For decades policymakers have been talking about creating high street health and wellbeing hubs: integrated spaces combining GP practices, community health, leisure and social services in accessible town centre locations.

Traditional high streets are in decline the country over, as long-standing retailers make way for vape and charity shops, bookies or, indeed, empty units.  With each new closure comes a further decline in footfall, reduced economic activity and loss of civic identity – a vicious cycle.  

As Radix Big Tent discovered when helping to establish the Platform Places project four years ago, with the right practical support there is an alternative.   Platform Places -convening investors, landlords, planners and community activists and now funded by the National Lottery - is showing how high street buildings can be brought back in to use as community assets which, in turn, can help revitalise town centres.

Health hubs offer a tantalising opportunity to driver further change, transforming under-used retail spaces into vibrant, multi-use community anchors.

It seems such an obvious solution not just to town centre regeneration, but to bringing health care closer to the people who need it.  For example, in Stockton-on-Tees and Barnsley, local councils are repurposing former shopping centres into state-of-the-art health and wellbeing hubs, combining NHS services, leisure facilities and community support. Such projects form part of wider regeneration strategies designed to reconnect civic, commercial, and health objectives.

Yet while the potential is clear, delivering them at scale remains complex, with significant policy and financial barriers to overcome.  As a result, there are precious few successful examples to which we can point. 

The first problem is that funding streams are hopelessly fragmented.  Capital investment in health infrastructure is typically controlled by NHS England and ICSs, while regeneration funding (e.g. Towns Fund, Levelling Up Funding etc) sits with local authorities. Misaligned timelines, political imperatives, eligibility criteria and priorities make it difficult to braid these streams into a coherent delivery plan. The result is often piecemeal financing rather than strategic investment.

Second, once built, health hubs require sustainable revenue models for maintenance and staffing. NHS property budgets are constrained and local authorities face ongoing financial pressures. Without integrated commissioning agreements and clear tenancy models, hubs risk becoming financially unsustainable beyond initial capital grants.

Third, delivering a multi-agency facility requires navigating NHS estate rules, local planning frameworks, and property law. Governance arrangements between ICSs, councils and private and voluntary sector partners are often unclear or cumbersome, delaying progress.

And fourth, repurposing retail or commercial property for healthcare use can trigger planning class complications that increase cost and timescales. There is often a lack of common-sense flexibility at a local level to get even the best financed projects of the ground.

Despite all these barriers, however, health hubs represent a unique opportunity for joined-up, place-based policy. So next year Radix Big Tent is looking to launch a new initiative - modelled on our successful Housing Commission - to produce practical recommendations for central and local government, and health commissioners and providers, to unlock the potential of health on the High Street. 

We start the week after next with an exclusive launch event in central London.  If this is a project in which you would like to be involved, please get in touch immediately for further information.

This is Radix Big Tent at its best: convening multi-disciplinary groups, stimulating discussion and focussing on pragmatic and deliverable solutions that can enjoy cross-party support to challenges recognised by all.  I encourage you to get involved.

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