Jennifer Hall Susan Forbes

Public Health Lead Health Improvement OfficerAberdeenshire CHP (Strategy)

Developing an Integrated Impact Assessment Screening Tool for use in Aberdeenshire Council – the challenges & successes

Map of Aberdeenshire

© The Gazetteer for Scotland, 2009Used with permission from The Gazetteer for Scotland at http://www.geo.ed.ac.uk/scotgaz

– Tool that encourages planners to think broadly about the effects of a policy, plan or strategy including unintended effects

– Examines impact of a PPS on a wide range of topics including environment, health, equalities and socioeconomic factors all at the one time

– Identify changes to maximise the positive impacts and minimise the negative impacts

– Identify those PPS that need further more detailed assessments

What is Integrated Impact Assessment (IIA) Screening?

Why do we need IIA?

• Use of IIA ensures against unintended outcomes of policies, strategies or plans.

• Covers legislative requirements for equalities, environment incl. socioeconomic assessments.

• Provides transparency and accountability to communities; serves as an evidence base that the council has considered all possibilities.

• Ensures that policies are as “health improving” as possible and not acting to increase inequalities in health

Take an upstream approach to improving outcomes •IIA screening ensures that the PPS is checked against a range of issues that can have a detrimental effect on communities at an early opportunity

Added benefits ?

• Spin off learning for those involved – policy makers (snowball effect)

• Encourages partnership working as it may require consultation with groups of interest

• Improves the quality and coherence of policy design

• IIA ensures that our council policies are assessed against impacts on health and socioeconomic issues (wider determinants)

• Offers consistency in policy design and decision making

www.aberdeenshire.gov.uk

What is the story ..... our challenge ?

• Development of 2nd Aberdeenshire JHIP • Data analysis using Com H&WB Profiles (2004) & SIMD income deprivation

domain• Overall health outcomes very good for Abshire but…. demonstrated small

pockets of deprivation & income deprivation throughout

• Senior Management Team of Council listening ..

The Story ….. 2006-7

Life expectancy - males

Life expectancy - females

Proportion of 15 year-old boys surviving to 65

Proportion of 15 year-old girls surviving to 65

Deaths

Teenage pregnancies (3 year total)Low birthweight babies (3 year total)Adults unable to work due to illness/disability

Long term limiting illness

Self-assessed health (classified as "not good")Alcohol related/attributable hospital admissions

Estimated smokers

Smoking attributable deaths

Smoking during pregnancy (3 year total)Immunisation uptake (excluding MMR)

MMR immunisation uptake

Drugs related deaths (5 year total)

AB54 7AB45 3 AB53 4 AB53 5 AB53 6AB43 9 AB44 1 AB45 1 AB45 2AB42 0 AB43 6 AB43 7 AB43 8AB42 1 AB42 2 AB42 3 AB42 4 AB42 5

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Communities/ Indicators

Traffic Lights - from Community H&WB Profiles (2004) (produced by NHS Grampian)

http://www.hi-netgrampian.org/hinet/5407.html

Figure 9 Annual hospital admissions for alcohol misuse (source: www.sns.gov.uk)

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2001/04

- Agreement by SMT to develop & pilot an IIA - IIA screening tool and guidelines developed - Incorporated the statutory Multi Equality Impact Assessment

(MEIA) and Strategic Environment Assessment (SEA) together with health and socio-economic assessments

- Initial Pilot on 3 policies (with policy officers):- Additional Support Needs (Education Learning & Leisure),- Homelessness Strategy (Housing & Social Work)- Community Engagement Strategy (Chief Executive Service)

Progress in Aberdeenshire Council (07-09)

Equally Well Healthy public policy as a key element to reducing health inequalities

Recommendation 77 –

“IIA processes for public policies and programmes should be developed ……”

http://www.scotland.gov.uk/Resource/Doc/229649/0062206.pdf

Progress in Aberdeenshire Council (09-11)

• Initial Pilot - Overall positive response!• Issues – capacity and resource for staff to use this

screening tool• Report (Nov ’09) – progress endorsed & agreement to

an extended pilot (2 policies / officers from each service) with a view to incorporate IIA into policy procedures & include training

• 14 PPS screened & 37 officers trained• Report (May ‘11) – Council agreement to use IIA as part

of formal policy development procedure!

And now ... More challenges?

• Equality Act (2010) requirements included• Changes in Council personnel• Agreement by SMT but ongoing concerns re implementation in current climate

• Holding the principle of IIA• Simplify and roll out with training

• Review of policy for Additional Support Needs for Learning by ELL

• More Choices More Chances Strategy

• Fuel Poverty Outcome statement

• Climate change action plan

• Burial Service Strategy

Some examples -

Dr Jennifer Hall

PH Lead

Aberdeenshire CHP

Inverurie Hospital

01467 – 672844

jennifer.hall@nhs.net

Contact details -: