Closing the gap between healthcare planning and investment

Robert Dibden, Planning Director at Lichfields, notes healthcare investment and planning isn’t aligned in England – so what can be done to close the gap?

Research from Lichfields has found that despite record levels of government investment in hospitals and neighbourhood health facilities, most local plans are not consistently making adequate provision for healthcare estates.

The study, Strategic Planning for Healthcare Estates, highlights a clear mismatch between national ambitions and local policy. Of the 88 local plans adopted since March 2020, only 63% contain a strategic objective to improve health or healthcare, while just 26% include site-specific policies or allocations for new health facilities. This patchy coverage suggests that many projects in the development pipeline, including those in the government’s new hospitals programme, will need to move forward without an up-to-date planning status or site designation.

The findings come at a critical moment, with national policy and funding creating opportunities to renew the country’s ageing healthcare estate. In Westminster, the Labour government’s revised National Planning Policy Framework, published in December 2024, mentions ‘health’ or ‘healthier’ no fewer than 39 times, underlining the drive to integrate health outcomes into planning decisions. Alongside this, the 2025 Spending Review confirmed a £4bn uplift to the Department of Health and Social Care’s annual capital budget and pledged £30bn over the next five years to maintain and modernise the NHS estate, including eliminating RAAC (reinforced autoclaved aerated concrete) by 2035.

Keeping pace?

Our research shows that many local plans are not always keeping pace with this new policy and investment landscape. Too often, there is a disconnect between health infrastructure strategies and the planning frameworks designed to support them. Closing that gap is essential if we are to see new hospitals and neighbourhood health facilities delivered on the ground at the pace that’s needed.

Lichfields is already advising on schemes such as Berwick Community Hospital, due to open in 2026, and the redevelopment of Leeds General Infirmary, scheduled between 2030 and 2035 – examples of projects where strategic planning alignment is crucial to timely delivery.

The report also points to 2026 as a pivotal year for plan-making, as local planning authorities update their evidence bases and begin consultations on new allocations to reflect higher national development targets. This year will be critical as local authorities move forward with new local plans. It’s essential that health trusts use this opportunity to engage early and secure the policy support that will ensure their projects are streamlined. By embedding proposals into statutory plans from the start, they can reduce risks, accelerate delivery and make sure communities see the benefits of investment in healthcare infrastructure much sooner.

Robert Dibden has an academic background in architecture, and his work has involved large commercial, healthcare and education schemes across the north of England and Scotland. He manages major planning applications and planning reports, providing due diligence advice on developer’s planning applications and development strategies.

Read the National Planning Policy Framework at b.link/MHCLG_NPPF
Download Lichfields’ study at b.link/Lichfields_study

Image credit | Alamy