NHS South Clinical Commissioning Group Enclosure 6

Report To: Primary Care Committee For decision

Report Title: Primary Care Estates/Planning Update For discussion

Report From: Anna Hargrave, Director of Strategy and Engagement For information

Date: 14 October 2015 Confidential

Purpose of the Report: Further to the report presented to the last meeting, to update the Committee regarding a number of issues relating to primary care estates and planning. Key Points: . Representatives of the CCG have met with representatives of both District Councils (Stratford- on-Avon and ) and have received updates in relation to the progress of Local Plans, including an overview of the identified key strategic sites for growth. . The CCG has responded to a number of planning applications which have come forward in Stratford-on-Avon District in the period since the last Committee meeting, including Phase 1 of the Long Marston Airfield development, which is expected to deliver a total of circa 3500 dwellings. . Work to progress the development of the Local Estates Strategy is ongoing. . A number of work streams have been identified which will require initiation in the short term to support primary care estate planning. Recommendation (s):

The Committee is asked to note the content of the report and provide any comments/feedback. Previously Considered By: Date:

Primary Care Committee 12 August 2015

CCG Objectives:

To build relationships with patients and our communities To improve health and reduce health inequalities To improve the quality of care and transform services To make best use of resources Governance and Assurance The revenue implications of primary care premises Financial Implications: development/improvement will need to be picked up via the CCG’s core budgets. It is anticipated that primary care premises Performance Implications: development/improvement will support access to general practice and improved care in the community. It is anticipated that primary care premises development/improvement will support an enhanced Quality Implications: patient experience of services delivered in general practice.

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Primary care premises development/improvement will Equality and Diversity Considerations: have a beneficial impact on all groups within the population but particularly those where physical accessibility to services is an issue. Patient and Public Engagement: None arising from this report. In light of the associated revenue implications, affordability is the greatest risk where primary care Risk Assessment: premises development/improvement is under consideration.

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1. Stratford-on-Avon District Council Core Strategy 1.1. The District Council’s Core Strategy is the key local planning policy document. It sets the overall vision and objectives for development in the district up to 2031 and includes policies relating to the scale and distribution of planned development across the District’s towns and rural areas. 1.2. AH and HW met with Dave Nash (Policy Manager (Planning and Housing) for the District Council) on 17 August 2015. The purpose of the meeting was for the District Council to provide an update regarding the progress of the Core Strategy and, specifically, an overview of the identified key strategic sites for growth (see 1.5. below). 1.3. DN highlighted that the Planning Inspectorate published its response to the Core Strategy in March 2015. This Interim Conclusions report identified a need for the District Council to revisit its Objective Assessment of Housing Need.1 1.4. In response to the Inspector’s findings, the District Council consulted on a number proposed modifications to the Core Strategy in August/September 2015; these include an approximate 28% increase in the total housing provision in the District in the period 2011 to 2031 from 11,320 to 14,480 dwellings.2 1.5. The Proposed Modifications document further: . Identifies a second site for a new settlement at Long Marston Airfield, in addition to the site already identified in the vicinity of / Heath; with the Long Marston Airfield site expected to deliver approximately 2100 dwellings by 2031 (out of a total of 3500 dwellings) and the Gaydon/ site expected to deliver approximately 2,300 dwellings by 2031 (out of a total of 3,000 dwellings). . Confirms an additional significant site for development in the vicinity of Long Marston Airfield at Long Marston Depot (with this site expected to deliver a total of 1050 dwellings by 2031). . Highlights other significant development in the vicinity of Stratford-upon-Avon town centre (3,189 dwellings) and at (1029 dwellings), which together with the Long Marston developments and the Gaydon/Lighthorne Heath development, account for approximately 65% of the total development planned for the period to 2031. 1.6. Following consultation with Stratford area practices and the CCG’s Public and Patient Participation Group, the CCG submitted its response to the Proposed Modifications on 25 September 2015 (see Appendix 1). 1.7. DN advised that the District Council currently anticipates that the Core Strategy will be adopted in or around spring 2016.

1 https://www.stratford.gov.uk/files/seealsodocs/170309/Inspector%27s%20Interim%20Conclusions.pdf 2 https://www.stratford.gov.uk/planning/core-strategy-proposed-modifications-2015.cfm NHS South Warwickshire Clinical Commissioning Group Page 3 of 7 Primary Care Estates/Planning Update Primary Care Committee, 14 October 2015 NHS South Warwickshire Clinical Commissioning Group Enclosure 6

2. Council Local Plan 2.1. The District Council’s Local Plan serves the same purpose as the Core Strategy (see 1.1. above), covering the period up to 2029. 2.2. AH and HW met with Chris Sharp (Major Sites Officer for the District Council) on 9 September 2015. The meeting followed a similar format to the earlier meeting with Stratford District Council. 2.3. CS summarised the progress of the Local Plan to date. In June 2015 the Planning Inspectorate published its initial findings on the Plan, concluding that it “is not sound in terms of overall housing provision and the supply and delivery of housing land”. The Inspector highlighted that there is likely to be substantial unmet housing need arising in Coventry, some of which (given that Warwick District forms part of the wider Coventry and Warwickshire Housing Market Area) will need to be met in Warwick. In view of the significant work required to address his findings, the Inspector’s recommendation to the District Council was to withdraw the Plan.3 2.4. CS advised that, having considered the Inspector’s findings, the District Council agreed to write to the Inspector asking him to agree to a suspension of the Plan until March 2016. Suspending the Plan (as opposed to withdrawing) will avoid building in a lengthy delay, making it feasible for the Plan to be adopted in or around December 2016 versus summer/autumn 2017. In its response to the Inspector, the District Council accepted that its housing requirement will need to be increased in order to ensure that the District is able to meet an evidenced proportion of any unmet need arising in Coventry. 2.5. CS confirmed that the District Council is currently awaiting a decision by the Inspector in relation to its response. 2.6. Discussion developed around anticipated key strategic sites for growth in the District. CS highlighted that taking account of the sites allocated in the current Plan (totalling circa 6200 dwellings), the majority (more than 50%) of the planned development is concentrated in greenfield sites on the edge of Warwick, Leamington and . This includes a planned strategic urban extension to the south of Warwick and Leamington totalling circa 3000 dwellings. A further significant strategic urban extension is planned to the east of (circa 760 dwellings). 2.7. CS advised that the timeline for adoption of the Local Plan will depend on the Inspector’s response to the District Council’s proposal to suspend, as opposed to withdraw, the Plan (see paragraph 2.4. above).

3 http://www.warwickdc.gov.uk/info/20410/new_local_plan/973/local_plan_examination

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3. Key Findings from District Council Meetings 3.1. Neither District Council has adopted a Local Plan for its area (nationally 64% of local planning authorities have adopted Plans). Stratford-on-Avon District Council is likely to be in a position to adopt its Plan (Core Strategy) at an earlier stage than Warwick District Council, which may in the worst case scenario be delayed as long as summer/autumn 2017. 3.2. As a consequence of the fact that neither District Council has an adopted Plan in place, the risk that applications for developments are submitted and approved on inappropriate and/or unsustainable sites arises. The CCG will be able to respond to such applications as and when they come forward; however, it will clearly not be possible to factor them in as part of any forward planning. 3.3. The delays affecting the adoption of Local Plans also have a knock on impact in delaying the introduction of the Community Infrastructure Levy (CIL cannot be adopted by a District Council until the Local Plan for its area is also adopted). The CCG must be mindful that although it has no resort to the CIL at the current time, as a consequence of restrictions introduced in April 2015, at the same time, it only has the ability to pool up to 5 requests for funding for a single project under Section 106 (S106) of the Town and Country Planning Act 1990 (as amended). In order to avoid engaging the pooling restriction, the CCG must think strategically about which applications it responds to, as well as how any S106 request is formulated e.g. requests are likely to become more site specific in nature and not, as they have been historically, worded as general contributions.

4. Section 106 Planning Obligations/Community Infrastructure Levy 4.1. Further to the update to the last meeting, the Committee requested further information regarding the operation of S106 Planning Obligations versus the operation of the Community Infrastructure Levy. A verbal update will be provided.

5. Planning Applications 5.1. Since the Committee’s last meeting, the CCG has responded to a number of planning applications. Stratford-on-Avon District 5.2. Long Marston Airfield (Phase 1) In response to this application for 400 new dwellings, the CCG requested a S106 capital contribution from the developer for primary medical care facilities required to support the development. The CCG specified that the contribution might be for: . The development of a new primary medical care facility requiring a contribution of £281,608; or NHS South Warwickshire Clinical Commissioning Group Page 5 of 7 Primary Care Estates/Planning Update Primary Care Committee, 14 October 2015 NHS South Warwickshire Clinical Commissioning Group Enclosure 6

. The improvement/extension of an existing primary medical care facility (Meon Medical Centre, Goose Lane, Lower Quinton, Warwickshire, CV37 8TA) requiring a contribution of £87,895. 5.3. Stockton Road, Napton-on-the-Hill In response to this application for 50 new dwellings, the CCG requested a S106 capital contribution from the developer for primary medical care facilities required to support the development. The CCG specified that the contribution of £10,987 would be allocated for the improvement and/or extension of Southam Surgery, Stowe Drive, Southam, CV47 1NY. 5.4. Land Off Falkland Place, Temple Herdewyke In response to this application for 59 new dwellings, the CCG requested a S106 capital contribution from the developer for primary medical care facilities required to support the development. The CCG specified that the contribution of £12,964 would be allocated for the improvement and/or extension of Surgery, Market Square, Kineton, Warwickshire, CV35 0LP. Warwick District 5.5. The CCG has not responded to any applications since the Committee’s last meeting.

6. Local Estates Strategy 6.1. Further to the previous update to the Committee, the Local Estates Forum has held meetings on 31 July 2015 and 2 October 2015, with its initial focus being on undertaking a high level analysis of the whole local NHS estate. 6.2. The initial phase of the LES workstream will focus on driving the realisation of benefits associated with better estates utilisation via examination of available opportunities for the NHS to: . Reduce running and holding costs; . Share property; . Dispose of surplus property to generate capital receipts for re-investment. 6.3. The CCG has identified that a number of supplementary work streams will require initiation in the short term to support primary care estate planning, including: . Consultation with member practices via an engagement event, with the objective of enabling practices to co-author and co-own future solutions. The will include consideration of various option categories, including practices coming together under federated/collaborative delivery models. . Detailed analysis of the existing primary care estate. Updated information will be required in relation to:

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o Functional suitability; overall internal layout and arrangement (room adjacencies and internal flow), and also location in relation to population served, car parking, premises’ capacity to achieve quality standards to support clinical activity o Condition; of fabric, infrastructure and fixtures and fittings. Also investment requirements for essential (statutory and mandatory) upgrades. o Utilisation; absolute space requirement i.e. space available in relation to registered list size and number of GPs and services delivered (core/non-core). o Flexibility; capacity to change to meet future demands e.g. population changes. o Asset ownership and valuation; analysis of existing arrangements including future flexibilities (lease breaks) and fixed points (e.g. ownership by GPs and third parties).

7. Recommendations 7.1. The Primary Care Committee is asked to note the content of the report and provide any comments/feedback.

End of Report

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