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Integrated Impact Assessment

Policy makers have a growing number of impact assessments to carry out as part of policy making and planning. These include economic assessment, environmental impact assessment, sustainability appraisal, equality impact assessment, assessment of effect on families, assessment of effect on law and order and many more. There is a clear need to reconcile and combine these various assessment processes to reduce the burden on policy makers and make any trade-offs between different development areas explicit. This has led to growing interest in integrated assessments, or at least integrated assessment screening, which include environment, health, equality, economic and other impacts as appropriate. Including health within integrated assessment can ensure it is considered as part of a wider framework and reduce duplication of assessment.

An integrated screening approach has been adopted successfully in NHS Lothian, which is using the Rapid Impact Assessment (RIA) Checklist to screen for impacts on both health and equality & diversity. It is Lothian NHS Board policy for all new strategies and policies to undergo RIA. If significant issues are identified, a more detailed assessment is carried out, the nature of which depends on the impacts identified.

Some Scottish local authorities have adopted a similar approach incorporating health, equalities and environmental impacts. Examples include Fife and West Dunbartonshire. Community Planning Partnerships are an ideal forum to develop these approaches.

Equally Well (external link) the report of the Scottish Ministerial Task Force on Health Inequalities, recommends the further development of Integrated Impact Assessment in which impact on health inequalities should be a clear component. Further guidance is expected, and the network will contribute to this.

Strategic Environmental Assessment (SEA) and HIA

Strategic Environmental Assessment (SEA) is environmental impact assessment as applied to strategies, plans and programmes rather than projects. SEA aims to ensure that significant environmental effects are identified, assessed, mitigated, communicated to decision-makers, monitored and that opportunities for public involvement are provided. The EU directive on SEA EU directive on SEA was introduced in July 2004 and includes a list of project proposals that must be subject to an SEA. In Scotland the scope of SEA was expanded to cover all public sector strategies, policies, plans and proposals in the Environmental Assessment (Scotland) Act 2005, which came into force in February 2006. Development of SEA in Scotland is led by the SEA Gateway (external link).

Under the European legislation, SEA requires explicit consideration of significant impacts on 'human health'. Involving health specialists in SEA can help to ensure health impacts are identified and considered. Another option is to do an HIA in parallel so its findings can be incorporated in the SEA. The SEA process and format of the reports are laid down in the legislation and associated guidance. This does not currently mandate consideration of differential impacts, which can be a barrier to consideration of health inequalities in SEA.

The network produced a briefing paper on integrating HIA into SEA in 2005 and is currently conducting a review of how health has been considered in a sample of recent SEA reports.

Mental Wellbeing

The network is currently undertaking a comparison of the Mental Wellbeing Impact Assessment Toolkit (external link) to be added with the Rapid Impact Assessment Checklist used in Lothian. We hope this will allow us to combine these to ensure mental wellbeing is addressed in HIA without requiring two separate assessment processes for each proposal.