BNG is a statutory planning requirement across England. For NHS bodies and healthcare providers – whether redeveloping existing hospital estates or delivering new services in the community – it should proactively be considered early in their development planning process.

Introduction

Biodiversity Net Gain ("BNG") is a statutory requirement for most new planning permissions in England, demanding at least a 10% uplift in biodiversity value over the pre-development baseline. The instinctive response to a new planning obligation may be to focus on burden. That approach risks missing a considerable opportunity.

For NHS organisations and health-sector clients, BNG is not simply a planning compliance hurdle. It touches the NHS's statutory environmental duties, its capital programme, its estate strategy and its wider ambitions on sustainability and place-making. The NHS estate – some 25 million square metres of trust land – offers a genuine opportunity to protect and enhance biodiversity as part of the wider environmental agenda. The question for healthcare proiders is not whether BNG is relevant, but how to engage with it strategically.

This article considers what BNG is and how it may apply in the health context, and we have separately considered, the opportunities that BNG can unlock for healthcare providers with significant estates.

What is BNG?

BNG requires at least a 10% uplift in biodiversity value over the pre-development baseline and is now a statutory requirement for most new planning permissions in England. That obligation can be met through:

• onsite habitat enhancement;
• offsite biodiversity units (which must be registered and allocated to a development/planning permission); and
• biodiversity credits.

For those with significant landholdings, this multi-pathway structure creates genuine flexibility: generate and sell offsite biodiversity units on the open market, or bank them against future development requirements.

Before development can begin, a biodiversity gain plan must be submitted and approved by the relevant planning authority. That plan must explain how adverse effects on biodiversity will be minimised and demonstrate how the 10% gain will be achieved – whether onsite, offsite, or through credits.

Why BNG matters for NHS and healthcare providers

The NHS is one of the largest landowners in England. NHS bodies are also significant and regular developers, whether redeveloping existing hospital campuses, constructing new treatment and diagnostic facilities, delivering primary care infrastructure in communities, or reconfiguring their estates to match changing service models. All of these activities are likely to engage mandatory BNG requirements.

Beyond planning compliance, NHS bodies carry specific statutory environmental obligations. NHS England, NHS trusts and NHS foundation trusts are subject to duties to have regard to the Government's key ambitions on climate change and the natural environment in everything they do. This can mean protecting and enhancing biodiversity across the NHS estate, alongside decarbonising energy and procurement. BNG sits squarely within those ambitions.

The Greener NHS programme – which commits to achieving net zero carbon across NHS operations by 2040 and across its supply chain by 2045 – provides further context. Nature recovery and biodiversity are increasingly understood as part of the same environmental agenda as carbon reduction: they are mutually reinforcing goals, and the NHS has both the scale and the statutory mandate to pursue them together.

Where BNG is likely to arise for healthcare providers

BNG is relevant across the full range of NHS capital and estate activity:

• Hospital redevelopment and new build: Major new hospitals and significant extensions will require a biodiversity gain plan as a condition of planning permission. Early engagement with ecological surveyors and designers is essential, as pre-development biodiversity value is the foundation of both BNG compliance and any commercial assessment.
• Community health infrastructure: New GP surgeries, diagnostic hubs, primary care networks, mental health facilities and community treatment centres are all likely to engage mandatory BNG requirements. Even smaller developments should be assessed at an early stage, as the planning authority must approve a biodiversity gain plan before works commence.
• Estate rationalisation and disposal: Where NHS land is identified as surplus or is being consolidated into a smaller operational footprint, the disposal strategy should consider whether that land could be used to generate offsite biodiversity units – either for allocation to development by the NHS itself or for sale on the open market. For operators with legacy landholdings or buffer zones outside the operational footprint, this creates a route to generating income from land that might otherwise represent only a management cost.
• PFI and design-and-build projects: Where new healthcare facilities are being delivered through private finance or public-private partnership arrangements, BNG obligations and associated land commitments should be addressed clearly in the contractual framework from the outset.

BNG as a material planning benefit

A genuine biodiversity gain that clearly exceeds the minimum 10%, and is properly distinguished from baseline planning obligations, can be a meaningful factor in tipping a finely balanced planning decision in an operator's favour. For NHS organisations promoting major development (for example, new hospitals, campus redevelopments or significant community infrastructure), a well-evidenced BNG strategy supported by an established habitat bank can strengthen the planning case and demonstrate commitment to the local natural environment.

BNG as a planning benefit and a strategic tool

BNG need not be viewed as a constraint. For NHS clients, it can support:

Better healthcare environments. Incorporating habitat creation, planting, sustainable drainage and green space into hospital and community health campuses contributes to environments that benefit patients, staff and the public. There is growing evidence linking access to nature with improved clinical outcomes and staff wellbeing.

• Planning weight: A genuine biodiversity gain that clearly exceeds the minimum 10%, and is properly distinguished from baseline planning obligations, can be a meaningful factor in tipping a finely balanced planning decision in an operator's favour. For NHS projects facing local planning challenges, a robust BNG strategy can strengthen the overall case for permission.
• ESG and sustainability credentials: A registered biodiversity gain site is a verifiable, legally secured commitment quantified by the statutory biodiversity metric – increasingly attractive to investors, lenders, and supply chain counterparties operating under their own ESG frameworks. For NHS bodies accountable for their sustainability performance, this provides a tangible and publicly verifiable contribution.
• Income generation and cost reduction: NHS organisations with suitable land may be able to create biodiversity gain sites and allocate units to their own development programme or sell them on the open market. Operators with a continuing development programme can use offsite biodiversity gain as an internal resource, banking biodiversity value from restoration or legacy land and allocating it against future BNG obligations, materially reducing compliance costs across a portfolio.

We further consider BNG strategic opportunities here.

Practical recommendations

1. Assess your estate and development pipeline now. Identify which projects are likely to require planning permission, the existing habitats on relevant sites and any surplus or peripheral land with biodiversity potential.
2. Commission ecological surveys early. Pre-development biodiversity value is the foundation of both BNG compliance and any commercial assessment.
3. Integrate BNG into capital project design from the outset. BNG is most effectively and cost-efficiently addressed at the design stage, not as a last-minute planning requirement.
4. Take specialist legal advice before entering any BNG land commitment. The 30-year obligation, conservation covenant mechanics, registration requirements, and interactions with planning conditions, environmental permits and site licences are all complex and affect future land use and value.
5. Consider your wider estate strategically. Land that is surplus to operational requirements may have real biodiversity value – and real commercial opportunity.
6. Consider NHS governance and land-use frameworks. Any BNG commitment on NHS land must be considered alongside NHS property governance requirements, including relevant consents, NHS Property Services arrangements and ICB oversight of major estate decisions.

Conclusion

BNG is a statutory reality for NHS and healthcare providers. For organisations with active capital programmes, significant estates and statutory environmental responsibilities, it is also a genuine opportunity – to design better healthcare environments, to generate income or reduce compliance costs from land not required for immediate operational purposes, and to build a verifiable nature-positive record aligned with the Greener NHS programme.

The legal obligations are substantial and the 30-year commitment demands expert legal and ecological advice before any step is taken. But for NHS bodies that engage with BNG early and strategically, the framework offers considerably more than a planning condition to be satisfied.

We have extensive experience advising on all aspects of BNG, including planning obligations, conservation covenants, habitat bank structuring and estate strategy. If you would like to discuss how BNG may affect your organisation or your development programme, please do contact us.

This article is intended as general information and does not constitute legal advice. Specific advice should be sought in relation to particular circumstances.