Agenda Item 5C

Page 37 Agenda Item 5c

8 week date Application No. Date of meeting Report No.

12/03/2010 20090979 17/03/2010

Land rear of The Theatre Guild, Vale Road, Northfleet

Erection of part two storey, part single storey building to provide a primary care centre and pharmacy (Stage 3) with associated car parking and landscaping.

GP Group

Recommendation:

To be set out in a supplementary report

1. Site Description

The application site comprises an area of land extending to approximately 0.5 hectares (1.1. acres) of land and is located at the rear of and to the west of the Gravesend District Theatre Guild building at the junction of Vale Road with Thames Way and extends beyond the site of the existing temporary doctors surgery.

It comprises a small part of the land comprising the Northfleet Urban County Park, which extends to some 25 acres in total.

Following a planning permission granted in May last year a temporary building for a primary medical care centre as a walk-in surgery together with a tarmaced car park for 12 cars (on 0.1 hectares) was built immediately adjacent to the Theatre Guild building and this became operational in mid September and is known as The White Horse Surgery.

That particular site was previously partly used as an overflow parking area (a hoggin surface, with some pot holes and ponding) and partly as a very small part of the larger Northfleet Urban Country Park. There was also a small brick storage building with a pitched felted roof on the site and which was formerly changing rooms for playing fields at the rear of Springhead Road. The building was subsequently used by the Gravesend and District Theatre Guild as a scenery store. This was demolished when the temporary surgery was built.

A further plot of land extending to 0.269 hectares (0.66 acres) immediately between the current application site and the temporary facility site was the subject of an approval for a permanent replacement medical care centre in November 2009. That site comprised a small part of the urban country park and a part of it was used for green composting/open storage by Gravesham Services.

There is a public footpath (NU21) shown on the definitive map that runs behind and on the south side of the Theatre Guild building running parallel with the building and alongside Thames Way and the Fastrack bus lane in the grass verge, but not within the application site. There is a kissing gate entrance from the public footpath in

Page 38

Thames Way into the Theatre Guild site. This runs as a rough path, but signposted as a footpath (permissive) along the edge of the car park and joins with another informal path that was created within the country park. There is also a pedestrian entrance into the car park of the temporary surgery.

Vehicular access to the site is from the existing entrance from Vale Road that serves the parking area for the Theatre Guild building. The access is gated. A play group also operates from the Theatre Guild building (Little Angels Day Nursery).

The Theatre Guild occupies a single storey brick building with a corrugated metal roof and which has a small flat roofed extension on the south side and there is a triple garage building used for storage just to the west. Both these buildings adjoin but are not within the application site.

The car park to serve the Theatre Guild building is roughly tarmaced but is not marked out. The access into the site is separated from the car parking area by a low post and rail fence. There is no lighting to the car park. As well as being used for parking by users of the Theatre Guild and the day nursery the car parking area is also used by the public visiting the Northfleet urban country park. There is no separate footpath through the site into the country park although there is a footpath that goes into the park from Vale Road next to the gated vehicular access from Vale Road.

The buildings and car park are enclosed by weld mesh fencing along the Vale Road frontage and new weld mesh fencing has been erected around the site of the temporary surgery.

2. Planning History

The Urban Country Park site

The land to the rear of the Theatre Guild building, originally part of a former chalk pit, was part of a much larger area of land either side of what is now Thames Way used partly for recreation purposes but was also used for waste disposal in the early 1950’s and as a public amenity tip in the 1970’s and 1980’s. Tipping ceased as a domestic refuse tip in 1973 but the land continued to be used as a Civic Amenities Tip until 1989. In 1992 gas venting trenches were installed on the edge of the former chalk pit along the Vale Road frontage and in the south west corner.

The ordnance survey plans show that the land immediately to the west of the Theatre Guild building and garage was used as allotment gardens. The current access to the site and to the Theatre Guild building was originally created in 1957 as an access to the refuse tip.

The brick storage building was originally granted permission in March 1974 (reference TH/3/73/467) as sports changing facilities along with planning permission for use of land as sports pitches on 20 acres of land including land at the rear of Brookvale Depot and Northfleet cemetery. This followed an earlier permission in 1970 for use of part of the tip site (18.9 acres) for recreation purposes.

In 1984 planning permission was granted for the construction of Thames Way as part of the South Thames-side Development Route, Stage 5, now classified the A2260. The site was partially restored in 1985 for use as a public open space. The

REPORT NO PAGE 2 Page 39

restoration programme resulted in the creation of a graded slope and levelling of a plateau and some planting.

Planning permission was granted in 1996 (reference GR/94/0656) for the use of the filled in chalk pit for an urban country park. This was on an area of 25 acres. It involved planting, creation of features and provision of footpaths. Longer term proposals for kiosk/toilets have not been provided.

Theatre Guild and Day Nursery

The Theatre Guild building dates from 1957 (reference TH/3/57/85). It was originally built, at the same time as the garage building, as a Cold War civil defence building. In 1978 planning permission was granted for an extension for a kitchen, when it was being used as the Northfleet senior citizens day centre.

In 1990 planning permission was granted for the use of the main hall building for storage rehearsals and performances by the Gravesend and District Theatre Guild with the garage building to be used for storage purposes. The garage building is now used for storage by the Theatre Guild but it was leased out by the Council for storage to local charities.

Planning permission was granted in 1991 to operate a day nursery from the main building.

Planning permission was granted in 1998 for a storage shed attached to the rear of the main Theatre Guild building.

The Primary Care Centre

An application was submitted in March this year (GR/2009/0215) for temporary planning permission for a period of five years for the erection of a pair of adjoining portable buildings for use as a primary care centre (doctors’ surgery).

The floor area of the units in total was 381m 2. The combined unit would measure 25m long by 15.6m wide constructed of plastic coated steel sheets (coloured green) and with a flat roof 3.3m high. The units would provide seven consulting rooms and two treatment rooms.

The units were to be located on the northern half of the site with parking on the southern half. The units/parking had been switched around since the application was first submitted due to the presence of a public sewer.

Twelve car parking spaces were shown within the site and an enclosed bin storage area. It was stated that an overflow parking area will be within the shared parking area on the north side of the Theatre Guild building.

The temporary facility was shown to be located to the west of the Theatre Guild building and garage building but would involve the demolition of the brick storage building.

It was intended to be the first phase of an Equitable Access to Primary Medical Care Facility (EAPMC) to serve the population of Northfleet. The EAPMC programme arose out of the NHS Review (October 2007) carried out by Lord Darzi. The contract to provide this facility was won by Fleet Healthcare and the buildings were to be

REPORT NO PAGE 3 Page 40

developed by GP Group (General Practice Investment Corporation Ltd) on their behalf.

It was proposed that permanent accommodation for the EAPMC service would be provided in an extended Health Campus to the west of the temporary facility which it is also proposed could potentially accommodate the relocation of existing substandard local surgeries and a number of Complementary Healthcare Service Providers.

The new facility was proposed to be named “The White Horse Surgery and Walk-in Centre.”

The application was accompanied by a geo-environmental desk study and contamination risk assessment.

A pre-report Members’ site inspection (Members and officers plus the applicants) took place on Saturday 9 May 2009.

The application was subsequently considered by the Regulatory Board on 27 May 2009.

It was resolved to grant planning permission subject to the following conditions:

1. The temporary building hereby permitted shall be removed from the site including any foundations or slab to accommodate the building not later than 5 years from the date of this permission.

2. The temporary building hereby permitted shall be used as a primary medical care centre within Class D1 of the Town and Country Planning (Use Classes) Order 1987 as amended and for no other purpose.

3. The car parking area shown on the approved drawing, including any access and turning areas shall be formed, surfaced, drained and marked out in accordance with details to be first submitted to and approved by the Local Planning Authority prior to the bringing into use of the temporary building hereby permitted; thereafter it shall be used for and kept available for such use for the duration of the use of the building hereby permitted.

4. Full details of all boundary treatments to the site shall be submitted to and approved in writing by the Local Planning Authority before the commencement of the development; the development shall be carried out in accordance with the approved details before the temporary building hereby permitted is brought into use.

5. Full details of all surface treatments and soft landscaping to the site shall be submitted to and approved in writing by the Local Planning Authority before the commencement of the development; the development shall be carried out in accordance with the approved details before the temporary building hereby permitted is brought into use.

6. Full details of the pedestrian route from Thames Way including the re-siting of the existing kissing gate, if required, as well as access and any gates to enable access for emergency and maintenance to the urban country park shall be submitted to and approved in writing by the Local Planning Authority before the commencement of the

REPORT NO PAGE 4 Page 41

development; the development shall be carried out in accordance with the approved details before the temporary building hereby permitted is brought into use.

7. The rating level of the noise emitted from any plant and equipment associated with this site (other than noise from the exit or entry of road vehicles), shall not exceed the existing background noise level by more than 5dB. The noise levels shall be determined at the nearest noise sensitive premises. The measurements and assessments shall be made according to BS4142:1997.

8. The building hereby permitted shall be open to patients and the public as a primary care medical centre between the hours of 8am and 8pm only on any day.

9. Full details of any lighting to the site or building shall be submitted to and approved in writing by the Local Planning Authority before the commencement of the development; the development shall be carried out in accordance with the approved details before the temporary building hereby permitted is brought into use.

10. Full details of the finished ground levels of the building hereby permitted including the method of construction shall be submitted to and approved in writing by the Local Planning Authority before the commencement of the development; the development shall be carried out in accordance with the approved details before the temporary building hereby permitted is brought into use.

11. If any significant ground works are proposed in connection with this temporary planning permission, the applicant, or their agents or successors in title, shall, before the development commences, secure the implementation of a programme of archaeological work in accordance with a written specification and timetable which has been submitted to and approved by the Local Planning Authority.

12. The developer shall notify the Local Planning Authority (in consultation with Southern Water) of the measures which will be undertaken to protect/divert the public sewers, prior to the commencement of the development.

13. Construction of the development shall not commence until details of the proposed means of surface water disposal have been submitted to and approved by the Local Planning Authority. An acceptable method would be connection to mains sewer. All foul drainage must discharge directly to mains foul sewer.

14. Prior to the commencement of development approved by this planning permission (or such other date or stage in development as may be agreed in writing with the Local Planning Authority), the following components of a scheme to deal with the risks associated with contamination of the site shall each be submitted to and approved, in writing, by the Local Planning Authority:

1) A preliminary risk assessment which has identified: - all previous uses - potential contaminants associated with those uses - a conceptual model of the site indicating sources, pathways and receptors - potentially unacceptable risks arising from contamination at the site.

2) A site investigation scheme, based on (1) to provide information for a detailed assessment of the risk to all receptors that may be affected, including those off site.

REPORT NO PAGE 5 Page 42

3) The site investigation results and the detailed risk assessment (2) and, based on these, an options appraisal and remediation strategy giving full details of the remediation measures required and how they are to be undertaken.

4) A verification plan providing details of the data that will be collected in order to demonstrate that the works set out in (3) are complete and identifying any requirements for longer-term monitoring of pollutant linkages, maintenance and arrangements for contingency action.

Any changes to these components require the express consent of the Local Planning Authority. The scheme shall be implemented as approved.

15. The development hereby permitted shall incorporate some or all of the following building design measures:-

a. The provision of gas impermeable membrane in a competent floor slab.

b. Above ground entry of services such that the floor slab is maintained intact.

c. The sealing of service ducts and entry points against the ingress of landfill gases. It is advisable that service junctions into buildings should be through vented junction boxes.

d. The provision of below floor venting by active or passive means. Passive means are by provision of air vents in outer walls to the below floor airspace. Air flow can be improved by adding vertical stacks incorporating a rotating cowl if required. Active venting is by means of positive ventilation systems. Air vents in passive systems must be kept free of any growth, a concentrate apron around the outer wall may secure this provision.

e. The provision of methane and carbon dioxide gas monitors/alarms in below floor spaces and dead air spaces within the building.

f. The provision of open hole windows in all occupied buildings.

g. Further measures to protect the site as a whole may include gas venting trenches and open grassed areas.

The need for such measures shall be determined on the basis of existing data from current and previous monitoring of land fill gas by Kent County Council. Details of the building design measures shall be submitted to and approved by the Local Planning Authority before the commencement of the development.

16. Floor levels of the units should be set a minimum of 300mm above local ground level

17. Details of a satisfactory method of anchoring the units should be provided before the commencement of the development; the development shall be carried out in accordance with the approved details.

18. A safe access route to the north, away from the flood zone should be identified.

An application (reference GR/2009/0610) was submitted in August 2009 for approval and discharge of planning conditions attached to the permission for the temporary

REPORT NO PAGE 6 Page 43

medical care centre. The application included details of car parking, boundary treatments, surface treatments and soft landscaping, pedestrian route from Thames Way, lighting of the site, finished ground levels, protection/diversion of public sewers, surface water disposal, contamination risks and means of anchoring the portable buildings.

That application was dealt with at officer level and approval was given in November 2009 to the various details.

A further application (GR/2009/0661) was submitted in August 2009 for a permanent medical centre facility at this site to deliver the second phase of the Equitable Access to Primary Medical Care (“EAPMC”) to serve the population of Northfleet.

It was proposed that the permanent accommodation for the EAPMC would replace the temporary facility which would then be removed.

The proposal was for a 879m 2 (Gross Internal Area) building. The ground floor would comprise consulting and treatment rooms with patients reception and waiting area with social services accommodation and plant room. At first floor the building would comprise further consulting rooms, minor operations suite, sub waiting area and staff accommodation. There would be a total of 10 consulting rooms compared to seven consulting rooms in the temporary building.

The building would be two storeys with a height of 7.5m. Because of the adjustment of the ground levels the ground floor slab would be approximately 350mm above existing ground levels. The building had an inverted ‘L’ shaped form with a maximum length of 28m and a maximum width of 23.5m.

The external walls would feature a mix of materials including a brick plinth, part textured facing blockwork with brick banding, part Thermowood timber cladding and principally Trespa Meteon cladding (colour: Moss Green) to the first floor. The roof would be partly flat but the south and east slopes will feature a ‘green roof’ with solar thermal panels. At first floor level skylights were incorporated.

Access into the site was from the existing vehicle and pedestrian entrance off Vale Road. The access road within the site is Council owned and the applicants would have rights of access to use this.

The new permanent building would be located immediately to the west of the temporary building. The existing access serving both the temporary facility and the Theatre Guild building would be extended and incorporate a disabled and ambulance drop off area outside the new building an access for the Kent Rescue and Fire Service into the linear park and an area for parking a mobile diagnostics unit.

The existing car park serving the temporary unit would be retained and extended from the existing 12 spaces to 21 spaces plus an additional three disabled spaces and cycle and motorcycle parking areas.

The new access road within the site and car parking would be built in two stages retaining an access for both cars and pedestrians. The access for the Council and Fire Brigade to the country park would be relocated, temporary while the building is constructed and then to a new permanent position.

REPORT NO PAGE 7 Page 44

In respect of staffing numbers the applicants advised that it was difficult to predict as staffing will depend on patient numbers. Additionally because of the 12 hours a day opening there was a necessity for shift working. Whilst overall staff numbers would be more than the current temporary facility it was anticipated that staff on site at any one time could be in the order of 10.

The applicants advised that the proposed building was simply a permanent replacement for the current temporary facility. To that end it was not a replacement surgery for any other in the area; it was an additional facility for up to 6,000 registered patients and walk- ins. It would operate in the same way as at present facility and would not necessitate the closure of any other practice.

The application was accompanied by a Phase 1 Contamination Desk Study and a Flood Risk Assessment (FRA).

The application was considered by the Board on 11 November 2009.

Planning permission was granted subject to similar conditions imposed on the temporary facility. The permission has not to date been implemented.

3. Proposal

This current proposal is for the third phase of the development of this site for a primary care centre and on site pharmacy and being a permanent replacement facility for the existing GP practices for the Forge and Gateway practices.

The first phase which is now on site was a temporary facility as a drop in centre (known as The White Horse Surgery). The second phase for which planning permission now exists, but which has yet to commence on the site, is the permanent replacement for the temporary facility providing an Equitable Access to Primary Care Medical Centre (EAPMC), being a new GP facility and walk in centre.

The third phase would be located to the west of the EAPMC facility and would provide a replacement for existing surgeries elsewhere in addition to the new facility.

The Gateway Practice currently provides services from two premises, the principal premises being in Hunt Road, Northfleet and the branch surgery being Granby Place, High Street, Northfleet. The applicants indicate that at present both premises are significantly substandard in terms of Disability Discrimination Act (DDA) and Health and Safety. In particular the applicants advise that Granby Place is so deficient in standard that it is now only open in the mornings and only provides standard consulting facilities in order to manage capacity at the Hunt Road premises. In order to access any other services by way of nurse lead treatment, patients have to travel past the intended development site to the premises at Hunt Road. It is likely that in the short term the premises at Granby Place will need to close because of the irreconcilable difficulties with DDA and other legislation.

The premises at Hunt Road are also, according to the applicants, significantly under capacity for the patient numbers it serves. There are already problems with securing appointments due to the lack of available consulting space and infection control issues limit the level of additional services available at this practice. There is no patient parking available at either practice making access problematical.

REPORT NO PAGE 8 Page 45

The applicants advise that the Forge practice currently occupies temporary accommodation in the Age Concern building in Coldharbour Road. The practice was placed in this location on a short term lease which has now expired. The nature of this temporary facility is significantly below standard for confidentiality and infection control. The severely limited space prevents the practice from offering the services that it wishes to and accessing appointment is difficult.

As a result of the above problems the applicants advise that the West Kent PCT identified these to practices as being amongst the most urgent in terms of alternative premises. The business case has been approved by West Kent PCT board.

The existing practices are to be relocated to permanent accommodation within an extended Health Campus which includes the Equitable Access building and a Pharmacy.

The applicant believes this proposal provides an excellent opportunity for the community of Gravesend, particularly as it provides an integrated solution for the relocation of existing GP surgeries that require new premises.

The Practices believe these new premises will make it immediately apparent that this is a development which has the capacity and ability to deliver the best possible primary care services for many years to come.

The specific proposal is for a 1422 sq m (GIA) building comprising Ground and First Floor accommodation for Doctors Surgeries including waiting areas and administration, and includes an on site Pharmacy. The pharmacy has a floor area of 120 sq m.

The building will be two storeys, but because of the adjustment of the ground levels the ground floor slab will be approximately 300 mm above the existing ground levels.

Access is from an existing vehicle and pedestrian entrance off Vale Road, the entrance way and carriage way will be amended to include a new pedestrian footway.

The new access road and car parking will be built in two stages retaining an access for both cars and pedestrians.

The new road layout will incorporate an ambulance/discharged drop off point incorporating a service bay.

The access for the Council and Fire Brigade to the country park is relocated, temporarily, while the building is constructed, and then to a new permanent position. Access will be maintained during construction.

The building has been located on the site to allow for a new sewer to take both surface water and foul drainage. The existing sewer running across the site will be diverted into this.

The total number of parking spaces will be 46 and there will be some cycle parking.

The building has external walls clad at first floor in part with Trespa Meteon moss green (or similar) cladding panels and part Thermowood Cladding with a facing brick plinth and textured fairfaced blockwork with ‘green roof’ to the south and east slopes with a flat roof to falls behind.

REPORT NO PAGE 9 Page 46

Solar thermal panels will be incorporated as a part of the green roof design. The green roof will reduce grey water run off and also provide a replacement ecosystem as well as acting as a buffer to Thames Way. The building will be detailed to have roof insulation and high air tightness reducing energy use. At first floor level skylights are incorporated to reduce the need for artificial light.

Lighting will be provided at low level from bollard type fittings throughout the car park and there will be a mixture of hard and soft landscaping. The building will have floodlighting mounted at high level on PIR sensors.

The applicants advise that the selection of this site was carefully made to take into account public transport links afforded by the fast track bus route. They point out that the most vunerable demographics are found in the area served by Granby Place as this has the lowest car ownership statistics and the most depravation indexes. Patients from this area are already passing the site to access services at Hunt Road, and there is some evidence from the existing walk in centre that patients are accessing this facility when appointments are not available at Hunt Road. This has the knock on effect of increasing waiting times unnecessarily at the walk in centre.

The applicants point out that the majority of patients from both practice areas live within a 10 minute walk of a transport node that will connect with the Fast Track that will bring patients directly to the proposed development. Patients served by the Forge practice similarly benefit from the public transport infrastructure, further more both practices are proposing to engage with Age Concern to arrange bus services from its buildings to the proposed new development and making appointments available to elderly patients around the time table of these services.

4. Development Plan

The Development Plan comprises the Regional Spatial Strategy and the Development Plan Documents (taken as a whole) which have been adopted or approved in relation to the area. These include:-

The Gravesham Local Plan First Review (1994);

The South East Plan (2009) which has recently replaced RPG9 (2001) as regional planning guidance; and

Other plans and planning guidance of some relevance are the Gravesham Local Plan Second Review Draft Deposit Version (2000) and Government Guidance in planning policy guidance and statements.

Gravesham Local Plan First Review 1994

The Gravesham Local Plan still remains as the adopted local planning document and the written statement and proposals map will continue to have effect as the development plan pending the preparation of the Local Development Framework (LDF). A substantial number of policies of the Gravesham Local Plan First Review have been saved by a Direction dated 25 September 2007 of the Secretary of State under paragraph 1 (3) of Schedule 8 to the Planning and Compulsory Purchase Act 2004.

REPORT NO PAGE 10 Page 47

In the Gravesham Local Plan First Review this site is shown as being part of a much larger area of land (26 hectares or 65 acres) running from the North Kent Railway Line in the north and Waterdales in the south and bounded by Springhead Road and Vale Road suitable for mixed use development and subject to major site proposal PM10. That policy/proposal is as follows:-

Proposal PM10: Vale Road and Springhead Road, Northfleet

The Borough Council will promote the development of land at Vale Road and Springhead Road, Northfleet, to provide the following:-

(i) Public open space, including sports pitches and facilities.

(ii) Housing development.

(iii) Employment development - including car showroom facilities (see Policy E4).

The site is also shown as subject to proposal PLT1 being a site for additional open space. That policy/proposal is as follows:-

Proposal PLT1: Additional Open Space including Public Open Space and/or Playing Fields

The following additional areas of land are identified on the Proposals Map for open space purposes, including public open space and/or playing fields:-

(i) Land north of Thames Way, Northfleet 9.2 ha (ii) South of Riverview Park 0.5 ha (iii) Third Avenue, Northfleet (part)* min. 0.40 ha (iv) College Road, Northfleet 1.9 ha (v) Waterton Avenue, Gravesend 1.3 ha (vi) Wombwell Hall (Phase 1), Northfleet* 0.4 ha (vii) Campbell Road Chalk Pit, Gravesend (after restoration) 1.48 ha (viii) Dover Road Pit, Northfleet (after restoration) 0.78 ha (ix) Bat and Ball Ground, Trafalgar Road, Gravesend 2.4 ha (x) Ordnance Road, Gravesend 0.76 ha

and as part of the development of major sites at:-

(xi) West of Wrotham Road, Gravesend* 9.2 ha (xii) North East Gravesend* Undetermined

Both Proposal PM10 and PLT1 are saved policies.

There are no policies/proposals within the adopted Local Plan relating to healthcare/GP provision.

Local Plan Second Review Draft Deposit Version 2000

The draft Gravesham Local Plan Second Review Deposit Version 2000 has been adopted by the Borough Council for development control purposes but in view of the provisions of the Planning and Compulsory Purchase Act 2004 and the intention to prepare a Local Development Framework, it is not being progressed any further. It remains a material consideration but the policies therein are of limited weight. The

REPORT NO PAGE 11 Page 48

weight which can be attached to its policies is greater where the policies are consistent with Government guidance and with policies of the adopted Local Plan First Review or South East Plan.

In the Local Plan Second Review the application including the site of the existing Theatre Guild buildings are shown as an existing Green Grid site and subject to policy LT2.

Policy LT2: Green Grid Site Protection

The Borough Council will protect and enhance the existing elements of the Green Grid network to help achieve the objectives of the Green Grid.

There are no specific policies relating to healthcare provision in the Local Plan Second Review.

There is a general policy (Policy SC1) relating to Social and Community Strategy and Provision as follows:-

Policy SC1: Social and Community Strategy and Provision

In considering proposals for new social and community provision or changes to existing provision, the following criteria will be applied as appropriate:-

i. facilities should be located near or adjoining public transport routes, for preference within existing or planned local centres to maximise accessibility; ii. full consideration should have been given to the accessibility of the facility to all the relevant catchment population by all modes of transport; iii. proposals should have considered the advantages of co-location with other services; iv. the impact of any loss of provision should have been fully explored and mitigated where possible; v. the environmental policies of this Plan (design, building access, car parking) should be taken into account; and vi. service plans should take full account of the future development of Kent Thames-side and the likely future demand for services.

Paragraph 14.7.3. of the Local Plan Second Review states:

GP’s and other medical practitioners (dentists, opticians etc) provide services at a more local scale. There is a clear logic in these being located, where possible, on public transport routes and at local centres, and not being car based. There is an issue about staff car parking due to the emergency element of the function. This approach also offers opportunities for co-location of services (for example Social Services) so that one facility provides for a range of needs by a variety of agencies. Such uses normally sit well with the mixed use concept.

Policy NE23 (Tidal Flood Risk Area) indicates that permanent development within the tidal flood risk area will only be allowed if certain criteria are met.

South East Plan 2009

REPORT NO PAGE 12 Page 49

In the adopted South East Plan planning policies relating to health care provision are wide ranging. These policies, S2 and S6, are as follows:-

POLICY S2: PROMOTING SUSTAINABLE HEALTH SERVICES

Local planning authorities should work closely with the NHS across its delivery bodies to ensure the provision of additional and reconfigured health and social care facilities to meet the anticipated primary care and capacity needs of local communities. Where need is identified, land should be made available for additional community, social and primary care facilities.

Local authorities and the various NHS Trusts should work closely together to facilitate joint planning and to influence NHS estate strategies. Health Impact Assessments should become an integral part of the decision-making process.

POLICY S6: COMMUNITY INFRASTRUCTURE

The regional planning authority and regional partners, including SEEDA, will work with Government and other agencies to increase investment in physical and social infrastructure and secure co-ordination between development and essential infrastructure provision.

Where appropriate, the mixed use of community facilities should be encouraged by local authorities, public agencies and other providers, through local development documents and other measures in order to make effective use of resources and reduce travel and other impacts.

Local planning authorities, in consultation with those delivering services using community infrastructure (including the Third Sector and Faith organisations), will ensure facilities are located and designed appropriately, taking account of local needs and a whole life costing approach.

Policies should also ensure that:

i. community infrastructure supports economic growth and regeneration, with particular priority for health and education provision

ii. creative thinking and action on new mixes of cultural and community facilities is encouraged

iii. appropriate facilities are made accessible to all sections of the community, in both urban and rural settlements.

There are no specific policies in relation to development on open spaces in the South East Plan.

In respect of flood risk there is a policy relevant to the sub-region of Kent Thames Gateway in policy KTG6 as follows:-

POLICY KTG6: FLOOD RISK

REPORT NO PAGE 13 Page 50

In order to accommodate the growth levels proposed in this strategy it will be necessary to implement co-ordinated measures for flood protection and surface water drainage associated with the Rivers Thames, Medway and Swale.

Strategic flood risk assessments will be kept up to date having regard to the latest intelligence on flood levels, and local assessments will be undertaken for major sites at risk, in the light of the Environment Agency’s long term plans for flood risk management. Development will be planned to avoid the risk of flooding and will not be permitted if it would:

i. be subject to an unacceptable risk of flooding or significantly increase the risk elsewhere

ii. prejudice the capacity or integrity of flood plains or flood protection measures

Development plan documents will include policies to:

i. adopt a risk based approach to guiding categories of development away from flood risk areas

ii. ensure that development proposals are accompanied by flood risk assessments

iii. identify opportunities for flood storage areas to contribute to green infrastructure networks.

Planning Policy Guidance and Statements

Relevant policy guidance is contained in PPS1: Delivering Sustainable Development, PPG13: Transport, PPG17: Planning for Open Space, Sport and Recreation and PPS25: Development and Flood Risk.

5. Reason for Report

The Borough Council is the landowner and the site has been the subject of a previous report to the Board.

6. Consultations and Publicity

Consultations

Regulatory Services

The Environment Agency need to be consulted on this application to ensure they are satisfied with the arrangements for protecting groundwater from contamination. There is no objection to the proposed application, subject to the following comments:

Control of noise emitted from premises

The rating level of the noise emitted from any plant and equipment associated with this site (other than noise from the exit or entry of road vehicles), shall not exceed the

REPORT NO PAGE 14 Page 51

existing background noise level by more than 3dB. The noise levels shall be determined at nearest noise sensitive premises. The measurements and assessments shall be made according to BS4142:1997.

Contaminated land

No development approved by this permission shall be commenced prior to a contaminated land assessment (in accordance with the CLEA guidelines and CLR 11 methodology) and if necessary an associated remedial strategy, together with a timetable of works, being submitted to the Local Planning Authority for approval.

a) The contaminated land assessment shall include a desk study to be submitted to the Local Planning Authority for approval. The desk study shall detail the history of the site uses and propose a site investigation strategy based on the relevant information discovered by the desk study. The strategy shall be approved by the Local Planning Authority prior to investigations commencing on site.

b) The site investigation, including relevant soil, soil gas, surface and groundwater sampling, shall be carried out by a suitably qualified and accredited consultant/contractor in accordance with a Quality Assured sampling and analysis methodology.

c) A site investigation report detailing all investigative works and sampling on site, together with the results of analysis, risk assessment to any receptors and a proposed remediation strategy shall be submitted to the Local Planning Authority. The Local Planning Authority shall approve such remedial works as required prior to any remediation commencing on site. The works shall be of such a nature so as to render harmless the identified contamination given the proposed end-use of the site and surrounding environment including any controlled waters.

d) Approved remediation works shall be carried out in full on site under a quality assurance scheme to demonstrate compliance with the proposed methodology and best practice guidance). If during any works contamination is encountered which has not previously been identified then the additional contamination shall be fully assessed and an appropriate remediation scheme agreed with the Local Planning Authority.

e) Upon completion of the works, this condition shall not be discharged until a closure report has been submitted to and approved by the Local Planning Authority. The closure report shall include details of the proposed remediation works and the quality assurance certificates to show that the works have been carried our in full in accordance with the approved methodology. Details of any post remediation sampling and analysis to show the site has reached the required clean-up criteria shall be included in the closure report together with the necessary documentation detailing what waste materials have been removed from the site.

f) Where applicable, a monitoring and maintenance scheme to include monitoring the long-term effectiveness of the proposed remediation over an agreed period of time, and the provision of reports on the same, must be prepared and approved in writing by the local planning authority.

Following completion of the measures identified in that scheme, and when the remediation objectives have been achieved, reports that demonstrate the

REPORT NO PAGE 15 Page 52

effectiveness of the monitoring and maintenance carried out must be produced and submitted to the local planning authority.

Commercial Refuse Arrangements

Storage facilities provided shall be of sufficient capacity having regard to the quantity of waste produced and the frequency of waste collection. All waste shall be removed from site on a regular basis by a licensed waste carrier and disposed of at a licensed waste disposal site.

Commercial Refuse Arrangements - Advisory Notes

Compliance with the Environmental Protection Act 1990 "Duty of Care" is essential.

Advice on Solid Waste Management can be obtained from Waste Services on [01474] 337533.

Works of Construction.

Please add code of construction practice informative.

Environment Agency

A formal response is awaited.

However they initially advise that:

Our previous comments regarding the sequential test and parts a) and b) of the exception test remain applicable.

As the site is under 1 hectare in area and will not discharge to a watercourse, we are satisfied that the proposal will not increase the risk of flooding in the wider catchment. As the drainage authority, the local authority should be satisfied that the drainage scheme meets the requirements of PPS25 and other relevant guidance, and will not cause or exacerbate localised flooding.

We are pleased that the proposal now includes raised floor levels to mitigate against the risk of flooding from surface water. It is difficult to quantify the risk from this source but we consider it unlikely that the depth of flooding would exceed the 300mm above local ground level by which it is proposed to raise the floor level.

Surface water flooding is difficult to predict and occupants of the site should therefore be made aware of the risk and provided with an exit to the north, away from the likely flow route.

The proposed development will be acceptable if the following measures are implemented and secured by way of a planning condition on any planning permission.

Condition

The development permitted by this planning permission shall only be carried out in accordance with the approved Flood Risk Assessment (FRA) and in particular the following mitigation measures:

REPORT NO PAGE 16 Page 53

1. Identification and provision of a safe route into and out of the northern side of the site.

2. Finished floor levels are set no lower than 300mm above local ground level.

Reason

1. To ensure safe access and egress from and to the site.

2. To reduce the risk of flooding to the proposed development and future occupants.

Southern Water

The application states that surface water disposal is to the sewer. There are no surface water sewers in the vicinity, the flows would result in causing flooding downstream. We would request that alternative means are sought for disposal of surface water and would recommend a condition requiring approval of surface water disposal details before development commences.

Horticultural Services, GBC

There were two pedestrian access points into this corner of the open space; one from Vale Road and one from Thames Way. Will these be maintained when the works are complete as it’s difficult to determine this from the plans on-line? Additionally, we had complaints from a disabled resident who found accessing the open space difficult/impossible whilst the works for the temporary structure were taking place and is having ongoing problems as the access is not as good as it was. Will access for pedestrians be maintained whilst building works are taking place and is there any provision for the disabled?

We need vehicular access during construction to enable us to carry out maintenance works and once the works are completed, we would either need two sets of keys to the gate or be able to provide our own padlock.

The Design and Access Statement, Section 7 mentions the landscaping but fails to go into any depth. Will there be any maintenance liability for the council with regards to the soft grassed areas to the south of the building?

Sport and Recreation Manager, GBC

I am aware from the associated drawings provided that the third phase of the development will involve a further erosion of amenity green space known as Northfleet Urban Country Park, albeit relatively small.

According to the latest draft of the PPG17 study, currently under development, existing per capita levels of amenity green space provision in Gravesham are around the median for neighbouring local authorities, so a standard equivalent to current levels of provision is justifiable. This means that any loss of land should be protected unless acceptable good quality replacement facilities are provided in accessible locations. The independent qualitative assessment for Northfleet Urban Country Park, as part of the PPG17 study, rates the current site as being of ‘poor quality’ on average. The main areas that the site scored poorly on were; pathways, grassed areas, litter bins, seating and general access.

REPORT NO PAGE 17 Page 54

Therefore, the small loss of amenity green space could be mitigated through some improvements to the park itself by the applicant, which could be mixture of new seating, bins, planting and signage at the access points to the park itself. The exact details of any park improvements or plans would need to be discussed with the Horticultural Team from the Housing and Environment Directorate. Also I understand that the issue of accessibility has already been raised as a concern by the Horticultural Team for this particular application and I concur that the issue of access, both during the proposed development works and afterwards, needs to be made clearer and where possible improved as opposed to making access to the park by residents (both pedestrians and car users) harder to access.

CAMS Manager, GBC

No Comments received.

Kent Highways

Views awaited

Planning Policy Manager, GBC

It is noted that the proposal is for a 1422 sq m building to provide a permanent replacement facility for the Forge and Gateway existing practices. The two practices currently provide services from Hunt Road, Granby Place and the Age Concern building in Coldharbour Road.

The Gateway Medical Practice, (Deneholm Surgery) at Hunt Road, Northfleet, and the Forge Surgery at Northfleet Age Concern are both currently accepting new patients, but the Granby Place Surgery at High Street, Northfleet, is not 1.

The West Kent PCT Investment Strategy 2008 – 2011 2 indicates that there are a number of plans to centralise GP surgeries. This includes Dene Holm Main Practice, Granby Place branch surgery and the Forge Surgery.

A letter dated 18 June 2009 from NHS West Kent in response to a letter from Adam Holloway MP states the following in relation to Granby Place branch surgery:

However, following a review of the surgery by the GP’s they have concluded that the building is no longer suitable for modern day primary care: there is neither disabled access, nor car parking facilities, and modernisation is not a feasible option for this building.

The GP’s are exploring options to provide brand new purpose built facilities in Northfleet at the junction of Thames Way and Vale Road, and discussions to this end

1 http://www.nhs.uk/Scorecard/Pages/Results.aspx?OrgType=1&Coords=1723%2c5635&TreatmentID= 0&PageNumber=1&PageSize=0&TabId=30&SortType=1&LookupType=1&LocationType=1&SearchT erm=DA11+8JT&DistanceFrom=5&SortByMetric=0&TrustCode=&TrustName=&DisambiguatedSearc hTerm=&LookupTypeWasSwitched=False&MatchedOrganisationPostcode=&MatchedOrganisationCo ords=&ServiceIDs=&ScorecardTypeCode=&NoneEnglishCountry=&HasMultipleNames=False&Origin alLookupType=1&ServiceLaunchFrom=&Filters=&TopLevelFilters=&PageCount=6 2 http://www.westkentpct.nhs.uk/download.php?id=848

REPORT NO PAGE 18 Page 55

are ongoing. As plans progress for the new surgery, the PCT would expect the GP’s to carry out appropriate public consultation.

In the formulation of their plans the PCT has asked the GP’s to consider the accessibility of the site to the practice population, including public transport links, and to have in place appropriate working and cover arrangements to meet the reasonable needs of their service users.

The Design and Access statement indicates that the Hunt Road and Granby Place surgeries are significantly substandard in terms of disabled access and health and safety. Neither of the premises has parking. It is stated that the premises at Granby Place will need to close because of difficulties meeting legislative requirements. It also states that the Hunt Road premises are not sufficient for the patient numbers it serves. It sets out that the Forge practice is within temporary accommodation and is below standard. For these reasons, the PCT has identified the need to provide alternative premises.

The Design and Access statement contains section 9.0 in relation to access. This states that parking is provided and there is a bus stop adjacent to the site on Thames Way. It further states that the location is within the residential neighbourhood which it serves and so can be accessed on foot. It considers that the selection of this site was carefully made to take into account the excellent public transport links afforded by the Fastrack bus route. It says that “the majority of patients from both practice areas live within a 10 minute walk of a transport node that will connect with the Fastrack that will bring patients directly to the proposed development.” It is unclear what this means. The statement also sets out the possibility of bus services being provided from Age Concern buildings to the proposed building.

NHS West Kent has a SHAPE (Strategic Health Asset Planning and Evaluation) database which is an NHS GIS mapping tool to show population statistics for new surgeries. It uses deprivation and census data, e.g. access to a car, to assess accessibility issues in relation to new surgeries. Has this been applied to the current proposal? If it has not, I would suggest that you contact Bob Sheridan ([email protected] ) to apply it in order to help the assessment of accessibility and obtain a PCT view on the proposal.

The methodology for assessing sites suitable for housing in the Strategic Land Availability Assessment (SLAA) included the following question:

Does the site benefit from good access to the nearest GP surgery? Sites within 800m or less walking distance to the nearest GP surgery were accepted and sites further than that were discounted.

There are significant reservations about the loss of the existing surgeries and their relocation to the site proposed. This is particularly the case in relation to the loss of Granby Place surgery at High Street, Northfleet, and the proposal for significant numbers of residential properties at Northfleet Embankment West which would exacerbate the problem.

The attached map shows the existing surgeries and the 800m walking distances to them (as per the SLAA methodology). The location of the primary care centre in the location proposed and the closure of 3 existing surgeries would place large parts of Old Northfleet, Pepperhill, Dene Holm and Painter’s Ash more than 800m from their

REPORT NO PAGE 19 Page 56

nearest GP surgery. Parts of Old Northfleet in particular are amongst the 20% most deprived in Kent.

The proposed primary care centre is located on the Fastrack bus route which does not serve any of these areas. Therefore, people without a car would need to take a bus and then Fastrack to reach their surgery by public transport.

The need to upgrade the standards of accommodation in understood but question whether this is a suitable location which will adequately serve the needs of the community it is intended to provide a facility for. The applicants have not satisfactorily addressed the access issues as set out in the PCT letter to Adam Holloway MP.

Property Services Manager

Happy to support the development.

Kent Fire & Rescue Service

Means of access for the fire and rescue service is considered satisfactory.

Police Architectural Liaison Officer

Views awaited

Ramblers Association

The development is taking part of an open space and as Northfleet area is undergoing a tremendous amount of development, consideration must be given to green open spaces to ensure that the nibbling away of them doesn’t continue.

Publicity

The proposal has been advertised on the site and in a local newspaper as a major development proposal and development not in accordance with the development plan.

In addition the owners/occupiers of 31 adjoining dwellings/premises in the locality have been notified of the proposal.

No representations have been received.

7. Service Manager (Development Control) Comments

This proposal is for the third stage in the provision of a health campus in this location next to the Gravesend and District Theatre Guild building at the junction of Vale Road with Thames Way within a part of the Northfleet Urban Country Park.

The first stage being the temporary doctors surgery (walk-in centre) is now in operation and has a temporary permission for five years although it is only intended to be in use for some 18 months and will be replaced by a permanent building (stage two) for which planning permission was granted towards the end of last year.

REPORT NO PAGE 20 Page 57

Both the temporary surgery and the permanent replacement are additional surgery facilities in the locality (the Equitable Access to Primary Medical Care Facility – EAPMC) and being both a walk-in surgery and also for up to 6,000 registered patients who may wish to register at the surgery.

This third stage is a proposal for the relocation of existing substandard local surgeries at the Gateway and Forge practices together with a number of complementary health case service providers including an on-site pharmacy. The intention is that if permission is granted the second and third stages would be built concurrently.

The principle of a health care facility at this location has effectively been established through the granting of the temporary and permanent planning permissions.

The site is adjacent to a housing area in the Local Plan in Vale Road and is very close to and within walking distance of a large housing catchment including Waterdales.

It is reasonably well served by public transport being on the Fastrack bus route and is arguably in a sustainable location. There is support strategically and regionally in the development plan to the provision of new health care facilities to meet the needs of the local community.

That said there is some concern, as set out in the planning policy comments, whether it is an appropriate location for the relocation of existing surgeries (the Gateway and Forge Practices) away from the current centres and catchments namely at The Hill, Northfleet (Granby Surgery), Hunt Road (near Painters Ash) and next to the Age Concern facility in Coldharbour Road.

In response to those concerns the applicants architects advise as follows:

We confirm that the NHS West Kent SHAPE evaluation database was used in evaluating this proposal and this was undertaken by Bob Sheridan. The practices have had to submit specific information to NHS West Kent in respect of access and this was considered in full by NHS West Kent Board in its approval of the business case for this project. It is appreciated that the FastTrack bus system does not serve all areas of Northfleet however our understanding it that FastTrack was intended to be a transport spine that connected with other bus and transport networks. This would then enable those qualifying for assistance to use public transport for free or at a discounted rate.

It is appreciated that there will be a net loss of GP premises in the area and this is indeed the policy of NHS West Kent under their 2008-2011 investment strategy. However this must be seen in the light of the substantial number of additional services that will be provided from the new premises. We note that the particular concern is the relocation of the practice at Granby Place. The letter from Bob Sheridan attached to your email gave an indication of the level of inadequacy of the premises at Granby Place, and in fact our understanding to date is that this premises now only operates in the mornings each day and only provides standard consultations and no additional services by way of nurse treatment. In order to receive treatment outside of these times or for any additional services patients have to travel to the practice in Hunt Road. This involves travel passed the proposed site for the relocation of the practice. Now that the temporary building for the Walk in Centre is open on the site it has been possible to obtain data from this facility and it shows that patients are accessing the facility from all over the Northfleet area, and in particular data is captured regarding

REPORT NO PAGE 21 Page 58

patients visiting the walk in centre who are registered at practices in the area. This shows that consistently the highest number of registered patients visiting the walk in centre each month come from the Gateway Medical Practice indicating that travel for these patients does not seem to be a problem.

It is of note that the system of visiting patients who are not able to attend the practice for any reason as indicated in the letter from Bob Sheridan will continue ensuring that access to a GP will never be an issue for the patients of this practice. It is indeed likely that this will improve, as the new building will enable the practice to recruit more staff as they are presently unable to do so due to the space constraints of their existing buildings. It is of further note that the reason why the provision of new accommodation for the Gateway Medical Practice was so important was due in part to the very poor state of the accommodation at Granby Place. The building is so unsuitable, and unable to be made suitable, that in the short term in the absence of new accommodation the building will need to close. The current situation has been maintained in order to continue service provision pending the opening of the new building.

It is noted the provision of the plan from planning policy showing the location of practices in the area and the 800m walking distance access circles. I can understand this aspiration however is must be accepted that in many circumstances that this will be impossible to achieve, and in these circumstances provision of public transport and appropriate parking facilities must reflect this as the proposal does. Additionally this map did not show the practices at Swanscombe Health Centre, or at 32 London Road. We are unable to comment as to the suitability of other land for proposed residential development, other than to say that if residential development is being proposed without adequate community facilities then this is a matter for the developer of the residential scheme and appropriate provision should be made via a Sec 106 agreement of other measure as is commonly done else ware.

In summary we would confirm that the proposals at Vale Road have been through a rigorous Board approval process at NHS West Kent, and have been widely consulted on both with Gravesham Borough Council and locally in Northfleet through the Area Forum and have received significant support. The development represents vital investment into the local health care provision of Northfleet and as can be seen by the immediate popularity and success of the Walk In Centre is both necessary and correctly targeted.

In addition to the policy and locational issues the other key issues to consider are the impact on the integrity of the urban country park, the environmental issues (having regard to the fact that the site was a former waste tip and to any flood risk issues), the highway impact of the development, and the amenity and visual impact of the development.

Similar to both the temporary building and its permanent replacement the current proposal does result in a further small loss to the urban country park and in that sense there is some development plan conflict and conflict with PPG17 advice (paragraph 10 advising that “existing open space, sports and recreational buildings and land should not be built on unless an assessment has been undertaken which has clearly shown the open space or buildings and land to be surplus to requirements”).

However because of the scale of the open space this is unlikely to affect its integrity as an informal recreational area. The Board will note that the Council’s Sport and

REPORT NO PAGE 22 Page 59

Recreation Manager does not raise an objection to the loss of open space subject to appropriate mitigation.

There will be some loss of small trees and bushes but there is an opportunity to replant within the application site to compensate for any such loss. In any event there are positive benefits to the community that have to be weighed against the loss of any open space that will occur (which is suggested in paragraph 16 of PPG17).

On balance it is considered that the community benefits outweigh any loss of small area of open space. Moreover the proposal effectively extends a community use (Theatre Guild/Nursery) already occurring on this site.

It is considered in any case that the scale of development is insufficient to justify notification as a departure from the development plan.

In respect of environmental issues discussions are currently ongoing with the Environment Agency (EA) to resolve and they had initially objected to the proposal in terms of flood risk. However they are indicating that the development is likely to be acceptable subject to appropriate mitigation measures. In respect of groundwater and contaminated land issues the EA will advise that these concerns can be safeguarded by planning conditions.

The Board are advised that there have been no objections from nearby local residents to the proposals.

It is not considered that there are any material concerns in terms of visual impact of the development. In design terms the proposals are very similar to the proposals that were approved by the Board in respect of the permanent facility and incorporate sustainable design principles. Any local impacts from the proposals are likely to be confined to the use and intensity of the existing access on to Vale Road.

Highway comments on the proposals will be set out in a supplementary report.

Having regard to the ongoing discussions with the Environment Agency and the applicants and the resolution of a number of issues these matters and a full recommendation will be set out in a supplementary report.