Elisabeth Jeffries explains how the environmental aspects of the Healthy New Towns standard aim to help improve public health
An environmentally friendly housing label pioneered by the NHS marks a new stage in the evolution of UK sustainable buildings brands. Known as the Healthy Homes Quality Mark, and accompanied by a Healthy New Town standard for the wider built environment, the label is the first homes brand specifically prioritising both health and environmental criteria. Guidelines for developing the standard and the label, following trials in 10 pilot Healthy New Towns, are to be published by NHS England in spring 2019.
“The Healthy New Towns contain a significant environmental element“
Devised from a platform of health policy priorities, the Healthy New Towns and the labels they promote contain a significant environmental element. These include access to green space and improving urban environments through air quality. “The Healthy New Towns and brands are rethinking how to encourage people to become healthier by embedding the social and environmental determinants of public health into urban developments from the outset,“ explains Kevin McGeough, director of the Ebbsfleet Garden City Healthy New Town programme in Kent – one of the pilots.
Ebbsfleet Garden City
That means planning for greater use of parks and green spaces – especially, for example, by people in lower income brackets with health problems such as obesity and diabetes. As a tactic to achieve that particular objective, the key performance indicators (KPIs) for developments in Ebbsfleet Garden City include net gain in accessible open space, public realm and recreation areas.
The development corporation intends to make the most of the green and blue (water) features in the area. These include cliffs, lakes, waterways, industrial heritage and archaeological assets. The aim is to create a stimulating environment with improved ecological and biodiversity value that supports mental health.
Several other KPIs aim to improve health and wellbeing through environmental features. They include: number of homes completed meeting enhanced standards for environmental performance, space and accessibility above the statutory minimum; net improvements to air quality and sustainable urban drainage from a 2016 base; and identification of innovative approaches and new and emerging technology to reduce carbon emissions.
“The concept is that overall improvements to quality of life are as important to improving health as specific health interventions,“ explains McGeough. Access to open and green spaces is one of the assumptions underlying evaluation of quality of life.
Other health-based objectives included by Ebbsfleet Development Corporation concern the use of the Healthy New Town designation to promote healthier lifestyles and to facilitate the delivery of innovative, effective and efficient health services across the Garden City. This could mean reformulating some of the relationships and roles of healthcare organisations involved.
Behaviour change
The inclusion of environmental or green space criteria in town planning consultations is not new. However, the motivation for doing so, as well as the approach to achieving these objectives, adds a new dimension to the planning model. For one thing, the criteria for integrating features such as green space and woodland originated by considering environmental characteristics primarily through the lens of health and wellbeing.
The guidelines for appropriate environmentally friendly characteristics in the forthcoming Healthy New Town standard and Healthy Homes Quality Mark differ in style from previous brands such as the Code for Sustainable Homes. They depend less on carbon emissions, benchmarks and buildings regulations.
“Healthy New Towns are not affected by targets such as including a particular percentage of green space. They are about a 'placemaking' approach, aimed at shaping and changing people's behaviours to create better health outcomes,“ says McGeough.
Bicester Healthy New Town
Ebbsfleet Healthy New Town is overlaying environmental criteria onto planning for healthy urban environments, but arguably the reverse is true for another pilot, Bicester Healthy New Town. The Bicester project overlaps with Bicester North West – one of the few new ecotowns to have outlived a government ecotown programme from the 2000s.
Elmsbrook is one of the areas in both the Bicester North West ecotown and the Healthy New Town. According to one property developer involved, Fabrica, it includes 232 ecohomes that contain eco-efficient characteristics. Its focus on heat and power equipment in building design will be familiar to ecohome developers. Homes benefit from rainwater harvesting, electric car charging and an electric car club, and are heated by a district heating network that connects to a combined heat and power centre.
But Elmsbrook also designs in health to create a place where healthy living becomes the norm. One aim is to provide greater opportunities to assess and share the health and wellbeing benefits of living in an exemplary development and to test new ways of delivering healthcare and disease prevention. The aim is to apply these designs to Bicester's wider 13,000 home strategic growth.
NHS governance
The Healthy New Town concept adds another perspective to ecotown developments, arising from unique administrative arrangements for promoting health. “Town planning schemes in the past have consulted health experts while considering how to nudge green spaces into new settlements. What's unusual with the Healthy New Towns is the incorporation of NHS Services into that mix of consultation and engagement,“ says GP Dr Rosie Rowe, Bicester Healthy New Town programme director.
For example, a clinical commissioning group – a statutory NHS organisation responsible for planning and commissioning healthcare – is represented on the governance and delivery board of the Healthy New Towns. This may lead to decisions on new behavioural change schemes or playgrounds, for instance.
“We say: are there opportunities in the built environment to promote healthy surroundings and way of life? In new developments, opportunities are easier to incorporate than in established towns,“ Dr Rowe says.
Prioritising lower-income groups
In Bicester Healthy New Town, the establishment of a Wayfinding scheme for greener spaces is already in place. This is required because the new town is part of the existing town of Bicester. “The scheme promotes modal shift – good for sustainability but a by-product of the existing urban environment“, says Dr Rowe.
The Healthy New Town standards may be an unexpected mutation of the defunct Code for Sustainable Homes, abandoned by the government in 2015 due to housing developer lobbying and a policy on 'red tape'. It faces a similar challenge: many of the people who benefit most will belong to the higher-income, healthier social groups that can afford new homes.
To counter that possibility, Ebbsfleet Garden City, for example, integrates policies on green spaces and healthy food in the adjacent communities at Swanscombe and Northfleet, which have significant health inequalities. It also contains plans for seven major city parks to attract residents from those areas. Prioritising these lower-income groups is presumably key to its success.
Principles for Healthy New Towns
- Plan ahead collectively
- Plan integrated health services that meet local needs
- Connect, involve and empower people and communities
- Create compact neighbourhoods
- Provide health services that help people stay
- Inspire and enable healthy eating
- Foster health in homes and buildings
- Enable healthy play and leisure
- Maximise active travel
- Create integrated health services
Source: Putting health into place, NHS England
Elisabeth Jeffries is a freelance journalist
Image credit: iStock
