuary is keen to explore how to apply the standard’s elements of air, light, and mind, amongst others, within the context of a historic building, where design interventions may be restricted. The developer describes its designs as seeking to ‘combine the latest neuroscientific research in areas like air quality, natural light and sleep, with observations of how people use spaces’ 19

Social sustainability

Against a backdrop of rising societal expectations and changing regulations, companies and investors are also focusing increasingly upon social sustainability – the ‘S’ in the ESG Framework20 and the process of identifying and managing business impacts, both positive and negative, on people.

Social sustainability correlates with commercial opportunity and risk in real estate. To help investors and companies prioritise social sustainability, the IWBI partnered with GRESB,21 a global ESG benchmark for real estate and infrastructure. The partnership seeks to improve reporting and disclosure capabilities across several social metrics, including health, equity and wellbeing, by:

• developing resources to help investors, companies and asset owners to incorporate social performance into the investment engagement process;

• co-creating a social sustainability dashboard with performance indicators that integrate data from the GRESB Real Estate Assessment, and

• convening stakeholders to explore best practice and reporting structures that support interventions for social sustainability.

Moreover, through a deeper integration of health, wellbeing and social equity within sustainability strategies and reporting, it’s envisaged that existing ESG frameworks will also narrow the social sustainability gap. Kelly Worden, IWBI vice-president of ESG commented:

‘By working together, we can serve as a pivotal force in promoting this shared mission, helping guide investors and organisations in navigating the complexities of social sustainability.’ 22

In October 2023, the IWBI partnered with the Royal Institution of Chartered Surveyors (RICS) to encourage adoption of strategies that advance health and wellbeing in buildings and organisations globally. The two bodies vowed to engage their networks in opportunities to support occupant health and wellbeing through WELL and the RICS International Building Operating Standard. This partnership will champion thought leadership in health and wellbeing in properties, and pledge to advance benchmarking, regulatory frameworks and standards.

For the IWBI, Ann Marie Aguilar said: ‘Our joint efforts will help to highlight the rising importance of health and wellbeing in buildings, organisations and communities, and how strategies to integrate health into the valuation process can improve ESG performance.’ 23

This collaboration builds on efforts between both bodies to highlight the benefits of prioritising health and wellbeing, including through a paper, ‘The design, delivery and management of healthy buildings’, 24 which sets out a roadmap for organisations to deliver ESG, as follows:

• appoint an internal health and wellbeing champion;

• co-ordinate an internal workshop or appoint an expert third party to lead the initiative;

• draw up health and wellbeing pillars under a company-wide ESG strategy;

• define health and wellbeing interventions in development briefs, design guides and operational guidance;

• brief design teams and operations teams on key requirements and how to achieve and record them;

• monitor delivery of health and wellbeing outcomes;

• review schemes against health and wellbeing targets, and

• carry out post-occupancy monitoring and implement lessons learnt.

Special issue: health and new towns

Albion Court, London

City Sanctuary

Success factors

In 2018, Deloitte’s 1 New Street Square development in London was verified under WELL, with its success founded in early engagement. Deloitte engaged the developer on base-build modifications to consider wellbeing principles; recruited a design team keen to challenge convention, and undertook extensive consultation.25

Environmental design features included performancebased design to prioritise energy efficiency and comfort; creating an operational energy model to inform energy-efficient design and procurement, and developing thermal, acoustic, daylight and circadian lighting models to optimise working conditions.

However, it was through its wellbeing features that the project came into its own. Firstly, it focused upon designing-out air pollution by requesting that suppliers assess their products against air quality and environmental criteria prior to approving their procurement. Deloitte also worked with its facilities provider to ensure that it used low-toxicity cleaning and maintenance products. Secondly, mindfulness was addressed through biophilic design, which included introducing 6,300 plants in 700 displays, 140 square metres of green walls, and the extensive use of timber and stone. Thirdly, movement was promoted through base-build alterations, such as fitting internal stairways; procuring 600 sit/stand desks; creating a 365-bay cycle facility, and installing a large gym. Fourthly, Deloitte’s restaurant developed a new menu with healthier foods, with fruit and filtered water subsidised.

Commenting on the value of early engagement, Deloitte explained:

‘Not only does this remove the idea that sustainability is a ‘nice to have’ or an ‘add-on’ but it also helps designers integrate sustainability and wellbeing measures in their design from the offset. This often results in a much more cost-effective way to implement sustainability and wellbeing, as well as better performance outcomes for the people who will be utilising the space.’ 25

External stimuli

But what’s the role of WELL in the post-pandemic world of work? Much has been made of the health benefits of working from home – a trend accelerated by the pandemic – by eliminating the daily commute and providing workers with greater autonomy. However, a 2020 report revealed that many people became wearier when remote working with people entirely through screens when compared with interacting in person. For some, the sense of being permanently ‘on call and connected’ can be less empowering and more stressful than working in an office, whilst the intrusion of work into the home may lead to longer hours and higher burnout rates.26

Moreover, homeworking can impact wellbeing though changes in the brain.‘People spending all day on endless video calls are suffering from deprivation of their neural networks,’ said the report. ‘They’re being deprived of emotional and behavioural cues, seeing colleagues only through a screen without direct eye contact; and they’re being deprived of external stimuli that are normally provided by commuting and the random encounters of office life.’ 26

By this token, standards such as WELL will be crucial in making a return to the office more attractive to workers, whilst for employers, it may be crucial in achieving productivity gains.

As experts advocating a smart-cities approach to planning concluded: ‘Cities are greater when the sum of their parts are working in unison, moving us towards achieving social equity and improving the human experience.’ 9

Standards such as WELL are one element – and an increasingly influential one – to help drive a more holistic and unified approach to strengthening the connections between public health and wellbeing and urban planning and design.

• Andrew Sansom is Editorial Director at SALUS Global Knowledge Exchange, a knowledge community focused on designing a healthier society and a more sustainable planet. All views expressed are personal.

Notes

1 ‘One million people in England living shorter lives than they should’. Website. UCL. 8 Jan. 2024. https://www. ucl.ac.uk/news/2024/jan/one-million-people-englandliving-shorter-lives-they-should

2 H Pineo: Healthy Urbanism: Designing and Planning Equitable, Sustainable and Inclusive Places. Palgrave Macmillan, 2022, p.41

3 ‘WELL v2TM’. Webpage. WELL Inc., Autumn 2023. https://v2.wellcertified.com/en/wellv2/overview

4 L Young: ‘The Well Building Standard: getting the measure of health and productivity’. Chartered Institution of Building Services Engineers, ICIBSE Journal, Apr. 2016. https://www.cibsejournal.com/ general/the-well-building-standard-getting-themeasure-of-health-and-productivity/

5 E Nelson: ‘Healthy offices, healthy life at work’.

1 New Street Square, London

DeLoitte and Constructing Excellence

Special issue: health and new towns

Presentation to SALUS Global Knowledge Exchange

Healthy City Design International Congress, London, 16-17 Oct. 2017. Recording available at: https://salus. global/article-show/healthy-offices-healthy-life-at-work

6 W Oosting: ‘People perform 10% better in a healthy office’. Webpage. CBRE. 15 May 2017. https://news.cbre. nl/people-perform-better-in-a-healthy-office/

7 H Pineo: Healthy Urbanism: Designing and Planning Equitable, Sustainable and Inclusive Places. Palgrave Macmillan, 2022, pp. 209-211

8 ‘WELL Community Standard’. Webpage. WELL Inc., Autumn 2023. https://v2.wellcertified.com/en/ community/overview

9 G Borthwick, R Schebesch, A Sabherwal, B Jackson: ‘The measure of intelligence is the ability to change’. Presentation to SALUS Global Knowledge Exchange Healthy City Design International Congress, London, 16-17 Oct. 2017. Full text available at: https://salus. global/article-show/the-measure-of-intelligence-is-theability-to-change

10 ‘Water Street Tampa Becomes First WELL Certified Community in North America’. Press release. International WELL Building Institute, 7 Sep. 2023. https://resources.wellcertified.com/press-releases/ water-street-tampa-becomes-first-well-certifiedcommunity-in-north-america/

11 A Fogarty: ‘WELL designed: the first project in Europe certified to the WELL building standard’. Presentation to SALUS Global Knowledge Exchange Healthy City Design International Congress, London, 16-17 Oct. 2017. Recording and slides available at: https://salus. global/article-show/well-designed-the-first-project-ineurope-certified-to-the-well-building-standard

12 ‘Cundall Office, One Carter Lane’. Webpage. International WELL Building Institute, 18 May 2018. https://resources.wellcertified.com/articles/cundalloffice-one-carter-lane/

13 H Pineo: Healthy Urbanism: Designing and Planning Equitable, Sustainable and Inclusive Places. Palgrave Macmillan, 2022, pp.211-212

14 ‘Healthy Homes Principles’. Webpage. Town & Country Planning Association, Feb. 2023. https://www.tcpa.org. uk/resources/healthy-homes-principles/

15 D Finch, J Farrington-Douglas, C Johnes: Moving to healthy homes. The Health Foundation, 20 Dec. 2023. https://www.health.org.uk/sites/default/files/pdf/202312/2023%20-%20Housing%20and%20health_0.pdf

16 ‘The fight for healthy homes will go on!’. Webpage. Town & Country Planning Association, 24 Oct. 2023. https://www.tcpa.org.uk/the-fight-for-healthy-homeswill-go-on/

17 M Sharp, J Lantz, A Seng: ‘Healthy Homes – Product Gaps and Opportunities’. Webpage. New Home Trends Institute, Nov. 2020. https://jbrec.com/wp-content/ uploads/2020/11/Healthy-Homes-BP-Version.pdf

18 ‘IWBI launches WELL for Residential Program with 25 pilot participants and nearly 30,000 enrolled homes’. Press release. International WELL Building Institute, 30 Jan. 2024. https://resources.wellcertified.com/ press-releases/iwbi-launches-well-for-residentialprogram-with-25-pilot-participants-and-nearly-30-000enrolled-homes/

19 ‘City Sanctuary Joins IWBI’s WELL for Residential Program’. Press release. 3BL CSR Wire, 10 Nov. 2023. https://www.csrwire.com/press_releases/788181-citysanctuary-joins-iwbis-well-residential-program

20 ‘Environmental, social, and corporate governance’. Webpage. Wikipedia. 26 Jan. 2024. https://en.wikipedia. org/wiki/Environmental,_social,_and_corporate_ governance

21 ‘Actionable ESG data and benchmarks for financial markets’. Webpage. GRESB. 2024. https://www.gresb. com/nl-en/

22 ‘IWBI and GRESB Announce Partnership To Accelerate Social Sustainability’. Press release. 3BL CSR Wire, 20 Dec. 2023. https://www.csrwire.com/press_ releases/791546-iwbi-and-gresb-announce-partnershipaccelerate-social-sustainability

23 ‘IWBI and RICS announce collaboration to integrate health and wellbeing into built environment sector’. Press release. International WELL Building Institute, 12 Oct. 2023. https://resources.wellcertified.com/ press-releases/iwbi-and-rics-announce-collaborationto-integrate-health-and-well-being-into-builtenvironment-sector/

24 J Rogers (ed.): The design, delivery and management of healthy buildings: a practical guide. Royal Institution of Chartered Surveyors, 1st edition, Oct. 2023. https:// www.rics.org/profession-standards/rics-standards-andguidance/sector-standards/real-estate-standards/ the-design-delivery-management-of-healthy-buildings1st-edition

25 ‘1 New Street Square’. Webpage. World Green Building Council Case Study Library, 2024. https://worldgbc.org/ case_study/1-new-street-square/

26 The Puzzle of Wellbeing – Where Next for Workplace Wellbeing Post Covid-19?. 360 Workplace and WORKTECH Academy. 2020. https://cdn.worktechacademy.com/ uploads/2022/02/Fourfront-The-Puzzle-of-WellbeingReport_2020.pdf

Cundall, One Carter Lane, London

Cundall and Dirk Lindner

off the rails

Robin Hickman examines the discursive formation of transport planning in Singapore –including the control of vehicle ownership and use, and its potential for application elsewhere

controlling vehicle ownership and use

Imagine your personal spending in a time of financial crisis. You would probably set a budget, giving yourself a specific amount to spend each week, seeking to manage the flow of your outgoings. This would seem an eminently effective approach – to actually plan for how much you spend? This is what Singapore has been doing for decades, seeking to manage the number of vehicles on its roads, in view of severe space constraints for urban development and ongoing concerns about the environmental impacts of traffic growth.

Singapore is a city-state with a population of 5.9 million in 2023.¹ It is also wealthy; derived from its history as a maritime mercantile city, and today as a centre for the financial sector and tourism in Asia. There is, therefore, much latent demand for private vehicles. The latest mode share data for trips to work is from the 2015 household survey, with private vehicle use only (i.e. cars, motorcycles and scooters) at 25%; public transport (i.e. bus and/or mass rapid transit (MRT)) at 59%; walking and cycling at 13 %, and taxi/private hire at 3%.² For several years, private vehicle use has been dropping and use of public transport has been increasing. There remains, however, much potential for increased walking and cycling.

The strategic approach to urban planning and transport planning was initially developed in the 1971 Concept Plan, with the city centre, satellite new towns and industrial areas located in a ring around the coastline and central water body, separated by open spaces and linked by the highways and public transport. Updates to the Concept Plan in 1991, 2001 and 2011, a related White Paper in 1996, and a Land Transport Masterplan in 2008 and 2013, have furthered the initial approach that was set.³

The MRT system was introduced from 1987 and provided a much-improved public transport service adding to the previous bus system. Over 20 satellite

new towns have been built, accommodating much of the population of Singapore, e.g. Toa Payoh (developed from the 1960s onwards), Serangoon (1980s) and Tengah (2020s). The MRT system has subsequently developed into an extensive network. The current Long Term Plan⁴ outlines the strategic approach to urban planning and transport, with a continued focus on polycentric growth to avoid movements into the city centre. The Land Transport Masterplan⁵ provides the transport strategy, drawing on the 20-minute city concept and applying this to the island context. The aim is to develop a 45-minute city across the island, where access is possible to employment and wider activities across the city; and 20-minute towns, with access at the neighbourhood level to everyday activities, such as schools and local retailing.

Traffic demand management (TDM) is the real innovation in the self-described ‘car-lite’ approach, focused on the control of private vehicle ownership and use. Singapore introduced a road pricing system, known as the area licensing scheme (ALS), in 1975, which was initially paper-based. The ALS was replaced by electronic road pricing (ERP) in 1998. The current charges vary by the level of congestion, hence spatially and by time of day, but can be around S$10 dollars for each gantry passed in the peak. A vehicle quota system has been in place since 1990. This involves direct management of vehicle numbers. Individuals can apply for a certificate of vehicle entitlement (COE) and a charge is set relative to demand. Only slow growth in vehicle numbers was allowed in the early years and then a cap of one million vehicles was set in 2008, which is still broadly in place today.

Imagine such a cap being imposed in London, or indeed across the UK. This measure seems so obvious for transport planners who are trying to reduce reliance upon the private car. Of course, this policy approach is rarely used in cities beyond

Singapore, and certainly not in the UK. The COE has varied in cost over time, but is currently expensive, at around S$100,000 for a 10-year licence. In 2024, ownership of a typical small car, such as a Toyota Prius C, costing about S$20,000, involved a COE of around S$85,000, an additional registration fee of 110% (S$22,000) and customs excise import duty of 30% (S$6,000). So, the actual cost of owning the vehicle is about S$133,000 (or £78,000).

The COE is linked to the vehicle, hence a second-hand car is sold with the remaining years left of the COE. COE also provides a significant income stream, estimated at S$6.9 billion in 2016.⁶ Alongside further income from ERP and motor vehicle tax, this can be used to fund wider infrastructure development. The management of vehicle numbers and charging for road usage have become a normalised part of transport planning in Singapore, with a general acceptance that it has been effective in managing traffic volumes. Vehicle taxation and road pricing are, however, flawed policy instruments in distributional terms. They are regressive in facilitating higher-income drivers to pay the charges and to use the relatively freeflowing roads, whilst lower or even middle-income groups are dissuaded from car ownership. This also

seems to be an accepted discourse, as a regime of truth; that the road system is prioritised for higherincome car drivers. Nevertheless, the income streams are significant and this helps fund public transport and wider infrastructure for a larger number of users. So, the system can also be viewed as a tax on car drivers for hypothecation elsewhere.

In 2012, 40%of Singaporean households owned a private car. In 2022, this figure had fallen to 34%,⁷ which is much lower than countries with similar income levels. However, this overlooks that vehicles are shared within and between households and vehicle kilometres travelled are high, at around 18,000 km per annum.6, 8 Even so, the result is that car ownership is held at low levels and there are relatively few vehicles on the roads. Singapore is therefore a very interesting model of TDM, with the potential for application elsewhere.

Alongside the management of traffic, the MRT system is being continually extended, providing an integrated and easy-to-use network that serves most of the island, facilitating good access to the city centre and satellite towns. Usage is more equitable across population groups due to the good spatial coverage and fares are relatively low (S$2

TDM measures, including restrictions on vehicle ownership and use are very effective in reducing traffic volumes.

Robin Hickman

per two-hour maximum journey period). Most stations are accessible, with escalators and lifts available for people with mobility difficulties.

Still, there are tensions in the approaches taken to transport planning. The highway network is dense, with three and four lane highways throughout much of the urban area. There is a contradiction between providing so much highway space and managing use so strictly.⁹ There have been many expressway projects, giving gradeseparated highways between urban centres. There is landscaping of highway corridors, which improves their visual appearance. But, there are few attempts to reduce the amount of space given to vehicles, even in the historic central areas, with street space reallocation rarely attempted. Cycling provision is almost non-existent, and walking facilities could be much improved. The high cost of vehicle purchase and, thereby, restriction of this, gives car ownership high social status.

From the early 1970s onwards, Singapore set an early pace for progressive transport planning in Asia, with TDM, an extensive MRT, and integration with urban planning. For sure, road space could be reduced and there is much potential for improving active travel networks. This would improve the liveability of Singapore by addressing the physical

severance of neighbourhoods by wide highways and give space for walking and cycling. However, the current restrictions upon vehicle ownership and use are extremely effective – it is surprising that they are not more widely used in other places, beyond some of the cities in China.

Politically, Singapore is, of course, unique. Ruled as a parliamentary representative democratic republic, but with one party rule by the People’s Action Party (PAP) since self-governance in 1959 and independence in 1965. This is the episteme (unconscious structure) for policy making, facilitating an effective implementation of interventions, including some participation and debate about options, but with limits and controls on contestation.

You will argue that this type of TDM is impossible in the UK, that there would be too much political and public controversy. And, probably, you would be correct. Yet, we still require a meaningful debate about new ways of reducing vehicle numbers in cities.

We face a climate crisis and experience worsening social inequity. Restrictions upon private car use could assist in resolving both of these problems. Controlling vehicle ownership and use will not be the centrepiece of any political manifesto

The governance structure for the city-state is the episteme that facilitates innovative policy making and effective implementation, but also with limited opportunity for contestation.

Robin Hickman

during the upcoming general election campaign. Nevertheless, the transition towards sustainable urban mobility is happening too slowly and the necessary debates about potential options are being avoided. The scale of interventions required to reduce transport-related greenhouse gas emissions will require some difficult discussions and probably some, as yet, unpalatable interventions. In the meantime, we are all aware that we do not sufficiently respond to the great public policy challenges that are faced.

• Robin Hickman is Professor at the Bartlett School of Planning, University College London. He is Director of the MSc in Transport & City Planning. e: r.hickman@ucl.ac.uk. The views expressed are personal.

Thanks to Timothy Toh, Chris Donaldson and Paul Barter for a city tour and discussions on the Singaporean approach to transport planning. This article draws upon material from ‘Discourses on Sustainable Urban Mobility’ (UCL Press, forthcoming, 2025).

Notes

1 Population in Brief 2023. National Population and Talent Division, Strategy Group, Prime Minister’s Office, Republic of Singapore. Sep. 2023, p.6. https:// www.population.gov.sg/files/media-centre/ publications/population-in-brief-2023.pdf

2 General Household Survey 2015. Department of Statistics, Ministry of Trade & Industry, Republic of Singapore. Mar. 2016, p.43. https://www.singstat.gov. sg/-/media/files/publications/ghs/ghs2015/ghs2015.ashx

3 T Lim: Planning a Nation: The Concept Plan. Biblioasia, National Library, Republic of Singapore. 1 Oct. 2014. https://biblioasia.nlb.gov.sg/vol-10/issue-3/oct-dec-2014/ singapore-concept-plan/

4 Space for Our Dreams – Long-Term Plan Review 2021. Urban Redevelopment Authority, Republic of Singapore. 2022. https://www.ura.gov.sg/-/media/ Corporate/Planning/LTPR21/LTPR_publication.pdf

5 Land Transport Master Plan 2040 – Bringing Singapore Together. Land Transport Authority, Republic of Singapore. 2019. https://www.lta.gov.sg/content/dam/ ltagov/who_we_are/our_work/land_transport_master_ plan_2040/pdf/LTA%20LTMP%202040%20eReport.pdf

6 M Diao: ‘Towards sustainable urban transport in Singapore: Policy instruments and mobility trends’. Transport Policy, Sep. 2019, Vol. 81, 320-330. https:// www.sciencedirect.com/science/article/abs/pii/ S0967070X16307508

7 E Loi: ‘472,000 S’pore resident households owned cars in 2022, up from 459,000 a decade earlier’. Webpage. The Straits Times, 21 Nov. 2023. https://www. straitstimes.com/singapore/transport/472k-s-poreresident-households-owned-cars-in-2022-up-from459k-in-2012-chee-hong-tat

8 P Barter: ‘Singapore’s Mobility Model: Time for an Update?’ In Megacity Mobility Culture: How Cities Move on in a Diverse World. Institute for Mobility Research (ed.). Springer, 2013, pp.225-242. https://link. springer.com/chapter/10.1007/978-3-642-34735-1_12

9 P Barter: ‘Singapore’s Changing Relationship with Cars’. In S Hamnett, B Yuen (eds.): Planning Singapore: The Experimental City. Routledge, 2019. https://www. taylorfrancis.com/chapters/edit/10.4324/97813510582308/singapore-changing-relationship-cars-paul-barter?co ntext=ubx&refId=de520e87-3326-4604-87b5097aebde1bee

design matters

Misplaced optimism about the mandating of good design in 2008 does not mean that 2023 provisions to achieve to same outcome will also disappoint, Matthew Carmona explains

design coding — it’s the law!

Legislation with a focus upon design quality is rare. Only twice, that I know of, has design quality been singled out for a mention in English planning legislation. Usually, it is a matter for policy and guidance only, perhaps reflecting the ambivalence that successive governments have demonstrated towards the subject, or maybe because of a sense that design quality does not require the stick of legislation.

Almost exactly fifteen years ago I wrote a Design Matters1 with the title Good design – it’s the law!2 The piece focused on the first occasion that design quality found its way into legislation, care of the Planning Act 2008, which amended Article 39 of the Planning and Compulsory Purchase Act 2004. Amongst other things, this laid down a legal requirement that the Secretary of State, when setting out national planning policy, and a local planning authority (LPA), when exercising their development plan functions, should ‘have regard to the desirability of achieving good design‘. The instigators of these late amendments to the then Planning Bill in the House of Lords had hoped that local expectations would be raised and that henceforth good design would be viewed as an obligation rather than part of a wish list never actually delivered.

Unfortunately, the provisions were never publicised and were soon forgotten in the turmoil of the financial crash and the austerity years that followed. These swept away much of the urban design governance infrastructure (nationally and locally) that would have been required to put any enhanced practices into effect. The result was initially a lost decade when design quality declined and then stagnated as (too often) de-skilled LPAs allowed (too often) disinterested developers to deliver mediocre and poor quality housing development across the country.3 This was followed by five years in which we have witnessed a gradual re-engagement of government in design and some

attempt to row back on the ‘lost years’. Late last year it culminated in provisions of the Levelling-up and Regeneration Act 20234 (the 2023 Act) that for a second time (amongst many other things) sought to use national legislation to focus greater attention on design quality.

Will a legislative approach be any more successful this time?

The 2008 legislation amounted to little more than a rather amorphous and undefined assertion, which LPAs (and the Secretary of State) could interpret in many ways – or effectively ignore. The new legislation, by contrast, is more specific. Under the heading ‘Design code for whole area’ it states:

‘A local planning authority must ensure that, for every part of their area, the development plan includes requirements with respect to design that relate to development, or development of a particular description, which the authority consider should be met for planning permission for the development to be granted.’

The implication is (although it never quite says it) that each LPA should produce an authority-wide design code.

Once mandated (sort of), the requirement is immediately watered down with two provisos:

• that there is no need for design requirements for every description of development for every part of a local authority area, and

• that there is no need for requirements in relation to every aspect of design.

As with the previous legislation, there is a lot of interpretation in all of this. To my mind, this is actually quite sensible as I have always argued5 that LPAs should concentrate their limited design resources and efforts where it matters (preferably on key sites) and on the issues that are most important locally, starting with what they already have in place and building from there. At the same time, it results in a system in which every LPA will understand the requirements differently, opening the possibility that some hard-pressed LPAs will see the provisions as an invitation to ‘business as usual’. In other words, doing little or nothing beyond their existing – too often ineffective – policies and practices that are

design matters

failing to deal with poor quality design outcomes.

Perhaps anticipating this, the 2023 Act gives the Secretary of State powers to intervene where a LPA ‘fails to ensure design code’. However, does this simply lump discretion (what it means) upon discretion (where it applies) upon discretion (what form it will take) upon discretion (is it good enough)? The danger is that there is enough wiggle room for another 15 years of mediocre and poor quality design.

Will the legislation ensure better design quality?

The lesson from 2008 is that, in isolation, the 2023 Act will not deliver better design. So, what is different this time? The answer is the ongoing engagement of government that, in order to deliver on its objectives, will need to back the hard legislative provisions with soft persuasive efforts.

This seems likely, at least in the short-term, as the current government is four-square behind the requirement that design codes should be produced. The opposition (on current trends the next government) has also made overtures in this direction, suggesting potential for support over the long-term as well. Thus, from 2008 when the governments of the day failed to follow up on legislative provisions for good design, interest quickly and progressively shifted away from a concern for design quality. Conversely, in 2024, government and its new offspring, the Office for Place,6 are actively using their soft powers (information, persuasion, support, guidance, etc.) to help ensure delivery – at least of the design codes. Moreover, design codes, evidence suggests,7 can be a very effective means of promoting the delivery of better quality development.

I conclude this Design Matters with exactly the same words that I concluded the 2008 one.

‘As we know, good design is not something that is readily available off-the-shelf, it requires a skilled infrastructure on both sides of the development process, allied with a willingness to invest in the necessary time and resources to ensure its delivery. If we want it, we will need far more than lines on paper, no matter how influential, to deliver it. Nevertheless, as a further piece in an ever more sophisticated national framework that is pursuing better design, this legislation is to be welcomed. One can only hope that over time it has the profound impact on local practice that its originators desire to achieve.’

In 2008 my optimism was misplaced. Let’s hope that in fifteen years from now the provisions of the 2023 Act come to be seen as a turning point and, at that time, we can look back with a far more positive story to tell.

Design coding research, 2022

• Matthew Carmona is Professor of Planning & Urban Design at the Bartlett School of Planning, University College London. All views expressed are personal.

Notes

1 M Carmona: ‘good design – it’s the law!’. Town & Country Planning, 2009, Vol. 78, Feb., 98-99

2 ‘Good design – it’s the law’. Blog. M Carmona, 20 Dec. 2008. https://matthew-carmona.com/2008/12/20/ good-design-its-the-law/

3 ‘A housing design audit for England’. Blog. M Carmona, 21 Jan. 2020. https://matthew-carmona. com/2020/01/21/68-a-housing-design-audit-for-england/

4 See: https://www.legislation.gov.uk/ukpga/2023/55/ enacted

5 ‘Authority-wide design codes, four key questions (and answers)’. Blog. M Carmona, 6 Jul. 2022. https:// matthew-carmona.com/2022/07/06/89-authority-widedesign-codes-four-key-questions-and-answers/

6 See: https://www.gov.uk/government/organisations/ office-for-place

7 M Carmona, W Clarke, B Quinn, V Giordano: National Model Design Code (NMDC) Pilot Programme Phase One, Monitoring & Evaluation – final research report Department of Levelling Up, Housing and Communities, 2022. https://assets.publishing.service. gov.uk/government/uploads/system/uploads/ attachment_data/file/1083852/NMDC_M_E_final_report_ v5.pdf

Bartlett School of Planning, UCL

designing new communities for the 21st century

new towns: the rise, fall and rebirth

New Towns: The Rise, Fall and Rebirth

By Katy Lock and Hugh Ellis

Published by RIBA Publishing, May 2020, HB, 192 pp ISBN 978 1859469286, £40 Available through the TCPA website £40 including postage & packing 10% discount for TCPA members using the code MEMBER Visit www.tcpa.org.uk/shop/new-towns-the-rise-fall-and-rebirth

Often misunderstood, the New Towns story is a fascinating one of anarchists, artists, visionaries, and the promise of a new beginning for millions of people. New Towns: The Rise, Fall and Rebirth offers a new perspective on the New Towns record and uses case studies to address the myths and realities of the programme. It provides valuable lessons for the growth and renewal of the existing New Towns and post-war housing estates and town centres, including recommendations for practitioners, politicians and communities interested in the renewal of existing New Towns and the creation of new communities for the 21st century.