Information on Health and Spatial Planning in Surrey July 2026

Page contents

• Background
• Planning in Surrey
• Surrey health and wellbeing partnerships
• Tools for healthy placemaking in Surrey

1. Background

1.1 The purpose of this document is to strengthen links across planning and health teams by outlining the organisations responsible for planning and health and signposting to tools which can be used for healthy place making.

1.2 The focus of this document is to highlight to individuals and organisations involved in the development process the benefits that can be achieved when health is considered as part of the development and planning process and to signpost to tools for healthy place making in Surrey. As well as being of interest to developers the document is intended for officers from health and planning teams across Surrey. It will also be of interest to other colleagues and elected members as well as adjoining authorities that share cross-boundary health issues.

1.3 There are two elements to planning and health; one is creating environments that encourage and enable healthy lifestyles by supporting the building blocks of health, and the other is identifying and securing appropriate health infrastructure to support the delivery of local health and care services.

1.4 The built and natural environment are major determinants of health and wellbeing. The built and natural environment refers to the characteristics of a physical environment in which people live, work and play, including schools, workplaces, homes, communities, parks/recreation areas, green (for example visible grass, trees and other vegetation) and blue (for example visible water) spaces.

1.5 The design of our environments helps to shape the social, economic and commercial factors that determine some of our health behaviours and health outcomes.   For example, the design of our neighbourhoods can influence physical activity levels, travel patterns, access to education and employment, and social connectivity, which in turn can influence our mental and physical health and wellbeing.

1.6 The UK Health Security Agency (UKHSA) defines the wider determinants of health (sometimes known as the social determinants or ‘the building blocks of health’) as ‘a diverse range of social, economic and environmental factors which impact on people's health’.

1.7 The health map in Figure 1 illustrates how health and wellbeing are shaped by these wider determinants, as well as the influence of individual factors and healthcare.

Figure 1: The health map, Barton and Grant 2006 (based on Dahlgren and Whitehead 1991)

• Global ecosystem impacts:
  • Natural environments; built environments and activities
• These in-turn impact:
  • Local economy; community and lifestyle.
• Climate stability impacts:
  • Natural habitats; buildings and places; how we work, shop and move
• These in-turn impact:
  • Wealth creation; social capital; aiet and physical activity.
• Biodiversity impacts:
  • Air, water and land; streets and routes; living, playing and learning
• These in-turn impact:
  • Resilient markets; social networks and work-life balance.

1.8 Social, economic and environmental factors are influenced by the local, national and international distribution of power and resources which shape the conditions of daily life. They determine the extent to which different individuals have the physical, social and personal resources to identify and achieve goals, meet their needs and deal with changes to their circumstances. People who are socio-economically disadvantaged are more likely to experience poorer health and wellbeing outcomes.

1.9 The increasing focus on health and spatial planning provides an opportunity to bring together health, Public Health and planning specialists across Surrey to address the wider determinants of health. It enables partners in Surrey’s councils and across the wider health system to collaborate to improve the health of our current and future residents through the planning of the built and natural environment.

2. Planning in Surrey

2.1 ‘Planning ensures that the right development happens in the right place at the right time, benefitting communities and the economy. It plays a critical role in identifying what development is needed and where, what areas need to be protected or enhanced and in assessing whether proposed development is suitable.’ From the Governments 2015 Plain English Guide to the planning system.

2.2 The National Planning Policy Framework 2023 and relevant planning practice guidance sets out the Government's planning policies for England and how these should be applied. The planning system aims to achieve economic, social and environmental objectives through sustainable development. Health and wellbeing are embedded in the social objective of the planning system, which should ‘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 foster ‘a well-designed and safe built environment, with accessible services and open spaces that reflect current and future needs and support communities' health, social and cultural well-being.’ Links to planning and health are found throughout the National Planning Policy Framework and the Planning Practice Guidance. Guidance on healthy and safe communities was last updated in August 2022.

2.3 Planning functions in Surrey are divided over three tiers of local government:

• County Council
• District and Borough Councils
• Parish or Town Councils

2.4 On 28 October 2025 Government confirmed plans for local government reorganisation in Surrey. Two new unitary councils will replace the existing 12 county and district and borough councils in April 2027. The creation of two unitary councils, East Surrey and West Surrey, means that from April 2027 an East Surrey unitary authority will replace the current areas covered by Elmbridge, Epsom and Ewell, Mole Valley, Reigate and Banstead, and Tandridge councils. A West Surrey unitary authority will take over the areas of Guildford, Runnymede, Spelthorne, Surrey Heath, Waverley and Woking.

2.5 East Surrey and West Surrey councils will take on the statutory planning functions of district and borough councils, which are plan making and development management. Town and parish councils will continue to be important statutory consultees in the planning process and will continue to produce neighbourhood plans for their local areas.

2.6 Work has commenced to prepare a Surrey Spatial Development Strategy (SDS), as introduced through recent national plan-making reforms. The SDS will be a statutory, high-level strategic plan covering the whole of Surrey, setting out the broad distribution of growth, key infrastructure priorities and areas for environmental protection over the long term. Once adopted, the SDS will form part of the development plan and will provide the strategic framework within which Local Plans, will be prepared. Local Plans will remain responsible for detailed policies and site allocations but will need to be in general conformity with the spatial direction established by the SDS once the SDS has been adopted.

2.7 The preparation of the SDS alongside local plans presents an important opportunity to align housing, infrastructure, environmental and health priorities across local authority boundaries, ensuring a more coordinated and effective approach to sustainable growth.

Surrey County Council

2.8 The County Council is the Minerals and Waste Planning Authority (MWPA) for Surrey and prepares development plan documents for both minerals and waste which set out a framework of policies to guide minerals and waste management development in the county. The County Council in its role as MWPA deals with applications for minerals and waste management development. In its role as County Planning Authority, it also deals with applications for its own development, such as schools and libraries.

2.9 Surrey County Council is a statutory consultee for Local Plans produced by district and borough councils and, as the Highway Authority and Lead Local Flood Authority for Surrey and lead authority for education and archaeology, it is consulted on planning applications for developments that are likely to have impacts related to those roles and functions.

2.10 As the local highways authority, Surrey County Council prepares the Local Transport Plan (LTP) which is a statutory document setting the strategy for the management, maintenance and development of the county's transport system. The LTP is presented to the Department for Transport and although it is not part of the Town and Country Planning Act it is closely related. See paragraphs 4.18 and 4.19 below for more details on the Surrey Local Transport Plan 4.

2.11 The Surrey County Council Public Health team review and comment on local and neighbourhood plans to ensure they align with Surrey’s Health & Wellbeing Strategy to meet the County Council's objective to tackle health inequality.

District and borough councils

2.12 In Surrey, district and borough councils are responsible for most planning matters. They have two statutory functions:

• Plan making – the Local Plan sets the vision for an area (spatial strategy), allocates sites and sets the framework for consistent decision making (development management policies).
• Development management – district and borough councils determine planning applications for building, extending or converting homes, offices and shops and development other than minerals and waste and major infrastructure projects.

2.13 The Local Plan addresses needs and opportunities in relation to housing, the economy, community facilities and infrastructure, as well as a basis for safeguarding the environment, adapting to climate change and securing good design.

2.14 Districts and Boroughs have a statutory duty to cooperate with numerous stakeholders when preparing the Local Plan. This includes: the relevant NHS Integrated Care Board covering the local planning authority area to ensure that provision of required health infrastructure is considered upfront in plans and in planning decisions; and the County Council in relation to the provision of additional infrastructure and services such as education and transport. The SCC Public Health Team is not a statutory consultee. However, through the joint working of the Health & Planning Forum, councils involve Public Health as a key stakeholder because of expertise on wider determinants of health and health inequalities.   Planners should work with SCC to identify local health and wellbeing priorities and issues.

2.15 New Town and Country Planning (Local Planning) (England) Regulations 2026 came into effect in March 2026 and replace the 2012 plan-making regulations. Changes to the plan making system include a 30-month local plan timetable, which will include a period of early engagement followed by two rounds of public consultation and three Gateway Assessments, with examination expected to occur within the 30-month timetable. There is a transition period in which current local plans can still progress under previous legislation. Plans that are at an advanced stage can proceed if they are submitted by December 2026. Some district and borough councils are proceeding with their plans under the legacy plan making system and others are preparing new-style plans under the new plan making system.

2.16 The position for Surrey district and boroughs as of July 2026 was:

• Elmbridge: New Local Plan at pre-commencement/evidence gathering stage.
• Epsom and Ewell: Local Plan under legacy plan making system at Examination in Public stage.
• Guildford: Regulation 19 notice of intention to commence new Local Plan.
• Mole Valley: Mole Valley Local Plan 2020-2039 was adopted October 2024.
• Reigate and Banstead: New Local Plan at pre-commencement/evidence gathering stage.
• Runnymede: Regulation 19 notice of intention to commence new Local Plan.
• Spelthorne: Regulation 20 scoping consultation for new Local Plan.
• Surrey Heath: Local Plan under legacy plan making system at Main Modifications Consultation stage. New Local Plan at pre-commencement/evidence gathering stage.
• Tandridge: Local Plan under legacy plan making system at Regulation 18 Spatial Development Strategy Consultation stage.
• Waverley: Regulation 20 scoping consultation for new Local Plan.
• Woking: Regulation 20 scoping consultation for new Local Plan.

2.17 An application for planning permission is required by planning law to be determined in accordance with local planning policies unless there are material considerations that indicate otherwise. Pre-application engagement, although not a requirement of developers, is an important feature of the development process providing an opportunity to engage with statutory and non-statutory consultees before submission of a planning application.

Parish or Town councils

2.18 Parish or town councils are not Planning Authorities, but they are important statutory consultees in the planning process. They can also produce neighbourhood plans for their local areas that are in general conformity with the Local Plan and can include site allocations. There may also be formally designated Neighbourhood Forums in unparished areas that are able to produce a neighbourhood plan for their area. Neighbourhood plans form part of the overall development plan.

Active Travel England

2.19 As of 1 June 2023, Active Travel England (ATE) is officially a statutory consultee on all planning applications for developments equal to or exceeding 150 housing units, 7,500 sqm of floorspace or an area of 5 hectares. The new role will enable ATE to help planning authorities in their work to implement good active travel design – for example, by ensuring developments include walking, wheeling and cycling connectivity to schools and local amenities. This will help improve public health, save people money and reduce harmful emissions. See the ATE website for details of the ATE planning application assessment toolkit.

3. Surrey health and wellbeing partnerships

Surrey and Sussex Integrated Care Board (ICB)

3.1 The Surrey and Sussex ICB is responsible for strategic commissioning and population health. It works with system partners and Surrey’s Health and Wellbeing Board through an Integrated Care Partnership (ICP) to create the integrated care strategy that informs ICB decision-making and resource allocation. Under government plans to deliver neighbourhood health, local planning authorities and developers may also need to engage with individual neighbourhood health providers.

Director or Public Health, Surrey County Council

3.2 The Director of Public Health (DPH) is responsible for the health and wellbeing of Surrey's population and is a statutory role in the local authority. The DPH sets out the overall vision and objectives for public health in the local area and provides system leadership to address those priorities. The DPH works across all three domains of public health; health protection, health improvement, and health intelligence/healthcare public health. The Director of Public Health at Surrey County Council is Dr Jack Bedeman. The Public Health team supports the DPH in improving and protecting the health of the local population.

Health and Wellbeing Board

3.3 Health and Wellbeing Boards (HWBs) are statutory committees in England that bring together local government, the NHS and the voluntary sector to drive integrated health and social care, reduce health inequalities and address the specific health needs of local populations. They are partnership forums with statutory duties to produce a joint Health and Wellbeing Strategy, a Joint Strategic Needs Assessment (JSNA) - an assessment of the current and future health and care needs of the local population, which informs the strategy – and a Pharmaceutical Needs Assessment.

4. Tools for healthy placemaking in Surrey

4.1 There is an established body of research on healthy place-making. The TCPAs work on healthy place-making includes links to their own publications and links to resources from external organisations Public Health’s Spatial Planning for Health: Evidence Review provides evidence-informed principles for designing healthy places. Section 4 summarises the healthy place-making groups and strategies being developed in Surrey.

Surrey Health and Planning Forum

4.2 The Surrey Health and Planning Forum facilitates links between planning and health (Public Health and the ICB) by providing a forum for health and planning officers to come together to:

• Discuss planning and health infrastructure issues
• Maximise opportunities for health to influence local plans and draw on available funds, including the Community Infrastructure Levy (CIL).
• Embed health and wellbeing into planning policies and decisions.
• Champion health by providing health and wellbeing evidence for local plans.
• Promote use of the Joint Strategic Needs Assessment, Health and Wellbeing Strategy, health intelligence and other health strategies as evidence for local planning.
• Explore the use of Health Impact Assessments (HIA) as a tool for guiding the planning process.

Health Impact Assessment

4.3 Health Impact Assessments (HIA) are a tool used to ensure health and wellbeing is a key consideration in spatial and development planning processes. A HIA assesses both the positive and negative health impacts of a plan, project or proposal and produces recommendations that maximise the positive impacts and mitigate against the negative impacts.

4.4 Local plans are required by law to go through a sustainability appraisal at the outset of each stage of plan preparation. The sustainability appraisal considers the potential social, environmental and economic impacts of the plan and should incorporate a HIA through the inclusion of relevant indicators.

4.5 Guidance on Health Impact Assessment in spatial planning was published by Public Health England in October 2020. Public Health and the Spatial Planning teams at Surrey County Council have published a Guidance Statement on Health Impact Assessments. The statement signposts to national guidance and further resources. It includes Surrey-specific guidance for local planning authorities to include a HIA requirement in their local plans for (a) residential schemes (Use Class C3) of 50 homes or more; (b) developments providing 50 or more C2 bedspaces; and (c) employment sites of 5 hectares (gross) or more.

Considerations for health and wellbeing in local plans

4.6 District and Borough Councils should ensure that the principles of health and wellbeing are integrated into local plans and related documents. They should involve public health colleagues at an early stage in plan development. Considerations include:

• Using the JSNA, academic evidence and other sources of information as the evidence base for policy- and decision-making and ensuring that local plans reflect the issues set out.
• Ensuring that health and wellbeing principles are supported by planning policies.
• Incorporating measurable outcomes on health and submitting health data for monitoring and plan review.
• Ensuring that health-related infrastructure is factored into infrastructure assessments produced in support of the Community Infrastructure Levy (see Coplug analytics tool below).
• Ensuring that health and wellbeing are adequately incorporated into the Sustainability Appraisal of Local Plans or considering requirements for a separate Health Impact Assessment (HIA).
• Adopting a policy requiring a HIA for all developments of 50 units and above.

Coplug analytics tool to assess the health service requirements of new developments

4.7 The NHS in Surrey commissioned Coplug Ltd to develop an analytics tool for use by Surrey councils (based upon the London Healthy Urban Development Unit planning contributions model). The tool uses a range of up-to-date assumptions to assess the health service requirements and cost impacts of new residential development. Outputs from the model have contributed to infrastructure assessments either for entire Local Plans or specific large development sites. The tool also captures pipeline health infrastructure projects both to inform Local Plan development and discussions around Community Infrastructure Levy (CIL)/Section 106 needs.

Planning obligations

4.8 For new development to be acceptable there may be a requirement for investment in affordable housing, infrastructure and supporting services. Section 106 agreements are put in place to make it possible to approve a planning proposal that might not otherwise be acceptable in planning terms. For example, a S106 agreement might require a developer to fund improving the access to a site, paying for a new health clinic, or ensuring the need for affordable housing is met.

4.9 The Community Infrastructure Levy (CIL) is a general charge which can be levied by local authorities on new development in their area. CIL is different to S106 in that it is levied on a much wider range of developments and according to a published tariff schedule. It is an important tool for local authorities to use to help them deliver the infrastructure needed to support development in their area. Most new development which creates net additional floorspace of 100 square metres or more, or creates a new dwelling, is potentially liable for CIL. CIL can be used to fund a wide range of infrastructure, including transport, flood defences, schools, hospitals, and other health and social care facilities.

4.10 In 2026, for example, Surrey Heath Borough Council awarded more than £200,000 in CIL grants to fund improvements to community buildings, facilities and new equipment to promote healthier and more inclusive communities and improve access to green space and recreation. In 2025, Reigate & Banstead Borough Council awarded 11 projects a share of £500,000 of CIL funding for improvements to local facilities, including Horley Health Hub and flood alleviation works.

Surrey 2050 Place Ambition

4.11 Surrey Local Authorities and their strategic partners have developed the Surrey 2050 Place Ambition (refreshed in 2023) which sets out the collective long-term ambition to achieve good growth. Critical to this will be the ambition to improve the overall quality of health and well-being across Surrey, recognising that healthy places and people are a key factor in our long-term prosperity and fundamental to the delivery of good growth.

Sources of local data on health and wellbeing

4.12 Data on health and wellbeing in Surrey can be found on Surrey-i. See the Unitary Authority summaries for local population data at new Unitary Authority level and the Unitary Council Ward summaries for local population data at ward level. The Surrey Health & Wellbeing Strategy Index combines physical, mental and wider determinants of health indicators into thematic groups at different geographic levels. The Index is presented in an interactive dashboard, which is updated every year. The third annual refresh was published in June 2026. The Office of National Statistics provides local data on population, including information on social and economic wellbeing.

Joint Strategic Needs Assessment

4.13 The Joint Strategic Needs Assessment (JSNA) is an assessment of the current and future health and social care needs of the local community. Surrey's JSNA is divided into chapters. Each chapter describes the needs around a specific area of health and social care. Selected chapters take a life course approach. There are five sections into which the chapters are grouped:

• Surrey Context
• Health Behaviours
• Emotional Health & Wellbeing
• Population Groups & Communities
• Wider Determinants of Health

4.14 Each chapter looks to understand the health and wellbeing needs within Surrey's population, identifying health inequalities, describing current service provision and any gaps, and making recommendations for the Surrey system to take forward to improve health outcomes and reduce inequalities. Current chapters include:

• The Surrey Context
• Food and Health
• Loneliness & Social Isolation
• Multiple Disadvantage
• Economy
• Community Safety
• Air Quality

4.15 The range of evidence contained in the JSNA can help inform and influence planning policy, development management and planning decisions. Spatial planning and development management can make an important contribution to meeting the health and wellbeing needs of Surrey’s population. The JSNA is a key source of data and insight for understanding these needs and recommendations for addressing them.

Health and Wellbeing Strategy

4.16 The Health and Wellbeing Board produces a joint Health and Wellbeing Strategy, which is aligned to the Joint Strategic Needs Assessment (JSNA). The strategy enables partners in the Surrey system to work towards shared priorities and outcomes to address health inequalities and ensure no-one is left behind. The strategy has a strong focus on Surrey’s 24 Key Neighbourhoods – wards that encompass the 20% and 30% most deprived Lower Super Output Areas (LSOAs) nationally – and Priority Populations of identity who experience the poorest health outcomes.

4.17 The Health & Wellbeing Strategy Index helps to track progress against delivery of the strategy and identifies existing and emerging needs more quickly.  Data on physical health, mental health and the wider determinants of health are available at district & borough level with some data also available at ward level.

Local Transport Plan 4

4.18 The Surrey Local Transport Plan 4 was approved by Surrey County Council in July 2022. It sets out a roadmap for a transport network in Surrey that helps tackle the climate emergency and includes healthy planning policies such as increasing walking and cycling and Liveable Neighbourhoods (LNs).

4.19 LNs are themed spaces that upscale the importance of neighbourhoods as places for people to live, work and play rather than their importance for the movement of vehicles. Key characteristics of Liveable Neighbourhoods include; increasing the comfort, safety and accessibility of walking and cycling; creating space for community facilities like parks, gardens, play spaces and seating; creating attractive local environments and welcoming neighbourhoods that people want to live in; reducing the dominance of cars and goods vehicles resulting in improved safety, air quality and noise pollution to encourage active travel and social cohesion.

Healthy Streets for Surrey design guide

4.20 The Healthy Streets for Surrey design guide was approved by Surrey County Council in October 2022. It establishes the standards that the County Council would expect newly designed streets to meet. The aim is to enable the creation of places that improve Surrey residents' physical and mental health and reduce their environmental footprint by encouraging walking and cycling; streets in which children can play safely; improved air quality; re-greened streets and public spaces; a reduction in residents' transport carbon footprint; and the creation of beautiful, resilient and popular streets that will ultimately require less long-term maintenance.