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 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 on

Role of the Greater London Authority Tasked with … promoting economic and social development in Greater London, and the improvement of the environment Subsidiary purposes  To promote health of Londoners  To promote equalities  To promote sustainable development In preparing strategies, the Mayor must ‘have regard to’ the health of Londoners 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 /ukpga_ _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 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. 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 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

London approach to HIA 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? Attendance at HIA courses by sector

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 Accessible evidence base on wider determinants 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 Gatewaywww.hiagateway.org.uk London Health Observatorywww.lho.org.uk London Health Commissionwww.londonshealth.gov.uk Greater London Authoritywww.london.gov.uk