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Impacts and Evidence: can integrated impact assessment improve policy making?

Impacts and Evidence: can integrated impact assessment improve policy making?. Margaret Douglas, Susie Palmer, Kay Barton, Alastair Pringle - Scottish Government Cath Denholm - Health Scotland. Equally Well (June 2008). “ Integrated impact assessment processes …. should be developed and

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Impacts and Evidence: can integrated impact assessment improve policy making?

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  1. Impacts and Evidence: can integrated impact assessment improve policy making? Margaret Douglas, Susie Palmer, Kay Barton, Alastair Pringle - Scottish Government Cath Denholm - Health Scotland

  2. Equally Well (June 2008) “Integrated impact assessment processes….should be developed and implemented at national and local levels… Impact on health inequalities should be a clear component… The Government should ensure that there is guidance and support…”

  3. Potential benefits Impact assessment fatigue Similar issues covered in different forms of assessment Simplifies and reduces work Champions for different issues can work together Potential problems Health (or whatever your favourite issue is!) will not receive adequate attention Potential for superficial treatment of issues Involving a wide range of stakeholders could create additional work The case for and against an integrated approach

  4. Health Inequalities Impact Assessment (HIIA) HEALTH & WELLBEING EQUALITY HUMAN RIGHTS

  5. Health Inequalities Impact Assessment ProjectPopulations people living in poverty/ low income transgender homeless people LGB people with different religions / beliefs HEALTH & WELLBEING EQUALITY HUMAN RIGHTS disabled people minority ethnic people carers children /young people women people with long term medical conditions people with low literacy staff older people

  6. Health Inequalities Impact Assessment ProjectImpacts Access to and quality of services Discrimination Equality of opportunity HEALTH & WELLBEING EQUALITY Physical environment HUMAN RIGHTS Tackling harassment Social environment Community capacity building Human rights Communication of information Promoting positive attitudes Promoting good relations Lifestyles

  7. The Process 10 Projects Scoping (Facilitated Workshop) 1 Scoping Report Appraisal (Evidence Gathering) 2 Stakeholder Feedback Final HIIA Report 3 Process evaluation & outcome evaluation

  8. Guidance & Support • Scoping Tool • Guidance Documents • The Process • Issues for Consideration: health & equalities • Issues for Consideration: human rights • Participant Information Sheet – key publications, web resources, help lines etc • Training workshop - ‘Trialling the Tool’ • General support from HIIA Project Team • SHRC involvement & support • Scottish Government support - ASD

  9. Process Evaluation: scoping workshops • Overwhelmingly positive: all said it added value and most said it raised new issues • Stage of policy is important • Mix of stakeholders allows wider perspectives • Participants must be well informed ahead of workshop • Importance of facilitation to challenge/ draw out different views • Structured but informal discussion allowed open discussion of range of issues • Large number of impacts and associated research questions identified for most policies • Some raised issues wider than policy being assessed • All scoping reports included tentative recommendations

  10. Process evaluation: Appraisal stage • Most said increased understanding of health and equality, but not human rights • Concern about assessing human rights issues • Commonly appropriate evidence was lacking • Most struggled to complete in the timescale • Was a pilot so not required for policy development or approval • In many reports recommendations were same as identified at scoping • Most felt appraisal stage added value

  11. Outcomes • Most stated plans to use the findings in policy development or related work • Main benefits stated were: • Involvement of stakeholders allowed broader perspective on issues • Time to reflect on priority impacts • Consideration of wider population groups • Human rights based approach • Better information for policy making • Creative process • Most said confident to do another HIIA

  12. Next Steps • Revise HIIA guidance to address comments • Outcome evaluation (end 2011) • Interest particularly in adopting workshop approach to EQIA • All examples so far in Health Directorates and NHS Boards • Need wider commitment to use as way to address inter-sectoral health determinants

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