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					                                                                                 Agenda Item      5
SOUTH EAST ENGLAND REGIONAL ASSEMBLY
HEALTH SUMMIT

Date:               1 December 2003

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).


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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