Case study B - A Health Impact Assessment (HIA) for Planning, for the Stroud Local Plan

“The Health Impact Assessment (HIA) framework was piloted with Stroud District Council in supporting the development of its local plan. This tool was chosen because it brings a focus on health and health inequalities to decisions and projects that are not directly health related but have potential health impacts.”

The Public Health team worked mainly with planners in Stroud District Council.

“In Gloucestershire, Public Health have worked with local planning authorities to devise a framework for completing health impact assessments (HIAs) that can be adapted for use in a range of different ways and at different stages in the planning process. The framework is intended to support the creation of healthy communities through health-promoting planning policies and development management in Gloucestershire.

The framework is a ‘live’ resource that will be continuously reviewed and updated. A range of downloadable resources, to use when undertaking a HIA, complement the framework. The framework includes an introduction and guide to HIAs and their context, a screening toolkit, a rapid HIA toolkit, a comprehensive HIA toolkit and guidance. The guidance brings together a summary of available evidence on how different aspects of planning impact on health and links to further information.

In 2019, Public Health worked with the Stroud District Council planners to apply the methodology of HIAs to help inform the potential health benefits and impacts of future developments in the district. This involved a screening exercise on the draft plan in order to prioritise key areas for further discussion and then a workshop with planners to look in depth at areas of the plan that could be enhanced or amended to reduce the impact of health inequalities.”

“In Gloucestershire, Public Health have worked with local planning authorities to devise a framework for completing health impact assessments (HIAs) that can be adapted for use in a range of different ways and at different stages in the planning process. The framework is intended to support the creation of healthy communities through health-promoting planning policies and development management in Gloucestershire.

The framework is a ‘live’ resource that will be continuously reviewed and updated. A range of downloadable resources, to use when undertaking a HIA, complement the framework. The framework includes an introduction and guide to HIAs and their context, a screening toolkit, a rapid HIA toolkit, a comprehensive HIA toolkit and guidance. The guidance brings together a summary of available evidence on how different aspects of planning impact on health and links to further information.

In 2019, Public Health worked with the Stroud District Council planners to apply the methodology of HIAs to help inform the potential health benefits and impacts of future developments in the district. This involved a screening exercise on the draft plan in order to prioritise key areas for further discussion and then a workshop with planners to look in depth at areas of the plan that could be enhanced or amended to reduce the impact of health inequalities.”

“One advantage is that the framework is flexible enough to be adapted for local use and the process can be as detailed or as brief as resources allow. The team recognised that each local planning authority will want to address the health and wellbeing impacts of development in a way that is locally appropriate, whilst providing some consistency of approach, evidence and methodology for developers, planners, residents and other stakeholders.”

“On the negative side, a full HIA can be quite resource intensive and will require extensive literature searches, the collection of data, and stakeholder and public engagement and this is most suited to more complex proposals.”

“One advantage is that the framework is flexible enough to be adapted for local use and the process can be as detailed or as brief as resources allow. The team recognised that each local planning authority will want to address the health and wellbeing impacts of development in a way that is locally appropriate, whilst providing some consistency of approach, evidence and methodology for developers, planners, residents and other stakeholders.”

“On the negative side, a full HIA can be quite resource intensive and will require extensive literature searches, the collection of data, and stakeholder and public engagement and this is most suited to more complex proposals.”

“The key learnings from this process were the importance of stakeholder engagement all the way through, the need for the framework to be locally adaptable and as easy as possible to use, with a robust evidence base.”

“The next steps for the project involve liaising with district planners to see if there are other projects to trial it on and how to embed it within planning policy. PHE used the example toolkit for their work on developing HIA tools and are in discussions with colleagues across the South West about expanding them to other local authorities.”

“Piloting the toolkit was a really helpful exercise for both the Public Health team and the local authority planners. The planners learnt more about the health needs of their local population and how some aspects of planning can have quite big impacts on residents health and wellbeing. Public Health colleagues learnt much more about the planning process, the language used in plans and what elements of a plan have the potential to be changed within planning laws.

The language used by different professional groups can sometimes be a barrier to understanding shared goals and it was helpful for us to explore a common narrative.

The draft Local Plan was amended in some parts to reflect our comments and discussions although it is too early to say what impact that will have on developments in the area in the future, there is a growing evidence base around the built environment and green and blue infrastructure that leads us to be hopeful of a positive impact in the future.”

“Piloting the toolkit was a really helpful exercise for both the Public Health team and the local authority planners. The planners learnt more about the health needs of their local population and how some aspects of planning can have quite big impacts on residents health and wellbeing. Public Health colleagues learnt much more about the planning process, the language used in plans and what elements of a plan have the potential to be changed within planning laws.

The language used by different professional groups can sometimes be a barrier to understanding shared goals and it was helpful for us to explore a common narrative.

The draft Local Plan was amended in some parts to reflect our comments and discussions although it is too early to say what impact that will have on developments in the area in the future, there is a growing evidence base around the built environment and green and blue infrastructure that leads us to be hopeful of a positive impact in the future.”

“The learnings from further local pilots and PHE’s work will be used to develop the framework and best practice examples. Then the team hopes to promote the use of the toolkits through engagement with a community of practice, the districts and other interested stakeholders.”

“The screening stage of the pilot took approximately 8 hours of officer time (it’s a big plan). It is reasonable to predict that this would be shortened once the screener was more familiar with the process and the evidence base. The workshop with the planners was a three-hour meeting and then further time was given to writing up the notes and comments and drafting our formal response to the consultation on the plan. So overall, around 2 days.”

“Health Impact assessments provide a systematic approach for assessing the potential impacts of development on the social, psychological and physical health of communities. Ensuring issues are considered at an early stage in developing planning proposals can help to improve both the physical and mental health of the population. Health Impact assessments are designed to consider whether a development proposal might reinforce health inequalities and inadvertently damage people's health, or actually have positive health outcomes for the local community and it is a really useful tool to help you focus on both the good and bad.

I would recommend this tool to others as a way of systematically reviewing impacts of development on health and then using the findings to influence partners, planners and developers. The HIA Framework consists of a Framework overview; a screening toolkit; a rapid HIA toolkit and a comprehensive HIA toolkit. OHID have also developed HIA tools which complement our toolkit.

If we were to do this again, it would be helpful to add relevant colleagues from other parts of the Council to the project team as well as to liaise with regional colleagues in the SW Built Environment Network. It would also be good to have scheduled in the pilot events in advance so that we could test drive and finesse the toolkit fairly rapidly and then start to roll it out more widely.

There is always a tension between the needs of developers and the planning system but introducing a toolkit that is as easy to use as possible means that it is more likely to be used and the impact will be greater.”

For more information, please contact Helen.Flitton@gloucestershire.gov.uk

“Health Impact assessments provide a systematic approach for assessing the potential impacts of development on the social, psychological and physical health of communities. Ensuring issues are considered at an early stage in developing planning proposals can help to improve both the physical and mental health of the population. Health Impact assessments are designed to consider whether a development proposal might reinforce health inequalities and inadvertently damage people's health, or actually have positive health outcomes for the local community and it is a really useful tool to help you focus on both the good and bad.