Health and wellbeing topic paper

1. Introduction and Background

1.1 This topic paper has been prepared to support the New Forest Local Plan 2024 – 2043. Its purpose is to explain how the Local Plan addresses a number of health issues identified during preparation of the local plan and set out in other evidence.

1.2 This paper also reflects the requirements of Hampshire County Council’s Public Health in Planning Position Statement, which refers to the principles of health and wellbeing being enshrined in local plans.

1.3 Health and well-being is a topic that cuts across a number of areas in spatial planning and can influence health outcomes of communities either directly or indirectly. This paper therefore reflects various sources of evidence and how the Local Plan responds.

National Park Purposes and Duty

1.4 The New Forest National Park was designated in 2005 and covers an area of 220 square miles within the counties of Hampshire and Wiltshire. The National Park operates within a detailed planning policy and legislative framework which is set out below. National parks have two statutory purposes that set out the main reasons for their designation and describe the overall focus for their management. The two Park purposes as set out in primary legislation are:

• to conserve and enhance the natural beauty, wildlife and cultural heritage of the New Forest; and
• to promote opportunities for the understanding and enjoyment of the special qualities of the New Forest by the public.

1.5 In taking forward the two National Park purposes, national park authorities have a duty under Section 62(1) of the Environment Act 1995 to seek to foster the economic and social wellbeing of local communities within the National Park.

1.6 These statutory purposes, related socio-economic duty and recently strengthened legal requirement to seek to further the purposes in the delivery of the Authority’s planning functions form the golden threads running through the Local Plan.

1.7 The vision expressed in the local plan and strategic objectives are drawn from these purposes and duty and the following special qualities of the National Park:

• The New Forest’s outstanding natural beauty
• An extraordinary diversity of plants and animals and habitats of national and international importance
• A unique historic, cultural and archaeological heritage,
• An historic commoning system
• The iconic New Forest pony
• Tranquillity
• Wonderful opportunities for quiet recreation
• A healthy environment
• Strong and distinctive local communities

1.8 All national parks are required by statute to have a management plan / partnership plan for their area, to help guide the work of those with responsibilities or an interest in the National Park itself, this has synergies with the local plan which has a focus on land use matters. A key recognition throughout the latest Partnership Plan (2022) is the role of the natural environment of the National Park in health and wellbeing and there is reference to the park functioning as a ‘Natural Health service’.

National Policy and Guidance National Planning Policy

1.9 Paragraph 8 of the National Planning Policy Framework 2024 (NPPF) discusses the three dimensions of sustainable development and the roles that the planning system plays to achieve this, through three overarching objectives:-economic, social environmental. The social objective states:” to support strong, vibrant and healthy communities, by ensuring that a sufficient number and range of homes can be provided to meet the needs of present and future generations; and by fostering well-designed, beautiful and safe places, with accessible services and open spaces that reflect current and future needs and support communities’ health, social and cultural well-being”.

1.10 Application of the social objective should not be undertaken in isolation but alongside the economic and environmental objectives.

1.11 Chapter 8 of the NPPF discusses the role of planning policies and decisions in promoting healthy and safe communities. Paragraph 96 requires that policies and decisions should aim to achieve healthy, inclusive and safe places, through enabling healthy lifestyles through provision of accessible green infrastructure, sports facilities, local shops, access to healthier food and encouraging walking and cycling.

1.12 As well as the explicit links between health and planning, the NPPF also requires consideration of a number of wider factors which are known to impact on health. The importance of access to high quality open space and opportunities for sport and recreation.

1.13 Under Chapter 9 Promoting Sustainable Transport paragraph 111 requires that planning policies should provide for attractive and well-designed walking and cycling networks, with supporting facilities. Paragraph 198 requires new development is appropriate for its location taking into account the likely effects of pollution on health and opportunities to improve air quality or mitigate impacts should be identified.

1.14 Chapter 12 Achieving Well-designed Places, refers to creating places that are safe, inclusive, accessible and which promote health and wellbeing, with reference to the national Model Design Code at Paragraph 138 and using assessment frameworks such as Building for a Healthy Life.

1.15 Chapter 14 Climate Change and Chapter 15 the Natural Environment, intrinsically cover matters pertinent to health and wellbeing.

1.16 Policy provided by the NPPF is expanded upon by Planning Practice Guidance (PPG) which includes a section on Achieving Healthy and Inclusive Communities, this notes that local planning authorities should ensure that health, wellbeing and health infrastructure are considered in both plan making and in planning decisions.

Other Planning Guidance

1.17 In addition, to specific policy and guidance related to planning, the topic of health and wellbeing has in recent years been subject to much debate. Organisations such as The Town and Country Planning Association, have published a range of documents, with a focus on health and actively promote a campaign for Healthy Homes with a pledge that states “The Healthy Homes Pledge recognises everyone has a right to a healthy, affordable and secure home in a healthy environment.”

1.18 In 2020, the Royal Town Planning Institute, published its Dementia and Town Planning practice note in recognition of the fact that there are around 850,000 people living with dementia in the UK and this is projected to increase to 1.6 million people by 2040. People living with dementia may experience the built environment differently to other people. Evidence has shown that good quality housing and well￾planned, enabling local environments can have a substantial impact on the quality of life for someone living with dementia, helping them to live well in their community for longer.

Health and Social Care Act 2012

1.19 The Health and Social Care Act 2012, places the duty of improving the health of populations, through encouraging healthier lifestyles and addressing health inequalities, to upper tier and unitary authorities such as Hampshire County Council as the responsible body.

1.20 Health and Wellbeing boards were established under the Health and Social Care Act 2012 to act as a forum in which key leaders from the local health and care system work together to improve the health and wellbeing of their local population.

1.21 The role of the Hampshire Health and Wellbeing Board is for the purpose of advancing health and wellbeing and to encourage persons who arrange for the provision of any health or social care services in Hampshire to work in an integrated manner.

1.22 Integrated Care Systems (ICSs) were legally established on 1 July 2022, covering all of England. These built on partnerships that were already in place across the country, with the aim of:

• improve outcomes in population health and healthcare;
• tackle inequalities in outcomes, experience and access;
• enhance productivity and value for money; and
• help the NHS support broader social and economic development.

1.23 They are formed by NHS organisations and upper-tier local councils and also include the voluntary sector, social care providers and other partners with a role in improving local health and wellbeing. Hampshire Integrated Care Board (ICB) is the statutory organisation responsible for setting the strategic plan for the NHS in Hampshire.

2. What’s the Evidence telling us?

2.1 Evidence on health matters for the Local Plan is limited, as data is not typically collated for the national park boundary but for the wider New Forest District.

Hampshire Public Heath Data

2.2 Hampshire Public Health Team published in 2024 A Healthy Places Report for the New Forest District covering matters such as:- Physical environment, Home environment, Social and economic environment, Community Safety, and Climate.

2.3 The following therefore reflects various extracts from the report in map form which allows for an indicative visual interpreation of the available data for the area of the National Park :

Physical environment:

2.4 Comprising green space such as parks, woodland, fields and allotments as well as natural elements including green walls, are recognised as important assets for supporting health and wellbeing. The figure below shows access to both green and blue space, given the predominance of the Open Forest and associated land uses in the National Park, the bulk of the area scores well.

Fig. 1. Access to Green and Blue space (1 = worst access), 2021

Home Environment:

2.5 Food security is a measure of access to good nutrition and food insecurity can affect the population in a number of ways as a result of being a benefit claimant, on low income, or experiencing poor mental health and educational attainment. Physical matters such as proximity to a bus stop, or distances to employment / food stores and internet speeds can also have an impact. The map below shows that the national park scores generally well in this respect with pockets of less well served areas :

Fig. 2. Food Insecurity Index (1 – highest insecurity), 2023

2.6 Poor quality housing or fuel poverty leads to people living in cold homes during the winter which increases the number of excess winter deaths. The output indicates that a large part of the national park does not score so well in this aspect, the bulk of this area comprises dispersed settlements and isolated homes, with a potential reliance on alternative forms of fuel for heating:

Fig. 3. Fuel Poverty, 2022

2.7 Census 2021 data specifically for the National Park indicates the range of fuels used for central heating purposes:

Social and economic environment

2.8 Social isolation is the objective term used to describe an absence of social contacts or community involvement, or a lack of access to services, generally the national park scores well is this respect, with isolated pockets scoring higher:

Fig. 4. Social Isolation Index (1 = most at risk of social isolation), 2023

2.9 Hampshire and Isle of Wight Public Health developed a Mental Health and Wellbeing Index in 2023 to identify small areas where residents may be at greater risk of poor mental health and wellbeing. :

Fig.5. Mental Health and Wellbeing Index (1 = most vulnerable), 2023

2.10 Employment can provide a positive sense of wellbeing and a stable income reduces the risk of poor mental health. The following map indicates overall the national park has lower rates of residents claiming benefits:

Fig. 6. Rate of people claiming benefits (all ages, per 1000 population) 2023

Community Safety

2.11 Published crime data provides information at force level which for Hampshire Constabulary includes Portsmouth and Southampton. Data presented below is for all crimes and incidents in the timeframe October 2022 to September 2023, areas to the north of the national park have higher incidents of recorded crime:

Fig. 7. Crime Rate (per 1000 population), 2022/23

Climate

2.12 Poor air quality is recognised as a risk to public health. Long-term exposure to air pollution can cause chronic conditions such as cardiovascular and respiratory diseases as well as lung cancer, leading to reduced life expectancy. Air pollutants are emitted from a range of man-made and natural sources. Many everyday activities such as transport, industrial processes, farming, energy generation and domestic heating can have a detrimental effect on air quality. Particulate matter (PM) and nitrogen dioxide (NO2) are both major components of air pollution. Given the industrial focus of land to the east and on the eastern edge of the national park, this area scores less well in this respect:

Fig. 8. Air quality, all pollutants (1 – worst air quality), 2019

Flooding

2.13 Flooding can take place from multiple sources including the sea, rivers, surface and ground water. The map below shows the proportion of properties at medium or high risk of flooding from the sea, rivers and surface water. Overall, the national park scores well in this respect:

Fig. 9. Proportion of properties at medium or high risk of flooding, 2023

2.14 There are particular groups of people that are more vulnerable to heatwaves, for example older people and those with long term health conditions or disabilities. The following map shows parts of the national park being more vulnerable :

Fig.10. Heat vilnerability index (1 = most vulnerable), 2018

2.15 The New Forest District Healthy Places report concludes as a large rural district there is a high proportion of elderly people and low levels of deprivation. The rural area adds different challenges as access to leisure facilities and shops is limited in large parts of the New Forest. Air pollution was low across most of the New Forest, although was higher towards the east of the district along the Solent. The following table provides a summary of the outputs and for the National Park reveals that most areas are at least risk from the identified theme/topic:

Census 2021

2.16 Census 2021 data does include some New Forest National Park specific data sets, which allows for assessment of the following headline data:

• 17.2% of residents are register disabled under the Equality Act;
• 83% consider their health very good or good, compared to 0.04% with bad/very bad health;
• 33% of the resident population is aged 65 and over (16% being aged 75 and over) – with older people generally experiencing health and mobility issues
• In terms of household deprivation 32% of households are deprived in 1 dimension (that is having any person falling into one of the specified four categories being education, employment, health and housing); 9% 2 dimensions; 1% 3 dimensions and a small proportion in all 4 dimensions:

Source: Census 2021 New Forest National Park Household Deprivation

Hampshire Local Transport Plan 4 (2024)

2.17 Health and wellbeing in relation to people and places is a recurrent theme throughout Hampshire County Local Transport Plan 4 (LTP4) (adopted February 2024), which includes a key principle to “shift away from planning for vehicles, towards planning for people and places” and promotion of active lifestyles through support for active travel opportunities.

2.18 LTP4 also includes some strong messages to be taken into consideration in plan making, such as under its theme Planning for People and Places a ‘Healthy Streets Approach’ is advocated which is based around ten healthy streets indicators, albeit it is acknowleded that the indicators reflect more urban situations than a rural area such as a national park . A further example is through promotion of walking and cycling for short/local journeys and the creation of ‘liveable neighbourhoods’ also referred to as 20 minute neighbourhoods, being a key foundation for a net zero transport network.

2.19 Improving air quality is also referenced numerous times through LTP4 in recognition of the challenge that poor air quality is the largest environmental risk to public health, adversely affecting a range of health conditions, with vulnerable people impacted the most.

New Forest’s Green Halo Partnership

2.20 Set up in 2016, the Partnership managed by the National Park Authority, brings together all sectors to focus on valuing nature and its benefits in terms of :

• Improving health and wellbeing
• Encouraging sustainable living
• Enhancing the natural environment
• Supporting the local economy

2.21 The Green Health Hub is a directory of activities supporting wellbeing in the natural environment. Organisations are also referred to collectively as the Green Health Network “ ensuring that our natural assets – from woodland, rivers and open spaces to our diverse wildlife – can help improve people’s mental and physical health and wellbeing. In doing so, we will help protect and enhance those assets, and so secure the benefits they offer society. “

2.22 The outcomes of the Green Halo Partnership feed into the National Park’s Partnershire Plan, with particular reference to objective 6 An Inclusive National Park, in recognition that “People need nature and culture for their physical, mental and spiritual health”. This objective has three priorities:

1. Promotes Health and Wellbeing by:

   • Building a strong, mutually beneficial partnership between the health and environment sectors, including a five-year programme of ‘Health Education Fellowships’ and facilitating effective local networks
   • Addressing health inequalities locally and regionally through improved green space, targeted interventions and nature-based referrals
   • Increasing uptake of walking for health, inclusive cycling for health and volunteering for health programmes.

2. Connects People with Nature and Landscape by:

   • Removing barriers to participation and access – physical and perceived, e.g. affordable public transport
   • Recruiting more rangers, part of whose role is to help people understand and enjoy the New Forest, including apprentice rangers
   • Using data and evidence to create a more accurate picture of the current and possible users of the New Forest National Park and barriers to participation
   • Developing comprehensive and inclusive programmes of health and youth engagement and outreach to build relationships with diverse communities and audiences, including a Youth Action Project and bespoke education activity.

3. Leads inclusive place making, celebrates beauty and safeguards our cultural heritage by:

   • Assisting communities and local organisations to lead and shape cultural and natural heritage projects that foster identity and a sense of place
   • Bringing together cultural heritage and archaeological datasets, identifying gaps and surveying identified areas to achieve a complete picture for future management
   • Interpreting and disseminating landscape, cultural and natural heritage through specific outreach such as the New Forest Knowledge website.

New Forest Sustainability Appriasal/Strategic Environmental Assessment for the Local Plan

2.23 A regulatory element of local plan preparation is for an assessment under the Sustainability Appraisal / Strategic Environmental Assessment Regulations. Initial assessment is through the Scoping Report (July 2025), to establish the baseline and issues arising. The scope is explored and presented under a series of key environmental themes as follows, including a specific section on ‘Communities, Health and Wellbeing’, albeit other themes may also link to health and wellbeing matters, such as climate change, economy and employment, housing and transport.

2.24 The scoping report highlights the following key issues for the local plan review, with regard to health and wellbeing:

• There is a continued need to monitor NO2 and particulate emissions from road traffic and local industry, particularly in areas adjacent to major routes through the National Park such as the A31 and A35;
• Health impacts, including increased risk of respiratory and cardiovascular illnesses during heatwaves, higher vulnerability among elderly and low-income populations, and mental health impacts associated with extreme weather events;
• An ageing population is expected to increase demand for accessible healthcare, social care, housing, and community infrastructure, particularly in rural areas with limited service provision;
• The modest projected population growth of the National Park and the surrounding areas may place additional pressure on existing services and facilities, especially in settlements already experiencing constrained access to healthcare, education, and public transport;
• Limited ethnic diversity across the National Park suggests a need to ensure inclusion and equitable access to services for all residents, including under￾represented and marginalised groups;
• The rural nature of the area may increase risks of social isolation, particularly among older people and those with disabilities or limited mobility;
• While access to green infrastructure is generally high and supports physical and mental wellbeing, pressures from tourism and uneven distribution between settlements may affect local access and recreational opportunities and the integrity of designated sites;
• Despite forecasted surpluses in school places, potential new development may require localised school provision or improvements.
• Crime levels are generally low but there are pockets of deprivation related to crime and the living environment, highlighting the need for ongoing community safety measures and improvements to the quality of housing and local environments

2.25 The assessment has then informed the SA objective: Support healthy, inclusive, and safe communities by improving access to services, promoting wellbeing for all ages, and reducing inequalities related to age, disability, deprivation, and rural isolation.

Habitats Regulations Assessment for the Local Plan

2.26 A further legislative requirement is for the local plan review to be assessed against the Habitat Regulations, in terms of assessing the impact of the local plan on the internationally important nature conservation sites in and around the local plan area. On the basis that such European sites are the top tier of protected sites in the UK and much of the National Park and adjacent areas are designated, reflecting the importance of the area for nature conservation

2.27 There are 33 European sites in total that are within the 20km radius, of which 11 sites are within or abut the National Park area. These include the New Forest SAC/SPA/Ramsar which covers the heathland, woodland and wetland habitats of the New Forest (and a suite of associated species) and also the coastal areas (the Solent Maritime SAC, Solent & Isle of Wight Lagoons SAC and the Solent & Southampton Water SPA/Ramsar).

2.28 The HRA report (September 2025) accordingly assesses the local plan through an an initial screening and the potential for likely significant effects when assessed in relation to the following types of impact and at least 1 European site:

• General urban effects
• Mobile species and functionally-linked land
• Recreation
• Water quality
• Water quantity; and
• Air quality

2.29 With regard to health and well-being matters a key link is air quality, which can have a detrimental effect on the heath of individuals. The HRA however, focuses on the impacts of air quality in terms of protected species.

New Forest National Park Strategic Housing Market Assessment

2.30 A key part of the local plan is to understand the housing needs of the National Park over the plan period to 2043. Consequently a Strategic Housing Market Assessment was commissioned, this also included an assessment of demographic data, which highlights changes likely to happen and implications for the local plan review.

2.31 A key output was acknowledgement that the population of the national park has been declining steadily since around 2011, this is being driven by the ageing population with a higher number of deaths than births (i.e. negative natural change).

2.32 The older population profile is more pronounced, with a lower proportion of the population aged between 20 and 39 years old and a much higher proportion of those aged 40+. More specifically, older age groups are anticipated to increase over the plan period,

Source: SMHA 2025

2.33 Consequently, this age cohort is likely to experience associated health and mobility problems:

Source : SHMA 2025

2.34 This data suggests the potential need for specialist accommodation such as residential care, nursing care or extra care housing:

2.35 A further factor explored through the SHMA is the proportion of the population using a wheelchair and therefore potentially in need of adaptable accommodation;

Source : SHMA 2025

Local Plan Regulation 18 Part 1 Consultation

2.36 Representations from over 80 individual sand organisations were received to the consultation on the Strategic Direction of Travel document published for consultation between February and March 2025. In addition to comments from many statutory consultees, comments were also received from local organisations and the general public. Whilst Hampshire Integrated Care Board was consulted no specific response was received.

2.37 None of the representations received referred specifically to matters in relation to health and wellbeing.

3. Key issues arising from the evidence and how the Local Plan addresses these:

3.1 In addition to the references above, health and wellbeing is specifically referred to the vision for the local plan and strategic objectives 4, 6 and 9.

3.2 Policy SP1 Supporting Sustainable Development refers broadly to fostering the social and economic well-being of local communities, with specific reference to the ability of the natural assets (capital) of the National Park to “contribute to society through the provision of food and water, regulation of floods, prevention of soil erosion and disease outbreaks, opportunities to improve health and well-being through informal recreation and access to open space.”

3.3 More detail is added to Policy DP2 General Development Principles, to be applied to all developments across the National Park and includes a specific criterion “contribute to society through the provision of food and water, regulation of floods, prevention of soil erosion and disease outbreaks, opportunities to improve health and well-being through informal recreation and access to open space.”

3.4 The following policies also provide support for health and well-being:

• SP15 Green and Blue Infrastructure – through the provision of areas for recreation, relaxation and social interaction
• DP16 Open Space – through the provision of more formal open space, sports and recreational buildings and land
• DP26 Design Principles – to ensure new development creates a safe environment where people want to live, work and visit
• SP41 Affordable Housing and SP42 Rural Exception Sites – to enable those in housing need access to appropriate accommodation which in turn will support their health and wellbeing.