Scotland's Population Health Framework

Places and Communities

Create healthy and sustainable places by working in and with communities.

What surrounds us shapes our health. Having well-designed, connected and sustainable communities where people can access the activities and services they need and are able to influence the decisions that affect them is important.

People in Scotland live in cities, towns and villages, rural areas, coastal communities and islands – all with unique features, identities and culture. Our homes, transport systems, access to nature-rich blue and green spaces, social networks and the services and facilities available in our communities are all features that contribute to our health.

Local government works collaboratively with NHS Boards, Health and Social Care Partnerships, Community Planning Partnerships, local businesses and community and voluntary organisations to coordinate services to meet the needs of the local population. These wide-ranging services are delivered both directly and indirectly and create the conditions for people to live longer, healthier and more fulfilling lives.

We know there is variation in the quality of our places and communities, which is leading to differing health outcomes and inequalities across Scotland. Further exacerbating inequalities are the effects of climate change. Communities across Scotland are already experiencing the impacts of the climate and ecological emergency. This includes extreme weather events such as high temperatures, flooding and drought as well as pollution and nature loss. Action taken within communities to address these emergencies represents a significant opportunity to improve planetary health, as well as human health and wellbeing.

Building Upon Existing Action

Actions within this driver build upon existing action already being progressed under the following, non-exhaustive, list of policies and strategies:

• Mental Health and Wellbeing Strategy
• Place Principle
• National Planning Framework 4
• Local Development Planning Guidance
• Local Living and 20 Minute Neighbourhoods: Planning Guidance
• The National Islands Plan
• Local Governance Review
• National Transport Strategy
• Housing to 2040
• Scotland’s domestic climate change strategies
• Environment Strategy
• Cleaner Air for Scotland Strategy

Conditions for Change

The physical and social aspects of our places and communities are all essential building blocks of health. Yet, the extent to which long-term considerations of health and wellbeing are taken into account and balanced against other priorities when making decisions varies.

Delivering improvements to our places and communities requires purposeful consideration of our natural, built and social environments. Planning mechanisms, including Community Planning Partnerships and Local Development Plans, are key to improving health outcomes, as they consider the physical environment alongside the composition, distribution and health needs of the local population. The collaborative, place-based working approaches promoted by the Place Principle, together with existing policies and resources like the Place Standard Tool form a comprehensive and progressive place toolkit for local partners.

The conclusion of the Local Governance Review and establishment of Single Authority Models in three rural and island areas will provide key learning and insights into new place-based approaches for Scotland. Work led by Democracy Matters will also provide blueprints for innovative, democratic community-level decision-making models.

Ensuring communities are at the heart of decisions about their local places is key to achieving meaningful change. Working with local government and communities to understand local need and co-create solutions that draw upon a community’s knowledge, assets and resources is essential. The community and voluntary sector are critical to enabling this transformation.

Community organisations are often better able to engage people who may be furthest from accessing public services, or who have frequent engagement with services due to their level of need. Social prescribing provides an important bridge between the NHS, local government and the voluntary sector, ensuring more people can access community support that benefits their health and wellbeing.

Climate change poses serious risks to physical and mental health and wellbeing. Addressing the climate emergency is not only an environmental necessity but also a critical opportunity to improve population health and health equity. Actions such as improving housing, transport and access to green and blue spaces can offer significant population health benefits. These efforts must align with our response to the housing emergency and the development of sustainable infrastructure.

In the medium to long-term our aim will be to:

• enhance planning and collaborative mechanisms to improve health and reduce inequalities
• strengthen resilience and sustainability of the community and voluntary sector
• support the growth of prevention focused supports in local communities
• increase social connections and community networks
• develop affordable, high-quality housing and good transport infrastructure
• improve the quality of the built and natural environments, including access to green and blue spaces
• reduce environmental related illnesses and harms

Building for Our Future

Over the next two years we will progress the following actions with our partners:

Community and Voluntary Sector

Build a resilient and sustainable community and voluntary sector that supports the creation of healthy communities.

This will include:

• implementing Fairer Funding principles to give organisations the ability to plan for the future and maximise the use of resources and their impact
• applying learning from the Fairer Funding pilot, which has awarded more than £60 million in multi-year funding for projects addressing inequalities across health, education, poverty and culture
• continuing to invest in the Communities Mental Health and Wellbeing Fund, which provides support for those most at risk and therefore most likely to experience poorer mental health, with a focus on prevention and early intervention
• fostering asset-based approaches to enabling the creation of health through powerful local communities

Social Prescribing

Develop a National Social Prescribing Framework for Scotland.

This will include:

• provision of referral links to health and wellbeing support in local communities
• developing a shared definition of social prescribing in Scotland
• supporting effective models of social prescribing based on existing good practice, including community link working
• improving equitable access and consistency in delivery regardless of the setting
• supporting workforce development and enabling better data sharing
• ensuring social prescribing supports ongoing efforts to tackle social isolation and loneliness

Planning

Embed health and wellbeing considerations into the development and delivery of Local Development Plans (LDPs).

This will include:

• supporting better collaborative working between Health Boards and planning authorities through Heads of Planning Scotland and the Improvement Service
• sharing contacts within Health Boards for planning authorities to engage with and to enable Health Boards to meet their legal duty to co-operate in the preparation of LDPs
• ensuring meaningful engagement and input from Health Boards and Health and Social Care Partnerships in LDPs specifically providing input to Evidence Reports, Proposed Plans and Delivery Programmes regarding the provision and delivery of health and care services or facilities
• completing of integrated/health impact assessments and strategic environment assessments
• continuing to promote and support the use of the Place Standard Tool
• applying the health and planning resources on OurPlace.scot

Housing

Support the contribution of better housing to health.

This will include:

• sustaining national and local cross-government collaboration to ensure inequalities are addressed and health outcomes are maximised as we respond to the current housing emergency
• progressing the Housing (Scotland) Bill – including rent control and the development of a homelessness prevention duty
• progressing joint actions agreed by Scottish Government and COSLA on improving the provision of temporary accommodation and affordable housing

Climate Change and Nature

Maximise efforts to tackle the climate and nature emergencies and recognise the close links between environmental and human health.

This will include:

• embedding health and wellbeing considerations through the delivery of actions and commitments outlined in our national climate and environment strategies
• embedding climate and environmental considerations in our health and wellbeing policies
• taking forward actions aimed at minimising the health harm caused by adverse weather events – heat, cold, flooding and drought
• supporting the development and delivery of the successor to the Cleaner Air for Scotland 2 (CAFS2) Strategy