The planning of new or reconfigured health facilities often takes place in a context where populations and health needs are changing as well as the policy, fiscal and organisational environment and models of care.
Part of the role of the local planning process is to consider the community (social) infrastructure needs and requirements of an area, including health facilities. Most local authorities will have undertaken an infrastructure study to support their Local Plan Core Strategy. Similar information is needed if a local authority intends to introduce a Community Infrastructure Levy.
Health and community infrastructure planning is one of HUDU’s core service offerings – see Our Services.
At its simplest, the healthcare system starts with a visit the local GP (the primary care system); with referral on to a hospital or other medical facility (the secondary care system) but the organisation and nature of health services and related facilities continues to evolve. For example, some GP practices have merged or co-located and/or are providing an extended range of services.
Demands on hospitals has led to a constant search for new and innovative ways of reducing lengths of stay and/or tackling people’s health needs outside of a conventional hospital setting and of giving patients greater choice of where and how they are treated. The result has been a continuing shift in the way health facilities are provided, with more emphasis on community health facilities and care closer to home.
Pressures to provide more integrated services have also led to a variety of initiatives to provide a wider range under one roof – for example local authorities and the NHS collaborating to provide a range of children’s services, or to co-locate health, housing and social care services.
Demographic change, fiscal pressures, advances in treatments and patient will continue to influence how and where services and facilities are provided.
Under the recent health and care reforms, most community-based primary care services are now typically provided by community health provider organisations. Some of these have become independent community foundation trusts and some have merged with local acute or mental health trusts. Whilst they operate services on behalf of the relevant commissioning organisations, they mostly do not own the facilities they operate out of.