Transcript Document

Health Impact Assessment
in London
Ben Cave, Ben Cave Associates
on behalf of
Bobbie Jacobson, Director, London Health Observatory
Slides prepared by
Gail Findlay, London Health Commission
Anthea Cooke, adviser to London Health Observatory
Ben Cave, Director, BCA
Bobbie Jacobson, Director, London Health Observatory
An overview … HIA in London
• [IAIA … ]
• Greater London Authority - context for health policy
in London
• London Health Commission - healthier public policy
• Healthy Urban Development Unit - health in planning
• London Health Observatory – support, advice,
capacity
• Some reflection and learning
International Association for Impact Assessment
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an international forum for advancing innovation and for
advancing the practice and science of impact assessment in
applications ranging from local to global;
it was founded in 1980;
it has approximately 1,500 members with 2,500 affiliated
members in 120 countries;
a network of practitioners and users of various types of impact
assessment (industry and consultants, academics, government,
multi-lateral funding institutions); and
it holds an annual international conference (Seoul, Korea 2007;
Perth, WA 2008; Accra, Ghana 2009; Europe 2010).
… there is a link to www.iaia.org on www.hiagateway.org.uk
Role of the Greater London Authority
Tasked with …
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promoting economic and social
development in Greater London,
and the improvement of the
environment
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Subsidiary purposes
 To promote health of Londoners
 To promote equalities
 To promote sustainable
development
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In preparing strategies, the
Mayor must ‘have regard to’ the
health of Londoners
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The Greater London Authority
Act (2007) updates and
enhances the Mayor’s
responsibilities and powers with
regard to health and health
inequalities in London
available at
www.opsi.gov.uk/acts/acts2007/pdf/
ukpga_20070024_en.pdf
 The Mayor must prepare a
Health Inequalities Strategy
 The Regional Director of Public
Health is the Mayor’s Adviser
for Health
London Health Commission
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Launched by Mayor in October 2000
Builds on London Health Strategy
Independent - Chair appointed by Mayor
Seven key partner agencies - GLA, Kings Fund, ALG,
GOL, LHO, LDA, RPHG
• All the ‘major London players’ at the table - 30
Members
• Seven forums link with wider London networks
Aim and Purpose
To reduce health inequalities in the
capital and to improve the
health and well-being of all
Londoners
• Raising awareness of health
inequalities.
• Promoting coordinated action to
improve the determinants of
health across London.
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Influencing key policy makers
and practitioners.
Supporting local action.
Driving on specific, priority
issues through joint
programmes
London Health Commission … key
achievements
• Engagement of major London partners
• HIAs on ten Mayoral Strategies
• Reporting annually on ‘Health in London’
• Conferences and Network Events
• Publications: Briefings, Evidence summaries etc
• Big Smoke Debate
• London and Londoners: ‘Making the links for health’
Healthier Public Policy …
HIAs of pan-London Strategies
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Transport
Economic Development
Air Quality
Waste Management
Ambient Noise
Biodiversity
Spatial Development
Culture
• Children and Young People
strategy
• Older People Strategy
• Review of the Economic
Development Strategy
• Extension of Congestion
Charging Zone
• Health Inequalities Strategy
(currently at Assembly Draft)
• Healthcare for London (NHS
London strategy)
Healthier Public Policy …
GLA Strategies … integrating
assessments
• Pilot IIAs … look to
requirements of the SEA
Directive
• Tested on sub-regional
development frameworks …
close work between LHC &
the London Sustainable
Development Commission
• Further Alterations to the
London Plan
• Climate Change Adaptation
Strategy
• Water Action Framework
• Municipal Waste and Wider
Waste Strategies
• Housing
… etc ...
Healthier public policy …
NHS Healthy Urban Development Unit
• Resources
Watch out for health
Model to calculate developer contributions to health
services and facilities
• Partnership work with PCTs: developing capacity for
health in planning
information at www.healthyurbandevelopment.nhs.uk
London approach to HIA
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steering group
screening & scoping of draft strategy
rapid appraisal of evidence
policy appraisal workshop
report & recommendations to Mayor
recommendations into final strategies
monitoring and evaluation
Publish evidence reviews & HIA reports
Sharing learning
• Publications:
 Short Guide to HIA
 HIA Key Messages
 HIA reports
 Evidence reviews
• LHC Regional Events: dissemination … networking
• Papers & presentations local, national, international
• Through capacity building, training - LHO key lead
role
… Providing tools for health improvement
London Health Observatory & HIA
•Remit to support HIA since 2000
•Advising on methods of HIA
•Developing resources – building capacity
Building capacity
• London working group established (2001) – oversee HIA
training programme
• Aims:
 raise awareness of HIA; &
 begin to build knowledge & skills to undertake HIA across range of
organisations
• Short introduction to HIA courses well received
• Followed by longer HIA courses & tailor made – borough
specific
• LHO HIA Coordinator available to offer limited follow up support
(until last year)
Who attends the LHO courses?
Number of those who attended
HIA training course attendance by sector
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Primary Care
Trust
Local
Government
Voluntary /
Community
sector
Private Sector
Attendance at HIA courses by sector
Sector
Academic
Other - Regional
& Central Gov't,
SHAs, PHO,
Environment
Agy,
Who goes on to do HIA?
• 52% of trainees … do or don’t ??? …
tbc …
• Reasons sited for not getting involved:
1. No opportunity
2. Attended course as training requirement
3. Others: changed job, lack of resources, trouble
convincing others of value
Evaluation of HIA training
• 2003/2004 LHO commissioned external evaluation of
HIA training
• One-day course very well received
• Four-day course met most expectations
• But …
 Are the right people being trained?
 Trying to meet too many needs – practical versus theory
 Mixed understanding of HIA & respective skills – strength &
weakness
 Needs to be more targeted & focused with on-going support
… and so … ?
Independent evaluation shows:
• HIAs have made a difference to
final strategies; eg:
 Economic Development
Strategy prioritises health
 Cycling & walking given high
profile in Transport Strategy
 Policies for health in London
Plan
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Accessible evidence base on
wider determinants
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Increased stakeholder
awareness of impact of wider
policies on health and
involvement in HIA
Health considered earlier in
strategy development & in
strategy review
Contribution to development of
HIA methods, tools & evidence
base at national, regional and
local level…
International links
Some reasons for progress in London …
some learning?
• Political commitment of the
Mayor of London
• Regional Director of Public
Health is
Health Advisor to the Mayor
• Health is a cross-cutting
theme in the GLA Act
• LHC partnership operating
formally and informally
• Good relationships and joint
working through LHC … built
up over eight years …
• LHC team, LHO, GLA Health
Policy Team, Regional Public
Health Group and NHS
London
• Approach ‘tailored’ to
London context
• ‘Keeping it simple’
Challenges and opportunities
• HIA not statutory
• Demand for HIA at
sub regional levels
• Resources
• Expertise
• Extended and New
Mayoral Powers
• Mainstreaming
• Capacity building
• Move to more
integrated
approaches
For more information …
HIA Gateway
www.hiagateway.org.uk
London Health Observatory
www.lho.org.uk
London Health Commission
www.londonshealth.gov.uk
Greater London Authority
www.london.gov.uk