Whose bed? Real time HIA Capacity Building Hilary Dreaves Research Fellow (HIA) IMPACT, University of Liverpool, UK

Definition of Capacity Building “an approach to the development of sustainable skills, organisational structures, resources and commitment to health improvement in health and other sectors, to prolong and multiply health gains many times over” (Hawe, P et al 1997)

HIA organisational competence is.... ‘a combination of organisational dimensions (policies, practices and behaviours) which together create and sustain an organisational culture in which the health impacts and implications of all its activities are routinely and systematically considered; this could also be referred to as an HIA culture.’ Abrahams,D., Scott-Samuel,A. (2009)

Case Study 1: North East Healthy Communities Learning Network. North East England, 2008/9. 80 people Municipal, Health, Community. 3 Stage programme: Introductory workshops x 4 Comprehensive course x1 Evaluation 6 months later Workshop evaluations very positive High residual interest after Stages 1& 2; additional introductory sessions; planned delay of follow-up On-line follow-up via local co-ordinator.

Outputs: 65 (81%) participated in Stages 1&2 Included elected representatives, senior municipal officers, planners, public health, epidemiologists, health promotion, third sector, etc. Stage 3 on-line evaluation: 23 responses (39%) Before: 17 (74%) had heard of HIA 2 ( 9%) had taken part in a HIA. After: 23 (100%) discussed with their peers 4 presentations to staff groups 4 HIAs underway 1 person advising commissioners 1 had HIA included in their role Evidence that “old” prior training was connected to the “new” programme

Enablers: Inequalities Review required a HIA working group HIA role identified in a new unitary authority Screening tool in development for systematic use Senior management sign-up 2 people funded to do HIA in their role Barriers: No HIA policy No senior sign-up “Old” organisation HIA literate, new not. Not mandatory or statutory Insufficient resource

Case Study 2: North West HIA Capacity Building (CB) Programme. North West England 2008/10. Target population: Municipal, Health and Community Geographical footprint 4 workforce areas Programme scoped by Steering Group: On-line baseline assessment Training programme Good practice guide to capacity building Capacity building literature review Organisational benchmarking tool Evaluation

Baseline Assessment : Target Group estimated at “Officers” Questionnaires 130 “Community” Questionnaires Response rates 21% and 30% Evidence of onward distribution beyond target group in Local Authorities Fewer responses beyond Public Health from Primary Care Trusts

Programme delivery to date Phase 1: Leadership Seminars Phase 2: Practitioner Training Phase 1Phase 2Total to date Leadership Seminar11 events3 events144 people Introductory Day-3 events51 people HIA Policy & Screening-11 events162 people Comprehensive course-3 courses57 people Action Learning Sets-2 sets25 people

Effects of “difficult times”: Disestablishment of Steering Group Programme reduced to training delivery Postponements due to low numbers Externalities, e.g flooding and serial killing incident Outputs to date: 1 known HIA screening delivered 1 HIA co-ordinators role extended 2 Action Learning Sets to report Co-ordinator secondment extended

Overall Enablers: Local co-ordination Good and frequent communications Senior level commitment HIA Policy in development/in place Willpower and tenacity Overall Disablers: Organisational cultures/language/ethos, i.e. Municipal v. Health v. Community Political drivers, with unresolved lack of clarity regarding transition to localism

Whose Bed?

IMPACT, International Health Impact Assessment Consortium, Division of Public Health, Whelan Building, University of Liverpool, Liverpool. L69 3GB Tel: +44 (0) Fax: +44 (0)