20 INSIGHTS FUTURE WATCH Care pathways
With the NHS showing increasing recognition of how the built environment contributes to the health of urban populations, Sébastien Reed reports on how it is promoting a holistic approach to planning ‘healthy new towns’
t a time when affordable housing is in such high demand, there is a danger that other priorities for urban planning fall by the wayside in the race to build in the necessary volumes. However there are loud voices reminding the UK that its housing crisis is being shadowed by a crisis in health – with a fast-ageing population the current age ‘pyramid’ ever increasingly resembles a mushroom, and the number of overweight and obese citizens has swiftly increased over the last 10 years to 63.8 per cent. This is echoing similar patterns across the world, leading
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the World Health Organisation to state: “Modern societies actively market unhealthy lifestyles.” Now, growing awareness of this health timebomb, against the backdrop of an NHS creaking under the pressure, is leading the Government to make more tangible interventions to try and address the problem. One way it is doing this is leveraging masterplanning of new towns to remedy some of the planning ills that may have contributed to unhealthy lifestyles. Traditionally the NHS has occupied a reactive, problem-solving stance based around primary care (GPs) and secondary care (district general hospitals), the latter fine-tuned to providing specialist care once a patient arrives at each individual department.
The scheme’s stated aim is to shape new towns, neighbourhoods and communities to promote health and wellbeing
By contrast, Healthy New Towns (HNT), a fast-developing scheme instigated by the NHS, is set to transcend former care frameworks of direct containment and treatment of disease, instead focusing on the development and maintenance of health via better-designed communities. This more subliminal – some might even say social engineering oriented – approach has been labelled as ‘the third era of health’, helping people to stay well, rather than stay alive.
The scheme presents a new challenge as well as opportunity
of ‘designing in’ healthcare benefits to our towns, offering the opportunity to creatively address the causes and incidence of key factors such as obesity, mental health, dementia, and ageing- associated diseases.
Inception
The idea for HNT was born out of the NHS’ Five Year Forward View 2014 strategy document. Focused around the impact of place
A concept drawing for Halton Lea at Runcorn, one of the more modest Healthy New Towns pilot projects
on health, the plan calls for a policy commitment to “getting serious about prevention” and asks how urban planning can be used as a strategic means to the goal of better health outcomes among the UK population, and a decreased reliance on traditional care models. The scheme’s stated aim is to “shape new towns, neighbourhoods and communities to promote health and wellbeing, prevent illness and keep people independent,” as well as “radically rethink delivery of health and care services in areas free from legacy constraints, and supporting learning about new models.” Since HNT’s 2015 launch, 14 demonstrator sites across England have been selected from 114 applicants offering housing and supporting infrastructure including healthcare facilities for more than 170,000 individuals. These include: Darlington, encompassing 2,500 residential units across three linked sites; Northstowe, where 10,000 homes on former military land are planned; and, perhaps the most ambitious pilot scheme, Ebbsfleet, which aims to deliver 15,000 new homes to a location just outside the M25. Fundamental to the process is a close scrutiny of how urban living affects health and how design interventions can benefit is key to the process, with example questions including: “Why are children happy to walk all day round a theme park but often get
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ADF FEBRUARY 2018
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