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					Agenda Item SOUTH EAST ENGLAND REGIONAL ASSEMBLY HEALTH SUMMIT Date: 1 December 2003

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Subject: Planning for NHS health services – the Regional Spatial Strategy Report of: Head of Policy

Recommendation Members of the Summit are asked to discuss the issues raised in the report and suggest ways to ensure that the Regional Spatial Strategy takes account of health service provision.

1. Purpose of Report 1.1 This paper discusses the strategic planning framework needed to ensure provision is made for health services (e.g. general practice, health centres and hospital facilities) across the region. 2. Context for Health Service Planning 2.1 The Regional Spatial Strategy aims to provide the framework for guiding the region’s developments over the coming decades, including health service provision, by providing the strategic framework for the development of local planning policy. A primary aim of the Strategy is to make economic development proceed in tandem with the physical and social infrastructure improvements necessary to support it - healthcare and community services will play an important role. 2.2 The Strategy will need to take account of the main issues to be considered in determining access to health services, including:    The current size of the population and health needs of the population served by existing services and its expected growth The options for networking or reconfiguring existing services Trends in primary care provision and organisation

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The effect of advances in the treatment of the population on the complexity of care, site of care and lengths of stay Workforce planning issues

2.3 At the same time it must recognise that the nature and organisation of health care provision is changing. This is a complex area without a clear central policy lead. In practice we can see a number of trends, including:      People are staying in hospital for shorter periods An increasing acknowledgement of the potential of preventive strategies and increasing technical expertise in health The increasing use of ICT in health care, including the development of electronic records systems, telemedicine and health information databases A move away from big district hospitals serviced by small GP practices, to a variety of specialist and generalist hospitals A range of primary health care services including larger practices with GPs and other professional staff, NHS walk-in centres and healthy living centres

2.4 The NHS Plan is an attempt to tackle these issues by redesigning patient care and treatment around patients’ needs. In order to deliver its vision the NHS has embarked upon a large building programme, with many major developments scheduled for the South East in the acute, community and mental health fields. These include substantial public-private partnerships as well as publicly funded schemes. 2.5 The Assembly recognises the importance of local health economies to the region and the dependence of health to wider factors. A Regional Spatial Strategy, aligned with other policies that impact on the health of the region, will aim to:    Accommodate the region’s projected population increase and demographic changes and ensure that adequate healthcare facilities are provided as part of large scale commercial and housing development. Ensure that adequate healthcare facilities are provided as part of other large scale commercial and housing development. While reducing inequalities in health among different groups and communities (through its wider remit to plan for improved transport, more affordable homes and workspace and better handling of environmental issues). For example, how can we ensure that new health service infrastructure does not add to congestion and provides adequate parking?

3. Healthcare provision in the South East – the spatial dimension 3.1 The pattern of public hospital services across a region is complex, with provision often determined by pre-existing infrastructure. This can lead to overlaps or gaps between providers and difficulties in meeting expectations because of pre-existing constraints that

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were not a consideration in the past. Changes to the planning guidance may have a number of implications to the provision and structure of health care through:    New operational healthcare development The extension and alteration to existing health care sites and buildings The redevelopment and/or disposal of some existing health care facilities.

4. Issues 4.1 Summit members are asked for their views on:    How the Regional Spatial Strategy can take account health service plans to develop new facilities and how members of the Summit can provide advise. How demographic trends and policy shifts should determine the scale of healthcare needs in particular locations? How the Regional Spatial Strategy should seek to accommodate the region’s projected population increase (particularly in the growth areas of the Communities Plan) and allow development where the current need is greatest and to areas where further growth demands it? How the planning process should address the issue of affordable housing for NHS staff (and what impact affordable housing will have for the recruitment and retention of NHS staff).

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Philip Craig Head of Policy 4 November 2003 Contact: Philip Craig, Head of Policy T: 01483 555216 E: philipcraig@southeast-ra.gov.uk

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