Summary
Sandwell Council and Sandwell Primary Care Trust (PCT) have created the Sandwell Healthy Urban Development Unit (SHUDU). This is a forum for officers and members to coordinate and integrate spatial planning and efforts to reduce health inequalities.
Background
A range of health indicators shows Sandwell fares worse - and sometimes much worse - than the English average. These include as deprivation, child obesity and early deaths from heart disease. This poor health profile was the catalyst for Sandwell Council and Sandwell PCT to submit a joint bid for Healthy Town funding for a Sandwell Healthy Urban Development Unit (SHUDU) in 2008.
While the bid narrowly failed, the application process built up a momentum for joint working between spatial and transport planners at the council and public health staff at the PCT.
Paul Southon, Public Health Development Manager at the PCT and SHUDU's nominated lead officer, says that it was the catalyst for continuing to explore "what we could do anyway".
In the end SHUDU did receive £50,000 of seed funding from the Department of Health (DH). This has been used for one-off costs such as training and some revenue support for planning officer time.
The problem and how it was tackled
Since 2008 SHUDU has continued to be active. The launch of the Marmot Review, with its objective of creating "healthy and sustainable places and communities", created fresh impetus.
Although the name SHUDU refers to a unit there are no dedicated posts, but rather a group of officers and members from the council and PCT. They meet regularly to identify potential opportunities, synergies and duplication with work in a variety of topic areas.
Members include:
- cabinet member for jobs and economy (formerly regeneration)
- council planners from policy, development management and planning development
- officers from community agriculture, transport and highways, environmental health and regulatory services
- the council's play strategy manager
- the PCT chair
- PCT leads on health and wellbeing and obesity
- PCT officers from food policy, physical activity, alcohol misuse and public health information.
SHUDU reports to the Sandwell Partnership (the local strategic partnership - LSP) through the Health and Wellbeing Board.
Southon sees his role as: "helping SHUDU members see how the links between health and planning fit into their existing role and work".
Alan Goodman, Senior Planner at Sandwell Council and a key member of SHUDU, adds that:
"We are a small ‘federation' with no dedicated funding. So we have to be focused on things that make a difference or where we are sometimes ‘pushing at an open door'"
There have been a number of projects that fall into this category.
Community agriculture - Salop Drive
Led by the third-sector organisation Ideal For All, Sandwell has been developing community agriculture. The council and PCT's community agriculture strategy defines this as "the art and science of growing food and other crops by and for local people".
Projects developed by Ideal For All include Salop Drive. This is a centrally-located three-hectare market garden and allotment site that has been painstakingly reclaimed from contaminated land.
SHUDU has recently taken on the responsibility of being the town's community agriculture steering group. This is to bring community agriculture further into the mainstream activities of the council and the PCT. Laura Davis, Head of Community Agriculture and author of the strategy, hopes that the new SHUDU role will bring strategic benefits to the community-based work:
"When we get sites they are often contaminated and derelict, and the community shouldn't have to be the ones finding the money to clean them up. Opportunities for community farms and gardens should be considered at the planning stage in major regeneration schemes. This is so that cleaning up sites becomes the responsibilities of developers wanting planning approval."
Access to healthy food
SHUDU has supported regional partners to develop an ‘Access to healthy food standard' to be used by all local authorities in the West Midlands. Partners include spatial planners, public health practitioners, accessibility planners and transport planners.
The standard was published last year. It defines the percentage of households within 20 minutes (walking, cycling or using public transport), of a place where fruit and vegetables are sold. Planners can use the standard to negotiate with developers to either improve access, or limit the impact on access to healthy food of any proposed new development.
SHUDU is currently examining how to use the standard locally. It is also pushing for the standard to be included as part of the West Midlands Local Transport Plan 3 (LTP3). This is the strategy that will guide transport infrastructure and development in the region to 2026 - starting from April 2011.
Angela Blair, Food Access Manager at Sandwell PCT, has welcomed the input of spatial planners and transport planners into the development of the standard:
"It has reminded them to constantly check on the spatial access to one of the everyday needs that influences health - fresh food."
Outcomes and impact
Despite having little dedicated funding, SHUDU has influenced several areas of work and raised awareness of the potential for health and planning to work together more effectively. It has also supported specific projects, for example, an access to fresh food standard to help planners improve people's opportunities to buy healthy food.
Environmental public health tracking
The PCT and council are leading the developing an environmental public health tracking system. When complete, it will track potential environmental health hazards and the effects these have on health. These could include air quality, exposures to dangerous chemicals, traffic accident risks, food safety and nuisance complaints. The potential value of the tool will be to highlight links between an environmental hazard and a health outcome.
The work is being led by Dr Patrick Saunders, Associate Director of Public Health:
"Apart from a couple of known exposures, we need more work to demonstrate the links between an environmental hazard and a health outcome, which is what we hope to achieve through tracking. In the long term this will have implications for where you site things such as housing, and that is where you come to planning."
Although not yet complete, the work is of great interest to SHUDU. Goodman believes that:
"The value of the tracking system will be to pick up on information that planning doesn't necessarily have access to or use currently, such as nuisance complaints, and express it in a spatial form so that we can identify whether proposed new development will improve or worsen these communities."
Joint strategic needs assessments (JSNAs)
Like most areas around the country, Sandwell's JSNA is not well used by planners. This is something which has prompted the council and PCT to refresh the JSNA to make it more relevant. In consultation with SHUDU the new document will have an overview section and concise needs assessments on specific subjects. This is intended to make the information the JSNA contains more useful to service areas such as planning.
An expanded role
As described above, SHUDU has taken on the role of acting as the steering group for the work in Sandwell on community agriculture. In the near future it is also likely to expand its activities to take on some formal responsibilities for addressing the links between the quality of local environments and physical activity and obesity. In time SHUDU may even take on a commissioning role as public health responsibilities transfer to local authorities.
Costs and resources
With little dedicated funding or officer time, SHUDU has worked as a model to raise awareness of the shared agenda that spatial planners, transport planners, accessibility planners and public health practitioners can pursue. Southon says:
"SHUDU members now understand ‘what we need to do to make a difference' and the potential that there is to do that… just making people aware of who else is out there working on a similar sort of area is a big advantage."
For example, Blair cites the development of the tender for the healthy food access standard as a:
"...key moment in bringing public health and transport and spatial planners together - that work has been published, and we are now working together to get that integrated into LTP3."
She adds:
"Some aspects of the standard remain contentious. For example, whether the households within 20 minutes stipulation is unrealistic, on the one hand, or too lenient on the other. But having everyone talking to each other through SHUDU has been the right model for keeping the discussions going.
A feature of this model is that the costs have been minimal. It has relied on the goodwill of officers and members and a belief that working together benefits their existing responsibilities.
Next steps
Goodman argues that, despite a lack of funding, developing a structure to improve joint working has been invaluable:
"SHUDU has worked for us because health is such a powerful message, politically."
One of the disadvantages of this approach is that if political priorities change then SHUDU's approach to joint working "will always be vulnerable."
However, even with limited resources, all areas will need to find some mechanism for improving the links between planning and reducing health inequalities. This will be more pressing in light of the health white paper proposal that local authorities take over public health responsibilities.
Contacts and links
Paul Southon
Public Health Development Manager
Sandwell PCT
Telephone: 0121 612 2846
Email: [email protected]
Alan Goodman
Senior Planner
Sandwell Council
Telephone: 0121 569 4877
Email: [email protected]
Growing Healthy Communities: Sandwell's Community Agriculture strategy
West Midlands Food Access project - including information on the healthy food access standard
Sandwell is a case study for a guide the Town and Country Planning Association (TCPA) is producing on aligning JSNAs and the spatial planning process - it will be published shortly.
Town and Country Planning Association
or for more information contact:
Michael Chang
Email: [email protected]