New research from UK planning and development consultancy Lichfields has found that despite record levels of Government investment in hospitals and neighbourhood health facilities, most local plans are not consistently making adequate provision for healthcare estates - raising the risk of delays to urgently needed new infrastructure.

The study, Strategic Planning for Healthcare Estates, highlights a clear mismatch between national ambitions and local policy. Of the 88 local plans adopted since March 2020, only 63 per cent contain a strategic objective to improve health or healthcare, while just 26 per cent include site-specific policies or allocations for new health facilities. This patchy coverage suggests that many projects in the development pipeline, including those in the Government’s New Hospitals Programme, will need to move forward without an up-to-date planning status or site designation.

The findings come at a critical moment, with national policy and funding creating unprecedented opportunities to renew the country’s ageing healthcare estate. The Labour Government’s revised National Planning Policy Framework, published in December 2024, mentions ‘health’ or ‘healthier’ no fewer than 39 times, underlining the drive to integrate health outcomes into planning decisions. Alongside this, the 2025 Spending Review confirmed a £4 billion uplift to the Department of Health and Social Care’s annual capital budget and pledged £30 billion over the next five years to maintain and modernise the NHS estate, including eliminating reinforced autoclaved aerated concrete (RAAC) by 2035.

Robert Dibden, Planning Director at Lichfields, said: “With the largest ever health capital budget now in place, the emphasis must be on delivery. Yet our research shows that many local plans are not always keeping pace with this new policy and investment landscape. Too often, there is a disconnect between health infrastructure strategies and the planning frameworks designed to support them. Closing that gap is essential if we are to see new hospitals and neighbourhood health facilities delivered on the ground at the pace patients need.”

Lichfields is already advising on schemes such as Berwick Community Hospital, due to open in 2026, and the redevelopment of Leeds General Infirmary, scheduled between 2030 and 2035 - examples of projects where strategic planning alignment is crucial to timely delivery.

The report also points to 2026 as a pivotal year for plan-making, as local planning authorities update their evidence bases and begin consultations on new allocations to reflect higher national development targets.
Robert Dibden added: “Next year will be critical as local authorities move forward with new local plans. It’s essential that health trusts use this opportunity to engage early and secure the policy support which will ensure their projects are streamlined. By embedding proposals into statutory plans from the start, they can reduce risks, accelerate delivery and make sure communities see the benefits of investment in healthcare infrastructure much sooner.”