Caron writes about her experiences with institutionalising HIA. In 2000 a regional assembly was created in London, with a directly elected Mayor. The Mayor of London has a statutory duty to exercise its power in a manner calculated “to promote improvements in the health of persons in Greater London”.The Mayor has a statutory duty to develop eight high level strategies for London, including strategies on transport, economic development and spatial development.
He has also undertaken to develop several other strategies including one on children. To ensure that these consider the health of Londoners the LHC and the Mayor agreed to conduct health impact assessments on them at the point when they went to the Assembly for scrutiny. This meant that 9 HIAs have been conducted on the Mayoral strategies. Usually there was no more than eight weeks in which to complete the whole HIA process, from scoping right through to delivering the final report to the Mayor and the Assembly.
The HIAs have been organised by a core team of people. This team has included the co-ordinator of the LHC, a Specialist Registrar in Public Health administrators who is based at the Greater London Authority (GLA), a representative from the London Department of Health & Social Care (DHSC) and the HIA Facilitation Manager for London who is based at the London Health Observatory. Each HIA has had a named Director of Public Health involved in the planning and a public health specialist with a direct interest in the strategy area has been commissioned to do a rapid review of the evidence and has, in most cases been part of the core team.
For several of the HIAs a member of the strategy development team has also been involved in the planning.Each of the HIAs involved the commissioning of the rapid review of the evidence, a stakeholder workshop and the writing of a report combining the evidence from the review and the stakeholder workshop. The workshops have mostly been half-day events and have been good forums for discussions about the likely health impacts related to the strategy. The invite list for each of the workshops has been large (up to 500 people) and has included new health specialists, local authority health community center policy advisors, local authority workers with an interest in the area of the strategy, NGOs and the private sector.
The report produced from the workshops was then passed to the Mayor who instructed the strategy development teams to include the recommendations in the draft of the strategy for publication. The HIAs have helped the Mayor to fulfil his statutory duty and have ensured that the determinants of health are firmly on the agenda of the strategy development teams.The GLA has undertaken a process evaluation of the work showing the positive impact that the HIAs had on the strategies, and this report is available on this website.