Future Cities Forum's 'Healthy Cities' report on 75th anniversary of the NHS

How do councils find the funds to green our cities? View to Tower Bridge at More London Place from Tooley Street, London

Future Cities Forum held its 'Healthy Cities' forum this week on the day that commemorated 75 years of the National Health Service. On 5th July 1948, the NHS was founded as the first universal health system to be available to all, free at the point of delivery.

As the NHS works on the underlying issues behind growing demand and the changing health needs as a nation, it has been useful to look back to the work of NHS England when it launched the Healthy New Towns programme in 2015. The aim of this was to explore how the development of new places could provide an opportunity to create healthier and connected communities with integrated and high-quality health services.

The programme worked with ten 'demonstrator sites' chosen in March 2016 from over 100 applicants. The programme has worked with government to influence policy in housing, planning and health, feeding into revisions of the National Planning Policy Framework, National Planning Practice Guidance and through the convening of a new cross-government network to share expertise and embed healthy place-making across policy areas. The NHS Long Term plan stresses the importance of the NHS and the built environment sector continuing to work together to improve health and wellbeing.

The Principles of Putting Health into Place demonstrate the value in doing this and will be followed by an NHS supported quality standard for healthy neighbourhoods, developed with among others, Homes England, to further incentivise building health and wellbeing into developments while tackling inequalities.

Recently, the Mayor of London, Sadiq Khan, has been highlighting in a new City Hall commissioned report how the most deprived communities of London are more likely to live in the most polluted areas. The whole population of London he says is forecast to remain exposed to Nitrogen Dioxide and Particulate Matter (2.5) concentrations above the recommended WHO air quality guidelines in 2030, unless further significant action is taken to reduce concentrations. However, black Londoners and diaspora immigrant communities are more likely to live in areas with more polluted air.

So how can the greening of our cities help to improve air quality and how can the improved design of our cities, towns and villages, create opportunities for better mental and physical health?

Future Cities Forum invited the City of London Corporation, MICA Architects, Ashford Borough Council, HOK and David Lock Associates, to discuss the issues around creating healthy places, the development of new garden communities, and sports-led regeneration that provide health benefits for the community and principles for ensuring active lifestyles.

King Edward Square development, view towards ruins of Christchurch Greyfriars, near St Paul's Cathedral in the City of London - courtesy of LDA Design

As people return to work and with a push to get back visitors back into the City of London, we asked George Wright, the project lead for the new King Edward Square at the City of London Corporation, how this could become a healthy place for young and old alike.

The City of London has approved plans by LDA Design for King Edward Square, a new green piazza north of St Paul’s Cathedral. Redevelopment in the area has provided a once-in-a-generation opportunity to transform an outdated road system to create a safer, more pleasant environment. King Edward Square will be created by removing the 1970s gyratory between St. Paul’s Cathedral and the former Museum of London, a complex one-way system which severs pedestrian and cycle connectivity. The aim is to transform a traffic dominated environment into 2,800 square metres of beautiful and peaceful new public realm. Traffic along Newgate Street and St Martin’s le Grand will become two-way, with pavements widened on St Martin’s le Grand.

Above: 2022 view of Christchurch Greyfriars Garden, next to Panorama St. Paul's and Newgate Street

George said:

'The St Paul's gyratory is a classic example of post war planning where you get cars through to the detriment of everyone else. It is part of our transport strategy to give pedestrians and cyclists more priority but we don't want to make an impact on bus travel and timings. Eight per cent of people arrive in the city through walking the last part of their journey and there are major high street names in banking and insurance who want to see the best possible environment for their commuting staff. We are proposing removing the gyratory to provide 3,000 square meters of public space next to church heritage and so that those visiting can see the dome of St Paul's Cathedral. It is a complex project and although the word 'transformational' is often over-used, we would say that this re-design is just that.

'We went through a round of consultation and the top answers showed that people wanted greening and seating the most with events and children's play areas scoring lower. A chance conversation led to about 80 large original slabs from the Victorian embankment - removed to make way for the new super sewer - being re-used in our scheme, arranged as a linear pathway with planting. So we will have this as a children's play area but arranged in a way that does not allow for skate boarding. We have also incorporated the slabs into our sustainable urban draining reducing the amount of rain water going into the sewer system - so the whole reclamation of the slabs has a circularity about it.

'The planting and future care has been planned for the next twenty-five years with a budget of £1.2 million. The trees and plants will be well looked after by our gardens teams. There has been a belief and requirement that the planting must be provided for and it is lucky that we are a wealthy authority and we can do this.'

Gilston Park development - courtesy of MICA Architects

Outside London, work is continuing on the UK government's plan for new garden villages to be built offering greater opportunities for active healthy lifestyles. Gavin Miller, Director at MICA Architects, has been working with Grimshaw on the Gilston Park estate, with the provision for new housing in connected villages, within acres of landscape.

The proposal for 10,000 homes to the north of Harlow is part of the East of England Plan to provide new homes, jobs, investment and prosperity to Harlow and the surrounding areas of Essex and Hertfordshire. Four major new accessible parklands and further natural space, including the centrepiece of Gilston Park, provide more than 840 hectares of green spaces, parks, public gardens, amenities, sports facilities and play spaces. These are to be held in trust by the residents and protected from future development.

The Stort tributary valleys provide green landscape corridors and separate the proposed villages from each other and from the existing villages of Eastwick and Gilston. Historic hedgerows, routes and settlements; significant contours; views and areas of particular ecological value are preserved and integrated into the design, rooting the development to its historic setting.

Gavin stated:

'We were first appointed in 2009 along with Grimshaw to the project which is in east Hertfordshire, adjacent to Harlow and on the Green Belt. There was local resistance to previous schemes and then a coalition government came in with no mandate for anything to be done on the estate. It is an interesting site with an old airfield on it and scheduled monuments, all on an elevated plain. In good conscience and with the site on the green belt, we knew we needed to give something back to the site, more than taking from it.

'The structure of the estate had been eroded but it covers a thousand hectares. Only a third of the estate will be built on and we are being very sensitive about where we build. We wanted to avoid building housing all over the landscape and treat it very preciously, giving it over to the community in trust. Only a few dog walkers have valued it and people have been missing out on this wonderful amenity. We wanted to flip the model of the backs of houses facing the landscape and create a new frontage onto it. The seven villages will be like a string of pearls, each with its own identity and a wider identity for the whole site. We have created some design principles with each village having a unique quality relating to the landscape, but the next stage is to consult with the community. There will be five new schools and new sports facilities with each village configured around a village green. No one will be more than a five minute walk from the wider landscape.

'When thinking about the project, we consciously looked at English landscape types. I live near Hampstead Heath in London and I love the way the heath as a natural landscape sucks in the people around it. We are trying to shift and manage density, so the homes will only be two or three storeys high. We were very aware from the Garden City movement of the sensibility of villages and their greens along with celebrating Capability Brown. A natural look was part of our thinking and we have around this unlocked negativity.'

Above: Chilmington Green developments in progress (courtesy Ashford Council)

Ashford Borough Council has been looking at how to avoid creating bland landscapes in its new garden communities and also designing health and sports facilities that serve the community from cradle to grave.

The South of Ashford Garden Community (SAGC) includes Chilmington Green, Court Lodge and Kingsnorth Green developments, and was named as one of nineteen Garden Communities by the Government in 2019.

Both Court Lodge and Kingsnorth Green are allocated in the adopted Ashford Local Plan 2030, and are now joined with Chilmington Green to become designated as a Garden Community.

Garden Communities must have local leadership, accessible transport links, climate resilient designs, community owned assets and long-term stewardship. By joining-up of these developments to ensure they work together – the Council says it can ensure they offer the right mix of services and amenities for existing and new residents.

The designation comes with the financial and professional support of Homes England to ensure key infrastructures are delivered at pace with development, and it comes with a commitment to achieving a sustainable, green conscious future for the wider area. Together the communities represent 7,250 homes (2,175 affordable), a 142 hectare public park along with new schools, a primary healthcare space, play spaces and ecological areas to be protected.

Mark Chaplin, Head of Place-making described how the Council had been on research journey to discover best practice in design:

'We looked first at the shared space for our town centre, with the idea of 'mend before extend' and on creating more attractiveness. We had a four lane one way ring road around the town which was choking the centre. We wanted to know how to kick start lots of regeneration so we went to Holland and came back with lots of ideas to create a ground-breaking project. It favoured cyclists and pedestrians, while keeping speeds low for cars. Drivers were encouraged to make eye-contact with pedestrians and give way naturally. It was truly transformational. We gave more definition to footpaths and pavements and modifications were made for disability groups. It all improved safety significantly.

Above: Images of Ashford, after the re-modelling of the ring road surrounding the centre (courtesy of Ashford Council)

'These ideas were not strictly used in our areas in the south, but gave us experience in dealing with traffic management. We looked at interesting ideas on how to create new settlements with inspiration from the traditional garden cities. Green spaces were at the heart of the masterplan. We only have four hundred units on site and how the spaces are to be maintained is key. We were keen on some principles from the garden city movement of the past and thought they still had an advantage to them.

'We want health for all, so our discovery park where all the sports facilities are taking shape will we hope be useable and popular and we are working with the community on that. Our Section 106 funding will drive it and we will be looking at what the sporting needs are for people since the pandemic. We are going into it with an open mind. We need to tackle issues such as childhood obesity and offer active lifestyles from the cradle to the grave.'

River Tyne panorama - courtesy Newcastle City Council

HOK's project lead for NewcastleGateshead Quays, Kar Paik Soon joined our discussion to talk about the importance for the community of the in-between spaces around entertainment and sports arena-led regeneration.

NewcastleGateshead Quays is a new arts and leisure destination under development in the north east of England. Sitting on the banks of the River Tyne and framed by views of the historic twin cities of Newcastle and Gateshead, the £260 million project includes a new 12,500-seat arena, an adjacent conference centre, a dual-branded hotel, and large areas of public realm and performance space.

HOK led the master planning for multi-site development and is designing the arena, conference centre and public plazas. Comprising more than 585,000 square feet, the development continues the transformation of the Gateshead and Newcastle waterfront from its industrial past to a modern destination for recreation and culture. The project will sit among some of the UK’s most distinctive cultural and civic spaces, including the Baltic Centre for Contemporary Art, Millennium Bridge and Sage Gateshead.

Nestled within the existing riverfront landscape, the development honours the surrounding civic spaces and natural geography. Pedestrian-friendly connections will open new accessways, linking NewcastleGateshead Quays to the town centre and the new Baltic Quarter to the waterfront.

HOK designed the arena, the development’s anchor component, to be highly flexible, allowing it to host music, cultural and sporting events as well as conferences and exhibitions. Its unique seating bowl features fixed, retractable and removable seats offering multiple configurations and the ability to accommodate audiences ranging from 1,500 to 12,500 people.

The adjacent conference centre comprises more than 67,800 square feet of exhibition and convention space with expansive views of the riverfront. Plazas surrounding both the arena and conference centre allow for spacious outdoor gatherings. Once complete, NewcastleGateshead Quays is expected to create nearly 2,000 jobs and generate £60 million annually for the local economy. Venue management firm ASM Global will operate both the arena and exhibition centre, which could host as many as 300-plus events per year and attract more than 750,000 visitors.

Ask:PATRIZIA, a consortium of Ask Real Estate and PATRIZIA UK, is developing the project with Gateshead Council. Sir Robert McAlpine has been appointed to build the project with a Phase 1 opening scheduled for late 2023. Planit is the landscape architect for the project. AHR Architects is designing the hotel.

Kar Paik Soon described the challenges of the project:

'The project will focus on a huge car park space next to the arena and conference centre. There has been a regeneration exercise at Gateshead around the Millennium Bridge and art gallery but this project will be quite a meaningful one and draw on existing infrastructure. It will make the quarter near the area a much better place in an urban setting. We started by looking at the green spaces that are there and we noticed that the site was on quite a hilly terrain so there weren't many purposeful spaces for pedestrians to hang around. We also wanted to consider the connectivity with the river front, a new staircase connection to it and good engagement within the performance square.

'You never get away from the need to build these entertainment centres to service the visitor economy and after all it is a very expensive construction, so they need to pay for themselves and give something back to the city economy. It is always a consideration how the revenue will generate value for the city and officers. But there is a genuine agenda to make that space between the arena and conference centre much better for the community. We have been through a few rounds of planning applications and the pandemic showed that the construction costs were getting too high, so we couldn't proceed at one point. But that was helpful in a way, because we have had more of a chance to put more thoughts into the project and it is our duty to provide a better space for the community.

'The safety aspect has been discussed thoroughly with the long stretches of walkways by the side of buildings, considering how big these buildings are. We looked at potential areas that might encourage unsociable behaviours and how to mitigate this, creating less hidden areas and more light open ones. We have also looked at how to avoid creating wind tunnels. All these things make the project safer for the individual and the community.'

Above: CGI of the SC1 project to regenerate the town centre in Stevenage (from Mace Develop)

Our focus in the discussion turned to the work that David Lock Associates has been carrying out with Sport England on health and fitness and how that has influenced its strategic work in town planning. Owen Reading, Principal at the firm explained that there is no one size fits all for developing healthy places;

'We have been working with Sport England for a number of years on a set of documents called 'Active Design'. Chris Whitty said recently that urban design has done more for public health than anything other than vaccinations over the past 150 years. The level of obesity is rising and 80% of fitness is through everyday activity not just sport. We are now on the third addition of the guide and asking how does planning encourage physical activity. We are working with ten principles but there are thousands of projects across the UK that are not getting attention and there needs to be a practical application to it all. We work on the strategic growth of towns with planning for the next 25 years. Sport and recreation is an important place-making tool and people really care about it.

'We have been working on projects in Thatcham in Berkshire and also Paddock Wood in Kent. How can these towns grow with local facilities and proper cycling and walking networks to improve health? These towns often do not have facilities on their doorsteps or active travel networks and we need to strengthen existing facilities in the town. The balance for each town will be different and there needs to be planning now with a focus on health and physical activity.

'Gamification is important for fitness - providing informal activity such as fitness and play trails on the way to school, like the project we have been working on in Rugby, where there are no cars and all is maintained and well looked after. Stevenage has put a playground in a high street. In the past, you needed to go to the high street, there were certain essential uses, but those aren't there anymore and if you want to encourage people to go there, it has to be a pleasant place, and then people will go and spend more. Where you are planning public realm, spaces have to have a clear use but be flexible and adapt and be monitored. You also don't want your sports facilities dominated by one group and we have been working on projects where teenage girls' needs have been ignored and how that can change. There are different challenges in planning for those suffering from dementia and we need to re-focus on that.

'When planning sports facilities in different spaces in public realm, you really have to look at the character of the space, the changes in levels, introducing sports through events from time to time and using sub spaces within the landscape that might enclose it, so that there are different areas dedicated to it and it provides interest.'

Future Cities Forum will be returning to this interesting and essential area of debate later in the year and would like to thank all those who participated in this special discussion on the 75th anniversary of the NHS.