The mismatch between national ambitions and local policy means that there is a disconnect between health infrastructure strategies and the planning frameworks.
Despite record levels of government investment in hospitals and neighbourhood health facilities, most local plans are not consistently making adequate provision for healthcare estates. This raises the risk of delays to new infrastructure.
A study from UK planning and development consultancy Lichfields highlights a mismatch between national ambitions and local policy.
Of the 88 local plans adopted since March 2020, only 63% contain a strategic objective to improve health or healthcare, while just 26% include site-specific policies or allocations for new health facilities.
This patchy coverage suggests that many projects in the development pipeline, including those in the government’s New Hospitals Programme, will need to proceed without an up-to-date planning status or site designation.
“With the largest ever health capital budget now in place, the emphasis must be on delivery. Yet our research shows that many local plans are not always keeping pace with this new policy and investment landscape,” says Robert Dibden, planning director at Lichfields
“Too often, there is a disconnect between health infrastructure strategies and the planning frameworks designed to support them. Closing that gap is essential if we are to see new hospitals and neighbourhood health facilities delivered on the ground at the pace patients need.”
Neglected infrastructure
The findings come at a critical moment, with national policy and funding pushing to renew the country’s ageing healthcare estate.
“There’s no strong economy without a strong NHS,” said chancellor Rachel Reeves as she announced a record £29 billion funding boost, along with a £2.3 billion rise in capital budgets to get the NHS back on its feet in June.
Yet the infrastructure is often neglected.
In May, TMLEP’s lead healthcare investigator Nina Vegad wrote that “we frequently encounter incidents where the limitations of a practice’s infrastructure have directly or indirectly contributed to substandard care”.
In January, Healthcare Today highlighted a report from The National Audit Office, which showed how building failures are now impacting the delivery of services within the NHS.
They had caused an average of 5,400 clinical service incidents within the health service every year between 2019-20 and 2023-24. Alongside clinical service incidents, the knock-on effects of these failures include poor staff retention and impacts on the ability to hit environmental targets.
“Not only do crumbling and dilapidated buildings make it more difficult to keep patients safe, but they hamper productivity and impede efforts to improve performance,” said Matthew Taylor, chief executive of the NHS Confederation at the time.
