How the new NPPF is reshaping Health and Social Impact Assessment

The publication of the latest National Planning Policy Framework (NPPF)[1] in August 2026 represents the most significant overhaul of national planning policy since the framework was first introduced in 2012. While much attention has been focused on housing delivery, infrastructure provision and the Government's ambition to create a clearer rule-based planning system, the implications for health and social impact assessments deserve equal consideration.

Health has long been recognised as a product of the places in which people live, work and spend their time. Planning decisions influence access to housing, employment, transport, green space, education, healthcare and community facilities, all of which are key determinants of health that underpin health outcomes. The revised NPPF provides an opportunity to consider whether planning reforms can support healthier communities whilst simultaneously delivering the scale of growth needed to meet national housing, infrastructure, energy and technological ambitions.

A new framework with familiar health ambitions

The August 2026 NPPF introduces a substantial restructuring of national planning policy, separating policies for plan-making from those used in development management and national decision making. It also establishes a more directive approach to planning decisions, intended to provide greater certainty for applicants, local authorities and communities.

Within this new structure, health retains a dedicated policy chapter titled Promoting Healthy Communities (Policies HC1-HC8). The retention of a standalone chapter demonstrates continued recognition that planning has an important role in supporting population wellbeing. However, the context in which these policies now sit is arguably different. The wider framework is strongly geared towards facilitating growth, accelerating housing delivery and supporting infrastructure investment. As a result, health considerations may increasingly need to demonstrate how they contribute to, rather than constrain, sustainable development.

Growth as a health issue

The relationship between planning and health is not a new concept. However, the revised NPPF's strong focus on housing delivery, infrastructure investment and economic growth provides an opportunity to place greater emphasis on the positive contribution that development can make to health and wellbeing, alongside the assessment and mitigation of potential adverse effects. Where growth delivers good-quality housing, employment opportunities, accessible services, community facilities and green infrastructure, it can positively influence many of the wider determinants of health that shape long-term wellbeing and health outcomes.

Access to suitable housing is a key determinant of health. New development can reduce overcrowding, improve housing quality and increase access to social housing and affordable homes. Increasing economic accessibility through affordable and stable housing ensures that people can afford a decent home without facing severe financial hardship, helping to drive stability and productivity, whilst reducing inequality.

Similarly, employment opportunities generated through construction and operation can support household income, reduce deprivation and improve wellbeing outcomes. Investment in infrastructure can also improve access to healthcare, education, local services and employment opportunities, while the delivery of green spaces, community facilities and active travel networks can encourage healthier lifestyles and strengthen social cohesion.

Growth can also help address some of the wider determinants of health by creating places that support social interaction, reduce isolation and provide opportunities for recreation and physical activity. Planning decisions can influence not only where people live, but also how easily they can access the services, facilities and opportunities that contribute to good health and wellbeing.

From this perspective, many of the reforms intended to increase housing supply and accelerate infrastructure delivery may also generate positive health outcomes. The challenge is ensuring that these benefits are realised in practice and shared equitably across communities. This will require growth to be accompanied by appropriate social infrastructure, including healthcare, education, transport and community facilities, so that development contributes to the creation of healthy, resilient and inclusive places rather than simply increasing population numbers.

The critical role of social infrastructure

Health outcomes are not determined by housing provision alone. Population growth generates demand for a wide range of social infrastructure, including:

• GP surgeries and primary healthcare facilities;
• schools and childcare provision;
• sports and recreation facilities;
• community centres and social spaces;
• public transport services; and
• green infrastructure and open space.

One of the more notable aspects of the revised NPPF is the increased prominence given to public service infrastructure, including healthcare facilities. Historically, healthcare planning and spatial planning have often operated within separate systems, creating challenges in aligning population growth with service provision. The revised framework appears to recognise the need for stronger integration between these processes, potentially creating greater opportunities for healthcare infrastructure requirements to be considered at both plan-making and decision-making stages.

The success of the NPPF from a health perspective may therefore depend less on the number of homes delivered and more on whether supporting infrastructure is planned and delivered alongside growth. There is increasing recognition across the planning sector that housing-led development without corresponding investment in services can place significant pressure on existing communities and undermine quality of life. This is further reflected in the government’s Pride in Place Strategy[2], which places considerable emphasis on protecting and investing in local facilities and community infrastructure to create "safer, healthier neighbourhoods where communities can thrive". The Strategy views social infrastructure as fundamental to thriving communities and recognises the role of community assets and shared spaces play in supporting health and wellbeing.

The challenge for the revised NPPF will not be identifying health impacts but ensuring that healthcare and social infrastructure are delivered alongside growth. The effectiveness of the reforms may therefore be judged not only on housing completions but by whether communities gain timely and equitable access to healthcare, education, public transport, green spaces, recreational facilities and other community services that support healthy, sustainable and inclusive places.

For socio-economic and health practitioners, the new NPPF reinforces the importance of robust assessments that examine not only population growth but also infrastructure capacity and service accessibility.

Implications for Health Impact Assessment

The revised NPPF does not introduce a statutory requirement for Health Impact Assessment (HIA), yet its continued focus on healthy communities means that health considerations remain a relevant component of planning decision-making.

However, the reforms may increase the importance of HIAs for strategic developments. As larger housing and infrastructure schemes come forward, local planning authorities and consultees are likely to seek greater assurance that health impacts have been appropriately considered.

Future assessments may place increasing emphasis on:

• Health inequalities and vulnerable groups;
• Access to healthcare services;
• Active travel opportunities;
• Community cohesion and social capital;
• Mental wellbeing;
• Access to green infrastructure; and
• Cumulative demands on social infrastructure.

This reflects a broader shift towards understanding health through the wider determinants of health rather than solely through environmental exposures. Whilst this approach has gain prominence within the UK Planning and EIA practice following the publication of the Institute of Sustainability and Environmental Professionals (ISEP) Health Impact Assessment Guidance in 2022[3], these principles have been long established in international HIA practice. The UK also benefits from a growing body of established health assessment guidance, including work from the Welsh Health Impact Assessment Support Unit, NHS London Healthy Urban Development Unit and a number of local planning authorities that have developed their own HIA guidance, frameworks and assessment tools.

As the role of health within planning continues to evolve as a result of the new NPPF, there is an opportunity to draw on this wider national and international experience to ensure that health considerations are integrated more consistently throughout the planning process.

Looking ahead

The August 2026 NPPF marks a significant evolution in planning policy. While its primary purpose is to create a clearer and more effective framework for delivering growth, it also reinforces the principle that planning should support healthy communities.

It is encouraging to see continued recognition of the relationship between planning, place and health. The challenge now, as practitioners is to help ensure that assessments not only assess the impacts of development, but they also challenge the need for infrastructure, services and community assets required to support growth. By highlighting these needs, assessments can help translate policy ambitions into tangible improvements in people's daily lives and contribute to the creation of healthier, more resilient and inclusive communities.

References

[1] Ministry of housing, Communities and Local Government, NPPF, 2026

[2] Ministry of housing, Communities and Local Government, Pride in Place, 2025

[3] ISEP, Health Impact Assessment Guidance - Effective Scoping of Human Health in Environmental Impact Assessment', and 'Determining Significance for Human Health in Environmental Impact Assessment', 2022