Gaining planning permission is a key point in any development project. However, for a health and wellbeing project, this milestone can be one of the most uncertain hurdles to overcome when improving facilities for the patients and local communities. It requires significant investment before successfully unlocking access to government funding or progressing through the business case process.
Recent modifications to the planning system can be used to see changes to the health estate without the need for planning permission. It is now widely acknowledged that the planning system is under increasing pressure and this is leading to delays in approvals being issued. Alongside this, there is the continual rise in requirements for technical surveys and reports to accompany any planning application – all of which costs the NHS time delays to the improvements of services and money that could otherwise be used towards the delivery of frontline clinical services. Our own calculations show how a two-year delay to getting spades in the ground adds 36% to the costs of a project. In three years – a not untypical; delay – costs jump an incredible 49%.
Therefore, these recent changes, if used effectively, can bring significant benefits to the healthcare sector.
Introduction of Planning Use Class E
From 1 September 2020, the planning use class order has been drastically changed with a new use class created called Commercial, Business and Service. This brings together a number of existing use classes into one single-use class which means a change of use between them can now take place without the need for planning permission. However, shops and facilities which are deemed as being important to the local community have been placed into Use Class F2.
This change has been made to allow flexibility at a time when it is most needed on our high streets and to allow for a mix of uses to reflect the changing demands on the high street. However, the consequences of this also apply to these uses away from high streets and town centres.
Why is this useful?
This opens up a huge amount of flexibility to health building owners and removes the risk, delay and capital cost connected with planning applications.
This means that if a health building is occupied by two different occupiers within Class E, for example, a GP surgery and a pharmacy, these uses can now flex internal space (subject to other agreements) between the two occupiers as the demands and needs change. Likewise, if the space is available, an additional use could now be brought into the building, such as another type of retail outlet or coffee shop with a rental income attached to it.
The flexibility of Class E means that the opportunity now exists for health uses to expand as well. If a neighbouring building is also in Class E, then it could be used for healthcare straight away, subject to any alterations necessary. This could be very useful as we emerge from the pandemic environment to provide additional space, such as waiting/circulation areas or clinical space such as vaccination rooms.
An unintended but positive change for the high street is health forming a key part of the town centre. As we are seeing larger retail units, such as department stores, becoming vacant these could form an existing building base for health to locate into at rates that are now affordable to healthcare, when previously they would have been prohibitively expensive.
Whilst more limited for hospitals in Class C2, if parts of the existing estate are used for ancillary purposes, such as an office or admin space, these could be repurposed to diversified supporting or income-generating uses.
Permitted development rights
Greater options are now available to acute healthcare operators. Permitted development rights have been increased to allow hospitals to extend by up to 25% of the existing footprint or 250sqm (whichever is the greater) and it could make the difference to a programme of works not requiring planning permission. This difference would not only relate to the capital cost saving but also to the time delay connected to planning as the risk connected to this would be removed.
Within this year’s Queen’s Speech, a new planning bill was referenced. This covers a variety of changes, including the introduction of a zoning system that could see certain uses allowed in certain areas where they conform with pre-agreed local plans. It will become important for healthcare to be recognised within these zones and for operators to ensure that they are included within these plans to remove any unnecessary delay connected to the planning system.
Other changes include reforms to speed up the planning process for more substantial infrastructure projects, including hospitals. This reform would encourage planners to prioritise these planning applications, including a shorter statutory timescale of 10 weeks for determination. Further details will follow, but how this will work in practice when planning applications are already taking significantly longer than the current statutory 13-week period to be determined needs to be considered.
Whilst some of the beneficial planning system changes are yet to be finalised, this shouldn’t mean a project is put on hold. With the recent planning modifications announced in 2020, these could well be enough to deliver the significant change needed in health and care estate, with only more to come.
 A1 (shops), A2 (financial and professional services), A3 (restaurants and cafes) and B1 (business) as well as parts of classes D1 (non-residential institutions, including health centres) and D2 (assembly and leisure)