Creating a fairer Salford by:
15.1 A healthy population is an essential component of a sustainable Salford. Good health not only makes a major contribution to quality of life, but also supports a strong economy. Salford currently suffers from very significant health inequalities, and average health levels in the city are generally much worse than the national average. Male life expectancy at birth for Salford residents is 2.5 years less than the UK average, and female life expectancy at birth is 2 years less. Healthy life expectancy (HLE) is the average number of years a person would expect to live in good health. Males in Salford are expected to spend 75.3% of their lives in good health compared to 79.7% for the UK overall. Females in Salford are expected to spend 73% of their lives in good health compared to 77.1% for the UK overall [1]. Average life expectancy in the city’s most deprived areas is 10.9 years lower for men and 7.6 years lower for women than in its least deprived areas [2]. These significant inequalities make it essential that all Salford residents have excellent access to high quality health facilities and have the opportunity to adopt healthy lifestyles.
15.2 Recent years have seen much greater local control over health services and expenditure. In April 2016, Greater Manchester became the first region in the country to take control of its combined health and social care budgets. The Health and Social Care Act 2012 has given local authorities new responsibilities for public health, joining up local health policy with all other areas of work. A key aim is to better integrate health and social care services including wider community health services. In Salford, the formation of the Salford Together Partnership brings together the city council, the NHS Salford Clinical Commissioning Group (CCG), Salford Royal Foundation Trust, Salford Primary Care Together and Greater Manchester West Mental Health NHS Foundation Trust, to deliver a clear vision for improved and more integrated health care for the people of Salford. The Salford Locality Plan sets out the vision for the improvement of wellbeing, health and care outcomes for residents in the city:
“Salford people will start, live and age well - People in Salford will get the best start in life, will go on to have a fulfilling and productive adulthood, will be able to manage their health well into their older age and die in a dignified manner in a setting of their choosing. People across Salford will experience health on a parallel with the current “best” in Greater Manchester (GM), and the gaps between communities will be narrower than they have ever been before.”[3]
15.3 Salford is also a member of the World Health Organisation global network of Age Friendly Cities and Communities and as such is committed to creating inclusive and accessible urban environments that more effectively meet the needs of an ageing population.
15.4 The Local Plan has a significant role to play in delivering the Salford Locality Plan vision, an age friendly city and supporting health improvements more generally. It is vital that health considerations are integrated into all aspects of the plan, and without this it is difficult to see how any development strategy for the city could be considered ‘sustainable’. The challenges are likely to increase given the forecast increase in the average age of the population.
Significant improvements in the health of Salford residents, and reductions in health inequalities in the city, will be sought, including by:
15.5 New development has the potential to support significant improvements in human health, but can also have considerable adverse impacts on health if it is inappropriately located, designed, constructed and/or operated. Certain types of use can cause detrimental cumulative impacts as a result of their concentration. It is important that specific consideration is given to the potential overall impact of development on health during the planning process, with individual proposals seeking to maximise their positive contribution as far as practicable, recognising that health requirements and issues can vary between different groups of identity and on an individual basis. Health impact assessments will be an important tool for this.
All development shall support an improvement in public health and a reduction in health inequalities, including by:
Health impact assessments will be required for development proposals that the city council considers would have the potential to have a significant adverse impact on health and wellbeing. Health impact assessments shall:
Development that would have an unacceptable impact on health or wellbeing will not be permitted.
In particular, the location and concentration of the following types of development will be carefully controlled to avoid possible adverse impacts on health and wellbeing:
Where new facilities related to points A-D above can be justified, these shall be located away from places that are regularly frequented by younger people such as schools and youth facilities. The proximity to other community uses where the residents can be vulnerable will also be considered, for example refuges and temporary accommodation for the homeless.
15.6 Health and social care facilities in England have traditionally been administered and accessed separately. As a result of people living longer on average, an increasing number of residents require both health and social care services and current policy is focussed on integrating the two services.
15.7 Recent practice mergers have helped to reduce the relatively high proportion of small and sole-practitioner GP practices in the city, and some further consolidation may be necessary to deliver service improvements whilst ensuring that facilities remain easy for residents to travel to. Salford Clinical Commissioning Group (CCG) has identified that whilst a number of neighbourhoods are well-served by modern purpose-built health care facilities, there are parts of the city where improved facilities are required. The vision to transfer all care that does not require hospital facilities to a more accessible neighbourhood setting will need to be taken into account in improving existing and providing new facilities.
15.8 The scale of additional housing proposed in the Local Plan will increase the pressure on existing health facilities. Improving the overall quality and, where needed, capacity of Salford’s primary care facilities will therefore be important, and this should also help to reduce pressure on hospital facilities. Maximising the accessibility of facilities to residents will promote their use and hence support better health, and so town and local centres will often be a suitable location for them.
Improvements in the quality and accessibility of health and social care facilities will be supported.
Where it would help to improve health outcomes whilst maintaining an appropriate level of accessibility for local residents, the merging of primary health care facilities such as GP practices, and their amalgamation with other health and social care facilities, will be supported.
Primary health care facilities shall be co-located with other public facilities where possible, in order to provide a stronger focus of public services for local communities and to promote linked trips.
The city council will work with the Clinical Commissioning Group and other health care providers to ensure that the capacity of health and social care facilities in Salford increases in line with the growing population and its changing needs.
Areas that are subject to a masterplan under Policy EF2 shall ensure that appropriate provision is made for primary health care facilities. Individual developments that would generate a significant additional demand for primary health care, including all those involving 300 or more dwellings, will be required to incorporate appropriate primary health care facilities, unless satisfactory provision can be made elsewhere within the local area.
Developers should engage with the Clinical Commissioning Group at the earliest opportunity in order to determine the health care requirements associated with new development.
15.9 Salford Royal Hospital is a large and busy teaching hospital, with around 750 in-patient beds. It provides a comprehensive range of services to the population of Salford, as well as a wider range of specialist services for the whole of Greater Manchester and beyond. The hospital is part of the Salford Royal NHS Foundation Trust which employs over 7,000 staff and also provides community, social and primary care services [4].
15.10 A programme of redevelopment has recently been undertaken at Salford Royal Hospital to deliver high quality new facilities. There is an ambition to move a range of services away from the hospital site and into the community, which will support more integrated services locally and enable more specialist services catering for a wider population to be based on the hospital site. It is likely that further improvements to the hospital will be required, and it is essential that these are coordinated so as to ensure that the site functions as efficiently and effectively as possible, high design standards are achieved, and the impacts on neighbouring communities are minimised particularly in terms of traffic generation and car parking.
The role of Salford Royal Hospital as both a local facility for the city’s residents and a regional centre of excellence will be further enhanced.
Development proposals for the hospital shall:
15.11 The main indicators that will be used to monitor this chapter are:
|
Indicator |
Target |
|---|---|
|
Average life expectancy at birth |
Increase (2018-2037) |
|
Gap between average life expectancy at birth between wards in Salford |
Decrease (2018-2037) |
|
Gap between average life expectancy at birth in the worst performing Salford wards and the UK average |
Decrease (2018-2037) |
|
Excess weight in adults (% of residents overweight or obese, based on body mass index (BMI)) |
Decrease (2018-2037) |
|
Excess weight in reception and year 6 children |
Decrease (2018-2037) |
|
Type 2 diabetes prevalence |
Decrease (2018-2037) |
|
Number of off-licences |
No target |
|
Provision of primary health care facilities
|
Increase (2018-2037) |
15.12 Health is influenced by all aspects of the Local Plan, therefore indicators in other chapters are also relevant to the delivery and monitoring of health improvement, particularly those on recreation, housing, education, accessibility, employment, energy, water, and pollution and hazards.
[1] Salford City Council (February 2018) Life Expectancy at Birth 2016: Analysis
[2] Public Health England (2018) Salford Health Profile 2018
[3] NHS Salford CCG (August 2017) Locality Plan for Salford: Start Well. Live Well. Age Well., p.6
[4] Salford Royal NHS Foundation Trust (2018) Annual Report and Accounts 1 April 2017 to 31 March 2018, p7 and 31