Payments to support health services can be secured as part of granting planning permission for development.

A key change now taking place in the planning system is the phased introduction of the Community Infrastructure Levy (CIL for short). This involves changing from an up-front negotiation of developer contributions (section 106 payments) on a site by site basis around a planning application to one where, when CIL is implemented, health professionals (including CCGs) will need to make the case to the local planning authority for investment and release of appropriate funds. While CIL may lead to more funds being secured from developers, there is likely to be significant competition for CIL funding, and the prioritisation and allocation of funding is a matter for the charging authority.

The Community Infrastructure Levy (CIL) is a development tariff (charged per square metre of net additional increase in floorspace) that can be charged on new developments (that result in a net increase in floorspace or residential units)to contribute funds towards a list of local infrastructure projects (known as a Regulation 123 list). CIL charges (which are set locally) and items on a CIL list need to be justified by evidence, which could include the identification of specific healthcare infrastructure needs resulting from planned growth, such as GP surgeries or hospitals. The list could also include contributions to wider infrastructure that could improve health or reduce health inequalities, such as green infrastructure or cycle paths – providing local need can be demonstrated.

It is important that health organisations have systems and plans in place to set out any health infrastructure requirements at the time the CIL Charging Schedule is prepared.

For further information on CIL and s106, including tools for calculating the costs of the health infrastructure implications of new development, see the Key stages in planning where health can input and How to address the healthcare needs of new development in the Joint Working section.

Redbridge is the first London Borough to implement CIL. The Borough opted for a single levy across the Borough as a whole of £70 per m2 which applies to all new development above a threshold of 100m2 of floor space and/or 1 new unit in the case of residential developments. The charge applies to all new planning applications received from 1 Jan 2012. In setting the CIL charge, a Community Infrastructure Plan was developed (Jan 2011). The Plan includes an analysis, based on the HUDU model, of the amount and cost of new primary and secondary health floor space required to meet the needs of the growing population over a ten year period. Funding sources are examined and the gap in funding for health and other forms of community infrastructure identified. This assessment forms the basis for the CIL charge.

Source: London HUDU website

Winchester City Council (WCC) adopted its Community Infrastructure Levy (CIL) on the 8th January 2014 and it was brought into effect on the 7th April 2014. The levy will apply across the area of Winchester District that lies outside the South Downs National Park.

The WCC CIL charge is levied on different land uses (for example, residential, retail, hotels and so on) and on different zones (Winchester Town, Market Towns & Rural Areas and Strategic Allocations & South Hampshire Urban Areas). The levy will be charged per square metre of new development (a new building or an extension) over 100 square metres of gross internal floorspace, or if it involves the creation of additional dwellings.

The Council has produced a CIL Regulation 123 list which sets out the infrastructure which will be, or may be, funded fully or partly by CIL contributions (and will not be funded through S.106 contributions). This includes a number of infrastructure types of direct relevance to health outcomes and health inequalities, such as open space provision, leisure facilities, community and cultural facilities.

Source: www.winchester.gov.uk/planning/cil/cil-charging-in-winchester/

In Tower Hamlets developer contributions (s106) are pooled towards the cost of new healthcare facilities to meet the needs of new residential development in the Borough (based on an agreement between the Council and the former local NHS Primary Care Trust). Bethnal Green had an existing GP practice operating from premises which were no longer fit for purpose and was unable to meet the needs of the growing population. Using pooled contributions of £1.6 million, a new health centre was created on the ground floor of a new residential development. The centre was opened in September 2011 and has 950sqm of floor space designed to accommodate an expanded GP service along with other primary and community care services. These include psychology and counselling, baby and antenatal clinics, family planning service, blood clinics, nurse clinics and health visitors. The practice also provides extended opening hours on Mondays and Tuesdays until 8pm for patients who may need to see a GP after work.

Source: www.healthyurbandevelopment.nhs.uk/our-services/delivering-healthy-urban-development/s106-planning-contributions-for-health

In October 2000, Southwark Council adopted a masterplan for the Bermondsey Spa regeneration area to provide 2,000 new homes, community facilities, offices, shops, open space and play facilities. NHS Southwark identified the need for improving primary healthcare in the area. Phase 2 of the masterplan included a new 1400 sqm medical centre on the lower floors of a building developed by Hyde Housing Association. The centre opened in December 2011 and incorporates facilities for GPs and child health facilities on the ground floor, with a mix of office accommodation and further clinic rooms on the first floor. Developer contributions from two developments in the area totaling £120,000 calculated from the Council’s s106 tariff based on the HUDU model (see how to address the healthcare needs of new development page (insert link)) have contributed to the purchase of furniture and equipment for the new medical centre. The centre opened in December 2011. The release of s106 funds was achieved through an agreed protocol between Southwark Council and NHS Southwark.

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