Exploring perspectives on the state of local healthy planning in England: results from a national survey

BACKGROUND: Spatial planning is increasingly recognized as a key mechanism for addressing general health determinants. However, persistent gaps between policy intent and implementation exist. Understanding practitioner perspectives is essential for identifying the factors that influence actions. METHODS: A survey was conducted to capture the views of health and built environment professionals. Questions were structured using the system-context-capability framework to examine how governance, context, and capacity impacted on healthy planning. Analyses focused on responses and stratified findings for planning and health professionals working in England. RESULTS: Respondents expressed strong consensus for planning's role in improving health and reported high awareness of national policy requirements for health. However, confidence in implementation was limited. Barriers identified were lack of capacity and resources and weaknesses in policy. Findings included misalignment between influence and responsibility where planning actors were viewed as highly influential, while health bodies were seen as responsible for health outcomes but constrained in their ability to shape decisions. Capacity building was identified as opportunities to strengthen delivery. CONCLUSIONS: Effective implementation of healthy planning depends not only on policy frameworks, but on system readiness, governance alignment, and professional capacity. Addressing these factors is critical for translating policy ambition into planning actions.