Source · Select Committees · Health and Social Care Committee
First Report - Prevention in health and social care: healthy places
Health and Social Care Committee
HC 484
Published 19 January 2024
Recommendations
4
Deferred
Para 17
Require Government to update and implement Decent Homes Standard for all rented sectors promptly.
Recommendation
We recommend the Government proceeds without delay in the consultation necessary to update the Decent Homes Standard for the social rented sector and in implementing a Decent Homes Standard for the private rented sector. It should set out a timetable …
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Government Response Summary
The government deflected the recommendation by discussing the role of the National Planning Policy Framework in creating healthy communities and stating they are not looking to extend the list of statutory planning consultees, rather than providing a timetable for updating and implementing the Decent Homes Standard.
Department of Health and Social Care
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5
Deferred
Expedite Awaab's Law implementation and extend safeguards against health hazards to private tenants.
Recommendation
It is welcome that the Government’s has proposed measures to protect social sector tenants from the worst impacts of unhealthy homes, via the implementation of “Awaab’s law”. We recommend that the Government act quickly on the outcome of its consultation …
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Government Response Summary
The government deflected the recommendation by discussing the growth and delivery of social prescribing initiatives and related targets, rather than providing an update on 'Awaab’s Law' consultation outcomes or considering extending housing hazard safeguards to the private rented sector.
Department of Health and Social Care
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6
Deferred
Para 26
Voluntary quality standards for housing development fail to adequately protect residents' health.
Recommendation
An absence of hazards is not enough on its own to ensure that housing protects residents’ health. Space, design and location matter, and these should not be the preserve of those who are able to afford more expensive housing. Several …
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Government Response Summary
The government deflected the recommendation by discussing the roles of local directors of public health and Integrated Care Boards, stating there are no plans to alter ICB membership requirements, rather than addressing housing quality standards, space, design, or developer requirements for health-protective housing.
Department of Health and Social Care
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7
Accepted
Para 27
Consult on making health-related design and space standards mandatory for all new dwellings.
Recommendation
We recommend the Government consult on both the content of existing design and space standards as they relate to health, and on the implications of making such standards mandatory for new dwellings—both for developments requiring standard planning consent, and for …
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Government Response Summary
The government acknowledges the importance of healthy places and is committed to the Levelling Up mission, highlighting existing cross-government work and initiatives, but does not commit to the recommended consultation on making design and space standards mandatory for new dwellings.
Department of Health and Social Care
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9
Accepted
Para 38
Lack of clarity and integration post-PHE hinders health promotion in planning applications.
Recommendation
The former Public Health England’s Healthy Places team had a clear remit to support healthy development. Following PHE’s dissolution and the division of its responsibilities, there is a lack of clarity over which part of DHSC is now responsible for …
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Government Response Summary
The government states that the former Public Health England's Healthy Places team transferred to the Office for Health Improvement and Disparities (OHID) within DHSC, where officials continue their work to improve public health through the built and natural environment.
Department of Health and Social Care
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10
Rejected
Para 39
Make OHID a statutory consultee for all new large housing developments.
Recommendation
We recommend that OHID be made a statutory consultee for new large housing developments, building on role already accorded to Active Travel England in supporting inclusive, effective and health-protecting development.
Government Response Summary
The government rejects the recommendation to make OHID a statutory consultee for new housing developments, citing concerns about justifying new consultees, slowing down the application process, and value for money, and states it is not currently extending the list of statutory consultees.
Department of Health and Social Care
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12
Rejected
Establish national social prescribing strategy to improve practitioner confidence and youth engagement.
Recommendation
We recommend DHSC work with NHS England and existing networks and providers to develop a national strategy for social prescribing. This should aim to improve understanding amongst frontline clinical practitioners of the benefits of social prescribing and to improve their …
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Government Response Summary
The government rejects the recommendation for a new national social prescribing strategy, stating that national ambitions are already set in the NHS Long Term Plan, significant progress has been made, and existing guidance provides strategic direction for its integration into care pathways.
Department of Health and Social Care
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14
Rejected
Para 56
Reconsider mandating public health representatives on Integrated Care Boards to prioritise prevention
Recommendation
We have previously recommended that all ICBs should include a public health representative, such as a public health director, and that DHSC considers making this a mandatory requirement. In response, the Department said it agreed that prevention needs to be …
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Government Response Summary
The government rejects the recommendation to reconsider mandating public health representatives on ICBs, stating it has no plans to alter the Health and Care Act 2022 and emphasizing ICB autonomy and existing duties for local authorities to provide public health advice.
Department of Health and Social Care
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Conclusions (7)
1
Conclusion
Accepted
Para 7
The places where people live—homes, communities and neighbourhoods—affect their health and wellbeing substantially. Place, health inequalities and the likelihood of developing preventable health conditions are inextricably linked. People from less well-off groups, and those who live in less well-off neighbourhoods, have a much higher likelihood of developing life-limiting health conditions …
Government Response Summary
The government is extending the Decent Homes Standard (DHS) to the private rented sector through the Renters (Reform) Bill and aims to halve non-decent rented homes by 2030. They have engaged with stakeholders, commissioned analysis, and intend to publish a consultation on an updated DHS soon.
2
Conclusion
Accepted
The evidence base on the importance of place in protecting good health is stronger than it has ever been. But as we discuss in the next chapter, we have known about the relationship between health and place for decades, if not longer. It is frustrating that more progress has not …
Government Response Summary
The government has introduced 'Awaab’s Law' via the Social Housing (Regulation) Act 2023 to mandate social landlords to address hazards like damp and mould within a fixed timeframe. The Renters (Reform) Bill will also introduce a Decent Homes Standard for the private rented sector and establish a new PRS Ombudsman.
3
Conclusion
Accepted
Para 16
Homes in the private rented sector contribute disproportionately to both the total number of poor quality homes and the costs that poor housing causes to the NHS. The existence of a statutory minimum standard for housing in the social rented sector is not enough on its own to protect tenants …
Government Response Summary
The government highlights existing measures such as the Nationally Described Space Standard, requirements for Permitted Development Rights, and design codes as mechanisms to maintain design quality. They conclude that further consultation on design or space standards is not necessary at this time.
8
Conclusion
Accepted
Para 37
Local authorities and councils necessarily consider a wide range of criteria in assessing planning applications. This, alongside pressures on their resources and skills, makes it difficult for them to prioritise ensuring that planning promotes health. The lack of changes to requirements relating to health in the revised National Planning Policy …
Government Response Summary
The government agrees that places where people live, work and age is critical to our health and describes actions being taken to ensure health, wellbeing and action to tackle disparities are embedded across new active travel policies and programmes.
11
Conclusion
Rejected
Para 47
Frontline health and social care staff do not only deal with immediate medical needs. People also present to the health service with issues that relate to unmet social needs, which can in turn, over time, develop into medical needs. Increased use of social prescribing can both relieve pressure on clinical …
Government Response Summary
The government declines the recommendation, stating that national ambitions for the delivery of social prescribing have been set out in the NHS Long Term Plan and that social prescribing has grown significantly across England since 2019, exceeding NHS Long Term Plan commitments.
13
Conclusion
Accepted
Para 55
Integrated Care Systems aim to enable a stronger focus on prevention, and on the specific approaches needed in different communities to help ensure that they are “healthy places”. But this is a long-term agenda. The mixed longer-term outcomes of initiatives such as Healthy New Towns demonstrate that building communities that …
Government Response Summary
The government agrees that much of what keeps us healthy lies outside the NHS and social care system and that creating healthy places and ensuring good health for all is essential to Levelling Up. DHSC is collaborating with DfT and Active Travel England to help deliver the Government’s cycling and walking plan. The Public Health England Healthy Places team transferred to the Office for Health Improvement and Disparities (OHID), within DHSC.
15
Conclusion
Accepted
Healthy places are vital to protecting people’s physical and mental health from both direct and indirect consequences and in turn, to building a sustainable health service. “Healthy places” include both the built environment—homes, communities and neighbourhoods—and wider environmental factors, such as air quality and emission levels. The benefits of building …
Government Response Summary
The government accepts the committee's conclusion, stating it is already committed to creating healthy places through the Levelling Up mission, the Green Infrastructure Framework, and collaborations with other departments on active travel and public health initiatives.