IOM CHIA HIA Training Course Workbook (2008)

8/14/2019 IOM CHIA HIA Training Course Workbook (2008)

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Health Impact Assessment

Training Course

Workbook

Developed by Dr Salim Vohra, Director, Centre for Health Impact Assessment 2003-08


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1. What is Health andWellbeing?

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1.1 Health as a Relationship

What item did you pick from the health box?

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How do you see your item relating to health?

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How do you see your item relating to ill-health?

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1.2 Health as a Connection

Write down other words and phrases that you connect with health and disease?

health

disease

wellbeing


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2. What is Evidence?


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2.1 Information or Evidence Used

What different types and sources of information/ evidence do you generally tend to usein your work ?

Type & sources ofInformation

Used/Not used

Why?

Professional journals

Local newspapers

Private sector surveys

e.g. MORI Polls

National governmentreports, consultations e.g.Department of Health

Your own and yourcolleagues judgement &experience

Business reports andsurveys, etc.

Userviews/feedback/surveys

Local residentsviews/surveys

National newspapers

Local government reportsand consultations

Others (please list below)


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2.2 Information or Evidence Relied On and Trusted

How do you judge or assess this information/ evidence? Which do you rely on more? Rankthe information/evidence in terms of which you rely on/trust the most (rank 1) andwhich the least (rank 10)

Type & sources ofInformation

Rank Why?

Professional journals

Local newspapers

Private sector surveyse.g. MORI Polls

National government reports,consultations e.g.Department of Health

Your own and yourcolleagues judgement &experience

Business reports and surveys,etc.

User views/feedback/surveys

Local residentsviews/surveys

National newspapers

Local government reportsand consultations

Others (please list below)


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3. What is Screening?


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Screening

Which of the project, service, programmes and policies listed below is it worth doing aHIA on and why?

Proposal project, service, programme or policy Do a HIA?Yes/ No/ Not

Sure

Why?

The building of a small block of flats for key workers on abrownfield site that will include landscaped gardens andwhere the nearest houses will be more than 500 metresfrom new block of flats.

A 20,000 a year three-year drop-in adult educationprogramme for refugees and asylum-seekers.

A proposed new public transport infrastructure project witha new tram-link and re-configuration of some existing busservices.

A local authority homelessness strategy.

A 5 million large commercial office development within anexisting commercial business park.

A mobile phone transmitter mast on the roof of a localhousing association residential block of flats of 20 storeys.

A 500,000 refurbishment of an existing leisure centre in arun-down and deprived area to enhance the existingfacilities. These include a swimming pool, football courts, agym and fitness centre and an outdoor running track.

A credit union project to help local people to access smallloans and develop budgeting and saving skills.

A 250,000 healthy living health promotion programmeaimed at educating people to eat more fruit and take moreexercise.

A 20 million regeneration programme involving the buildingof a range of business, leisure and residential developmentsincluding a range of programmes to tackle inequalities.

The replacement of an old waste-to-energy incinerator witha new modern one in a sparsely populated area.

The setting up of a community-wide children in schools artproject run from a local community centre.

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What informal/implicit criteria did you use to make your judgement?

What more information, if any, would you have liked to have had in order to make adecision?

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4. A multi-layered case studyto explore HIA


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Yourboro RenaissanceImproving peoples lives through social, environmental and

economic action

Dear Colleague,

As you are aware this leading nationalgovernment directed local programme hasbeen working for many years with local

communities through local governments to improve and enhance urbanand rural neighbourhoods and environments.

The Yourboro Renaissance team include internationally renownedeconomic, social, environmental, educational, regeneration andcommunity development experts.

They are currently working in urban-rural Yourboro to help deliver a

major 20 million (social, environmental and economic regenerationand welfare programme based on the regional strategy New Beginnings an opportunity for all involving new business, leisure and housingdevelopments as well as educational, cultural and communityprogrammes and activities.

We need your help to ensure that we succeed in making Yourboro one ofthe most successful areas in Youregion.

Below we provide some key information about Yourboro which we hope

you will use to help us assess the health aspects of some of the existingand new initiatives which are outlined in this pack.

Regards,

Sally WrightMayor

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Area Context

The development parts of the regeneration will occur in a brownfield area which was originally the site

of mining works and heavy industry. The overall renaissance area straddles two adjoining local districts

(and hence two local government authority boundaries). The renaissance area also encompasses some

rural areas on the outskirts of Yourboro.

The renaissance area is divided and defined by a number of large roads which separate commercial and

residential areas. The area is a main thoroughfare for traffic, commercial and private into and out of

Yourboro.

Both local districts have pockets of affluence. The regeneration area encompasses some of these pockets

of affluence from one of the local districts but not the other. There are also areas with high levels of

poverty which have a high rating on the national Index of Deprivation. Services within the area are poor,

there is only one large supermarket, very few local shops and public transport links are via buses only.

The population is diverse with large numbers of ethnic minority residents, a mobile population, large

numbers of young people and some refugees and asylum-seekers. The pockets of affluence are made up

of newly arrived families and older couples while the social housing is mainly comprised of long-standing

families and residents of the area.

There are large numbers of community and voluntary sector organisations within the area but most, if not

all, tend to operate in isolation and therefore are not well organised and not influential.

Fig. 1: High Level Map of the Area

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Historical Context

The area still has a strong mining and rural identity even though all the

mines have shut and there are only a few large farms in the area. The area

has become increasingly urbanised with Yourboro having a population of over

250,000.

Social Context

There are substantial concentrations of poverty, largely in the south-east of

both districts. The districts have areas of significant deprivation and there

are crime hotspots with high levels of personal crime e.g. muggings and

burglaries.

There is also a well established ethnic minority community. Overall, the

population of the area is young with very few people of middle age and small pockets with a high

concentration of older residents. There are significant gaps in primary health care provision. `Parts of one

of the districts have poor child health outcomes. There has been a recent influx of refugees and asylum

seekers. Numbers of children from more affluent backgrounds attend fee paying schools outside the area

for both primary and secondary education. All secondary age children travel outside the area to attend a

secondary school.

Economic Context

There are no major businesses in the area and a high ratio of economically active

residents work outside the districts. In the rural areas there are high levels of

unemployment especially among young people.

Since the closing of the mines and the heavy industries the areas economy has been

stagnating. The rural areas had a thriving number of small farms which over the years

have amalgamated so that now there are only a few large sheep and cattle farms.

Tourism has been increasing in the area with people coming to enjoy the outdoors,

walking and camping.

Environmental Context

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The old mining and heavy industrial areas are brownfield sites with significant surface and soil

contamination. Some of the rural parts have areas of outstanding beauty with rare species of flora and

fauna.

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Key Initiatives of the Renaissance Programme

1. New Waves Call Centre

Part of a broader information technology and communications business development programme

funded from national regeneration funding. The proposed site is on the border of the two local

districts. It will become a call centre for a number of large companies and public agencies. One

thousand part-time jobs, including call operators and call handlers, as well as ancillary staff e.g.

cleaners, caterers, maintenance and management staff. The site is bounded by roads with a large

social housing estate nearby. There are no existing local amenities near the site and the transport

links to the site are currently by bus. All the staff will be newly recruited and the majority of

posts will be part-time shift work, 24 hours a day, 7 days a week.

2. Enhancing Community Care One-stop Primary Care Centre

This will involve the relocation of the three major primary care practices from existing

accommodation into a single purpose-built facility that will include a minor surgery unit, podiatry,

community nursing, childrens and family planning services. Current primary care services are

based in converted residential accommodation. Public transport services to the proposed site are

currently very limited. The site for the proposed new facility will be a high density residential

area with a mix of social and owner occupied housing.

3. Kids in the Community Summer School

The activities are free to all young people aged 14-25 years who live in the renaissance area. This

will include the cost of weekly outings and all equipment. The programme aims to meet a range of

young people's needs: school curriculum revision and enhancement, the opportunity to try

subjects not studied at school and taster sessions for further education. Projects and courses

giving young people the opportunity to immerse themselves in a creative art project for a week

e.g. producing your own theatre performance, exhibitions and films will also be on offer. Courses

and seminars offering information and advice on training and employment will be available. There

will be varied opportunities to acquire and develop ICT skills, and to enjoy sport and fitness

activities both to improve sports skills and to try something new. Young people will be directed to

year round provision or specialist agencies as appropriate as part of the programme.

4. Open Access - Equal Access Community Caf

Community consultation showed strong support for a community caf. There are no multi-purpose

community facilities where people with physical and learning disabilities can have access to andparticipate in a range of social and leisure activities. The lack of opportunity for disabled

residents to access and participate in such activities has meant that they are amongst the most

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excluded people in the area. Access to such facilities is vital to improving the quality of life,

health status and social inclusion of disabled residents. The community caf will have a coffee

shop and restaurant as well as a range of indoor and outdoor leisure activities including a

swimming pool. The caf will also provide a range of outreach health, social care, education,

training, employment support and welfare services.

5. Homes for All Extending Housing Choice

This is a new national government initiative to extend housing choice. Local authority owned and

maintained properties across the area will be transferred to a number of social landlords who will

then have responsibility to maintain and develop this housing stock. The selection process for

social landlords has started and various housing associations are presenting their business cases to

the local community. As yet there has been no detailed national guidance on how this initiative

will work and no national or local authority monies have been earmarked. Additionally, theinitiative will involve the refurbishment of existing housing, the demolition of housing that is

judged as not worth refurbishing and the buying of new houses to supplement the housing

associations housing portfolio. The aim is for the housing associations to create more balanced and

mixed communities than has been the case in the past.

6. Culture into Communities Theatre, Music, Gallery and Museum Complex

There is no theatre, music venue, art gallery or museum in the area. The Culture into

Communities complex will provide a state-of-the-art theatre, music venue, art gallery and

museum for the renaissance area. The events proposed will include national and international

theatre performances, opera, classical music, pop music events, international and national art

exhibitions and a museum recording and archiving the historical, social and cultural changes to the

area over the last one hundred years. The complex will be managed by a national art and heritage

charity that has a strong international presence.

7. Transport for the New Millennium Tram-linkThe aim of Transport for the New Millennium is to improve the roads from the renaissance area

to the major urban conurbation of Yourboro as well as to extend the existing tram-link network in

Yourboro into the renaissance area. This will substantially improve the public transport

infrastructure of the area and increase the economic benefits of companies locating here. The

construction of the tram-link network will take ten years and involve the purchase of, used and

unused, rural and urban land.

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Using a HIA tool

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Screening

Assess whether an proposal (plan, policy programme, project or service) should have a health impactassessment undertaken by answering as honestly as you can the following questions.

Name of Proposal:

Answersfavouring

doing a HIA

From your knowledge and/or

in your judgement

Answersfavouring notdoing a HIA

Health Impacts

Yes / not sure

Yes / not sure

Does the proposal affect health directly?

Does the proposal affect health indirectly?

No

No

Yes / not sure Are there any potentially serious negative healthimpacts that you currently know of?

No

Yes / not sureIs further investigation necessary because moreinformation is required on the potential healthimpacts?

No

No / not sureAre the potential health impacts well known andis it straightforward to suggest effective ways inwhich beneficial effects are maximised andharmful effects minimised?

Yes

No / not sureDo you (or others) judge the identified healthimpacts as being small in effect?

Yes

Community

Yes / not sure Is the population affected by the proposal large? No

Yes / not sure Are there any socially excluded, vulnerable ordisadvantaged groups likely to be affected?

No

Yes / not sure Are there community concerns about anypotential health impacts?

No

Proposal

Yes / not sure Is the size of the proposal large? No

Yes / not sure Is the cost of the proposal high? No

Yes / not sure Is the nature and extent of the disruption causedby the proposal likely to be major?

No

Organisation

Yes Is the proposal a high priority/ important for theorganisation/ partnership?

No

= For TOTAL Against =

Screening contd

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Assess what kind of HIA should be done on your proposal by answering as honestly as you can thefollowing questions.

Rapid Type of HIA Comprehensive

Yes Is there only limited time in which to conduct HIA? No

Yes Is there only limited opportunity to influence thedecision?

No

Yes Is the timeframe for the decision-making process setby external factors beyond your control?

No

Yes Are there only very limited resources available toconduct HIA?

No

Assess who should do the HIA on your proposal by answering as honestly as you can the followingquestions.

External Assessors Internal

No Do personnel in the organisation or partnership havethe necessary skills and expertise to conduct theHIA?

Yes

No Do personnel in the organisation or partnership havethe time to conduct the HIA?

Yes

(Adapted from a screening tool developed by Erica Ison in Resources for Health Impact Assessment, 2000)

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5. What is Scoping?

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Scoping

Question Answer Who will lead on the project management

of your HIA?

Will you have a HIA steering group, if yes,who will make up the members, what will

be its terms of reference?

Are there other professional or communitystakeholders - not included on your

steering group who should be involved in

the design of your HIA?

When do the decision-makers you areaiming to influence make their decision and

hence when does your HIA report need tobe completed by?

Why is the proposal being undertaken?What are the proposals aim and

objectives?

Why do you want to do this HIA?What are your HIAs aim and objectives?

What geographical area will your HIA cover?

What population group will your HIAencompass?

Will the population assessed reside within thegeographical area described above or include

workers living outside the area,travelling families, etc?

Scoping contd

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Question Answer What definition of health will you use

for your HIA?

What HIA model/approach do you want touse?

Are there any specific health impacts thatyou want your HIA to focus on?

Do you know which specific population sub-groups/ community groups will be directly

affected by the proposal underconsideration?

Will your HIA give specific detailedrecommendations or will you just detail the

potential health impacts so that yoursteering group and other decision-makers

can then separately think about the

implications and recommendations?

Other issues relevant to your local ororganisational setting

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Methodology

Question Answer Depending on what HIA model you chose in

scoping,will you use a quantitative, qualitative

or mixed approach?

Why?

What health evidence and research sources

will you use?

What sources wont you be able to use?

Why?

Current evidence on health needs (public health, localauthority, etc)

Research review evidence on health impacts

Will you do an informal windscreen orwalkabout observation of the

geographical area and community?

Will your HIA include a formal consultationof professional and community

stakeholders?

Why?

What method/s are you thinking of using?

Baseline Assessment

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Question Answer What are the characteristics of the

local people age, gender, ethnicity?

What is the health situation likeof local people?

What is the social situation like?

What is the economic situation like?

What is the local environment like?

Baseline Assessment contd

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Question Answer What health & social care services are

there in the area/serving local people?

What voluntary sector and charity servicesare there?

What retail, shopping and banking servicesare there?

What culture and leisure services are theree.g. cinemas, theatres, sports centres?

What urban/rural regeneration or otherarea or health improvement programmes

are there?

Policy context (and policy evidence)

Question Answer

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What international policies does theproposal link into?

Which parts of these policies does the proposalfollow and which parts does it ignore?

What are the reasons for this?

What national/regional policies does theproposal link into?



What local policies does theproposal link into?



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6. What is Analysis?

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age

sex

geneticeffects

leisureactivities

exercise

sexualbehaviour

smoking

alcohol

prescription

substancemisuse

familyrelationships

housingtenure

housingconditions

employmentstatus

workingcondition

income

education

means oftransport

socialcontact

socialsupport

communityparticipation

peerpressure

fear ofcrime &

anti-socialbehaviour

fear ofdiscrimination

crime &anti-socialbehaviour

discrimination

health & socialcare services

childcarecommunity

facilitiesleisure

facilities

education& trainingworkplaces,

employment opportunities& services

adviceservices

housing

voluntary &charity groups

publictransport

shops andbanking services

jobcreation

distributionof incomes

availabilityof training

quality ofemploymen

availability ofemployment

businessactivity

research & technologicaldevelopment

land use &planningnatural

resourcesgreenspacewaste

management

public &environmental

health

naturalhazards

civic design

smell noise

vibration

airquality

waterquality

soil

qualit

Determinants of

Health & Wellbeing

Lifestyle

Social influences

Environment

Economic

conditions

Availability & access

Biologicalfactors

Personalcircumstances

Adapted from Rapid Health Impact Assessment: a guide to research by AmandaHarris, Mar 2002


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Health appraisal rapid adapted from the British Columbia HIA model as described by Erica Ison in Resources for HIA, 2000

Yes,

No,

Not Sure

If Yes,

is the health impactlikely to be positiveor negative (+/-)?

Who or what peopleor group(s) will thisimpact potentially

affect?

How is the impact likely tooccur?

How do you know this?

If the impacts are negativeWhat possible mitigationmeasure(s) would reduce thenegative affects?

Will the proposal affect thecreation and distribution of

income or wealth levels?

Will the proposal affectemployment opportunities?

Will the proposal affectlearning opportunities?

Will the proposal createhealthier beginnings for

children?

Will the proposal affect thenumber and quality ofpersonal connections?

Will the proposal affect crimeand safety?

Will the proposal affectpeoples ability to influencetheir lives and locality?

Will the proposal affectthe local environment?

Health effects and pathways of impact adapted from the Westminster Toolkit: Health and Wellbeing, 2004

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Impact Effects on health and wellbeing Pathway of impact If the impacts are negativeWhat possible mitigationmeasure(s) would reduce thenegative effects?

Employment Leads to poverty and a reduction in personal and social esteem.

Poverty excludes people from:

being able to afford quality and variety of foods

engaging in opportunities for leisure and physical recreation

enhancing their education and learning

having warm and comfortable homes

It also increases their

difficulties in travelling and therefore accessing other services andamenities

levels of stress

All leading to poorer physical growth and development, reducedimmunity to disease and reduced physical and mental health wellbeing.

Affects all age groups but greatest effects on those already on lowincomes, those with disabilities and children.

Through reducing employmentopportunities, affecting there socialand welfare entitlements, affecting theviability of the organisations they workfor, reducing their opportunities foreducation and training, reducing theirability to travel and access

Ensuring that existing employment,education, training, amenities and publictransport are not reduced.

Increasing and promoting the range ofemployment, education, training,

amenities, public transport and welfare.

Housing Poor housing that is damp, cold with poorly maintained water, electricand gas appliances has an effect on physical growth and development,reduced immunity to infections and mental health and wellbeing.

Affects all age groups but greatest effects on older people, thosewith disabilities and children.

Construction work that causes vibrationand subsidence in existing homes.

Poor maintenance of social housing.

Homes where large families live inovercrowded conditions.

Ensuring housing meets decent homesstandards especially social housing.

Building more cheap and affordable homes.

Improving the access to housingmaintenance services.

Education Access to education improves the life chances and opportunities ofpeople in terms of access to employment, uptake of health promotionand disease prevention information and being able to articulate need andhence access services more effectively.

Affects all age groups but greatest effects on children and youngpeople.

Direct changes to an education ortraining programme e.g. closure of aschool and move to a new one.

Disruption to access to an education ortraining facility or disruption of theirability to deliver e.g. construction.

Ensure that existing education and trainingopportunities are not reduced or affected.

Increase educational opportunities.

Impact Effects on health and wellbeing Pathway of impact If the impacts are negativeWhat possible mitigationmeasure(s) would reduce thenegative effects?

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Transport Can lead to traffic which leads to poorer outdoor air quality which inturn leads to respiratory problems.

Affects all age groups but greatest effects on those with pre-existing chronic illnesses and children.

Can lead to improved access to services and amenities e.g. health andsocial care, parks, leisure centres, etc. which leads to increased healthand wellbeing. Increased opportunities for business expansion leading tomore employment opportunities.

Affects all age groups but greatest effects on older people, thosewith disabilities and those with very young children.

New roads, greater flows of trafficbecause of new or denser housingdevelopments, greater flows of heavytraffic because of new or expandedbusiness/ industrial facilities.

Reduce the outdoor air pollution caused bymotor vehicles and industrial factories.

Ensure that residential and outdoor playareas are not built near roads with heavymotor traffic.

Increase public transport provisionwherever possible.

Crime and safety Fear of crime causes stress which reduces immunity to disease andmental wellbeing.

Actual experience of crime causes stress and physical injury whichreduces physical and mental health and wellbeing.

Affects all age groups but fear of crime greatest among women.

Construction and changes in a localitycan bring in new people and new

routines in a community which canmake crime easier to commit and lesseasy to notice.

Buildings that do not have naturalsurveillance from neighbours can createisolated areas where crime can occurwithout being noticed.

Use designing out crime building designprinciples.

Improve local peoples relationships withthe Police. Build neighbourhood communitynetworks e.g. neighbour-hood watch.Ensure schools, youth facilities and othersare brought together to develop acollaborative strategy.

Access to health and social careservices

Reduced access to health services leads to ill-health becoming worse,less amenable to treatment and more likely to lead to a permanentphysical or mental impairment. Reduced access to social care servicesleads to stable chronic conditions becoming worse and the loss ofindependent living skills which in turn lead to greater physical andmental impairment.

Disruption to or reduction of publictransport buses, tube trains, trams,cycle routes, pedestrian paths, etc.

Closure of local facilities or disruptionduring a move to a new facility.

Appropriate planning and communicationabout disruption to access.

Ensuring alternatives are developed.

Social cohesion and capital Disruption and reduction in the quality of the social relationships andsocial networks that local people and communities have can lead tofeeling isolated and excluded which in turn can lead to depression andpoor mental wellbeing. It can also make individual more vulnerable tocrime and to reduce their access to health and social care services.

An proposal that is disliked and notwanted by the community.

An proposal that benefits some peopleat the expense of others.

Ensuring that there is acceptance of anproposal by local people and affectedgroups. Ensuring that everyone benefitsand those that dont are compensated.

Environment Dirty and poor quality built environments as well as little or poor qualitygreen space have a negative effect on mental wellbeing.

Reduction in street cleaning amenitiesand park officers, etc.

Ensuring that green space islooked after and managed.

Health appraisal detailed adapted from the East London and Merseyside HIA models

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Themes

What are the potentialeffects on ..?

Will thechange be

+/-for

peopleshealth?

What stakeholder/sare likely to be

affected?

When is the impactlikely to occur

(start, during or end ofthe proposal)

EVIDENCE OF IMPACT

- TYPE

(reports, reviews,surveys, experiences)

EVIDENCE OF IMPACT

- SOURCE

(agency, institution,expert, community)

Mitigations

(how can the negativeimpacts be reduced)

Enhancements

infectious diseasese.g. TB, measles, foodpoisoning, salmonella, BSE,SARS

non-infectious/ chronicdiseasese.g. heart disease, cancer,

accidents & physicalinjuries

mental health &

wellbeing

Health appraisal detailed contd

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Themes


Will thechange be

+/-for

peopleshealth?


affected?



EVIDENCE OF IMPACT

- TYPE


EVIDENCE OF IMPACT

- SOURCE


Mitigations


Enhancements

housing &accommodation

education & learning

employment & economy

transport & connections


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Themes


Will thechange be

+/-for

peopleshealth?


affected?



EVIDENCE OF IMPACT

- TYPE


EVIDENCE OF IMPACT

- SOURCE


Mitigations


Enhancements

crime & safety

social capital &community cohesion

health & social careservices

retail shops and other

amenities


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Themes


Will thechange be

+/-for

peopleshealth?


affected?



EVIDENCE OF IMPACT

- TYPE


EVIDENCE OF IMPACT

- SOURCE


Mitigations


Enhancements

culture & leisure

lifestyle & daily routines

energy & waste

land & spatial

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Blank Page for Notes

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Evaluating the evidence

Assess how strong the evidence of positive or negative health impacts is likely to be byanswering as honestly as you can the following questions.

Answers showingthe evidence is

more likely to be ofgood quality

To your knowledge

Answers showingthe evidence is lesslikely to be of goodquality

Research

Yes Does the evidence for each impact come from more thanone source?

No

Yes Is the evidence for each impact of more than one type (i.e.both quantitative and qualitative and/or a range ofquantitative and qualitative studies/reports)?

No

Yes Has some or all the evidence for each impact been reviewedby other research experts (peer-reviewed and/or published)

No

No Is the evidence for each clear and consistent or are thereareas of ambiguity and differences of emphasis in thedifferent types and sources of evidence?

Yes

Front-line experts and professionalsYes Is there broad consensus among front-line experienced

experts and professionals that the impacts can/do occur inthese kinds of proposals?

No

Yes Is there broad consensus among experienced front-lineexperts and professionals that the evidence for each impactis sound?

No

Lay publics

Yes Is there broad consensus among resident and communitieswho have experienced the impacts (lay experts) that theseimpacts can/do occur in these kinds of proposals?

No

Yes Is there broad consensus among the public (non-experts)that the evidence for each impact is sound?

No

Assessors/Evaluators

Yes Do the assessors/evaluators of the evidence of impact have

experience and expertise in reviewing health and socialcare evidence?

No

Social Context

No Is there current heightened public concern and/ or local,regional or national political issues surrounding some or allthe impacts?

Yes

More likely = TOTAL Less likely =

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7. What is Consultation?

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7.1 Who to consult?

Write down the key individuals and groups you have consulted in the past.

Stakeholder Why did you want to consult them?

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7.2 How to consult?

Write down the key methods you have used to consult these individuals and groups.

What methods have you used to talk to them?

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8. Developing aConsultation Plan

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Consultation plan

What group/s of people is the proposal aimed at?

What group/s of people does the proposal not target or exclude from benefiting?

What public, voluntary and private sector organisations will the proposal benefit or workwith?

What public, voluntary and private sector organisations will the proposal not benefit orwork with?

What do other influential stakeholders think e.g. journalists, local politicians,professional groups?

What is the overall aims/objectives of the consultation?

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Consultation plan

Stakeholder

Aim of consultation Key issues to be discussed Consultation method/s Potential difficultiesin doing theconsultation

Options

Public

Consultation plan contd

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Stakeholder

Aim of consultation Key issues to be discussed Consultation method/s Potential difficultiesin doing theconsultation

Options

Professionals

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9. ConsultationRole Play Exercise

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Stakeholder Consultation Meeting

The occasion

The scene is a stakeholder consultation meeting to discuss the implications of the proposed

developments/projects.

The stakeholders

The following stakeholders are represented at the meeting

Residents

Media

Private Developer

Local Authority

Health Agency

Existing Businesses

Local Voluntary Group

The issues

Each stakeholder sees things from a range of perspectives, have different priorities and see a lot to gain

and lose. Some issues are described in the prompts below. You may identify other and more interesting

issues that you would like to bring up.

The task

Each stakeholder group has 15 minutes to think through what the key issues are for them before the

meeting starts.

The meeting will be chaired and facilitated by a community development and stakeholder engagement

officer from one of the local district authorities (the trainers).

The agenda

1. Introductions (going round the table with each stakeholder group saying who they are and why

they are here).

2. Each stakeholder then tells the others what their key concerns/ objections are (max 3min)

3. A round table discussion ensues with the group aiming to reach some consensus on the way

forward and how key objections and issues can/ should be dealt with.

4. Five key recommendations on what should be done next are developed by the group as a whole.

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10. Key Conclusions,Mitigations

and Enhancements

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OPERATION OR WORKING PHASE (short & long term)

Question Answer What are the key potential positive

impacts?

- short term

- long term

What are the key potential negativeimpacts?

- short term

- long term

What groups are likely to be affectedpositively?

How?

Will this widen existing health inequalities?

What groups are likely to be affectednegatively?

How?


How strong is the evidence for the positiveeffects?

Do the affected communities agree?

How strong is the evidence for the negativeeffects?


Key conclusions contd

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END OF PROPOSAL PHASE

Question Answer

What are the key potential positiveimpacts?

What are the key potential negativeimpacts?

What groups are likely to be affectedpositively?

How?


What groups are likely to be affectednegatively?

How?


How strong is the evidence for the positiveeffects?


How strong is the evidence for the negativeeffects?


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Mitigation and enhancement

Question Answer What are the key options to reduce

(mitigate) the potential negative impactsfor each stage:

implementation/ construction phase

operation/ working phase (short & long term)

end of proposal phase

What are the key options to increase(enhance) the positive impacts?

implementation/ construction phase

operation/ working phase (short & long term)

end of proposal phase

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11. What is Monitoringand Evaluation?

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11.1 Outputs

What health and wellbeing (or other) outputs are you currently measuring in your work ?

Area Output Why?

Diseases

Crime

Employment

Education

Transport

Housing

Health & social careservices

Social capital

Culture & leisure

Quality of life

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11.2 Outcomes

What health and wellbeing (or other) outcomes are you currently measuring in your work?

Area Outcome Why?

Diseases

Crime

Employment

Education

Transport

Housing

Health & social careservices

Social capital

Culture & leisure

Quality of life

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Monitoring and evaluation

Question Answer What monitoring processes will you put in

place to ensure that negative healtheffects are reduced?

What indicators will you use?

What monitoring processes will you put inplace to ensure that positive health effects

are enhanced?

What indicators will you use?

How will you evaluate the proposal interms of health outputs and health

outcomes?

- process evaluation

- impact evaluation

- outcome evaluation

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Process evaluation

Did the proposal have explicit values to guide its design and implementation and what were they?

To what extent did the proposal work to these values?

If the proposal did not have explicit values what values should have been used to guide the design andimplementation and to what extent did the proposal work to these values?

Impact evaluation

What were the objectives of the proposal in the short term?

To what extent did it achieve those objectives? What enhanced and what hindered the achievement ofthose objectives?

Were these the right objectives for the proposal?

Outcome evaluation

What were the objectives of the proposal in the long term?

To what extent did it achieve those objectives? What enhanced and what hindered the achievement ofthose objectives?

Were these the right objectives for the proposal?

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12. What can we do?What should we do?

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Upstreamers versus Downstreamers

Once upon a time in a land far, far away.Villagers living in a village on the banks of a river

began to find drowning people being washed away by the riverand calling out for help.

1. As a villager what 3 things would you do in the short term?

Short term options

1

2

3

Questions

1. Why did you choose the options that you did?

2. Did you use any criteria if so what were they?

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2. What 3 things would you or could you do in the long term?

Long term options

1

2

3

Questions

3. Why did you choose the options that you did?

4. Did you use any criteria if so what were they?

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Recommendations

Question Answer What key recommendations emerge from

your assessment?

Should the proposal go ahead?

How should the proposal be taken forward so thatit is provides the greatest health benefits?

Which mitigation and enhancement options will

local people and/or other key stakeholders findmost acceptable?

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13. To Do of Not to DoThat is the Question?

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On the horns of an ethical dilemma or two!

The following are amalgamations of real life situations faced by HIA practitioners duringthe course of planning, implementing and writing up a HIA.

Case

1 You are asked to undertake a rapid HIA which the client a local authority -wants to keep confidential for their use only on an issue of local communityconcern. However as part of the HIA you have talked to many local residents whowill be affected by the proposal and who have expressed a strong desire to read

the report.

2 You are asked to undertake a HIA to help in a planning inquiry - involving legalrepresentation - to present a case that one development option is better thananother for a private sector developer. The client wishes to present the bestcase possible for the positive health benefits of their case.

3 You are doing an HIA on a new proposed proposal and are asked to identify onlythe positives to help support the business case for the proposal to be funded by anational government department.

4 You are asked to undertake a HIA on the siting of a mobile phone transmittermast on a run-down council estate. This has upset and angered many localresidents especially those with children who are opposed to the siting. Theincome from the mast siting will be used to refurbish the estate.

5 You have presented your HIA statement/report and while some aspects of therecommendations have been actioned many of the key issues have not beentaken forward or even discussed. You are keen to help to move forward theprogramme but other organisational priorities and the uncertainty around whenand if the proposal will go ahead has made the HIA less pertinent and relevant tothe organisation.

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Whats the key ethical dilemma isinvolved here?

How would you resolve this andwhat would the likelyconsequences of your decision be?

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HIA evaluation

Question Answer What was the proposal that was assessed?

What type of HIA did you undertake?

What HIA model/method did you use?

Why?

What were the costs (financial, human, time)involved and could these have been better spent

elsewhere?

Did you use a wide range of evidence sources tomake the assessment and did they inform the HIAs

recommendations?

Were health inequalities assessed and if so howwere they assessed?

How were recommendations formulated andprioritised?

What factors influenced this decision-makingprocess?

Were decision-makers involved and engaged in theprocess and if so how was this done?

What were their expectations and were theyfulfilled?

Were the recommendations delivered in a form andwithin a timescale that was relevant and

appropriate to decision makers?

What did the steering group, consultees and othersinvolved in the HIA think about the HIA process and

themethod used?

HIA evaluation contd

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Question Answer Were all or some of the recommendations accepted

and implemented by the decision makers?

What factors contributed to theiracceptance or rejection?

Were the aim and objectivesof the HIA met?

What other impacts were associated with the HIA?

- improved partnership working,

- raising the profile of local health needs andputting health on partner agencies agendas,

- organisational development

- new ways of working within and across theorganisations involved

(Adapted from the Health Development Agency Learning from Practice Bulletin Evaluating Health Impact Assessmentby Taylor, L., Gowman, N., Quigley, R. 2003.)

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Documents

IOM CHIA HIA Training Course Workbook (2008)