Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise because of it. In 2018, the HIA support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. It followed a five-step process for HIA and utilised a wide range of evidence sources and health intelligence including both quantitative and qualitative evidence. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers. It does not concentrate on the findings of the HIA in detail, but focusses on what worked and any challenges encountered. It has been used to progress the practice of HIA in Wales and demonstrates the value of HIA as a method to inform and influence complex decisions.

The use of health impact assessments (HIAs) has rapidly increased over the last two decades and has been undertaken to evaluate the health implications of many new projects across the globe. In July 2017, Wales became the first country to legislate for broad approach HIAs, i.e. it considers not only environmental health effects but the social determinants of health, wellbeing and inequalities. Although the introduction of statutory HIA will ensure the use of HIAs, experts have expressed concerns that legislative measures could lead to poor-quality HIAs and associated reports. This paper outlines the development process and analytical reflections of a quality assurance (QA) review framework for HIAs. The framework has been developed over a 2-year period which allowed the collective intellectual capital behind it to evolve in response to practice-based learning. A standardised form of QA for all types and levels of HIA will provide greater clarity regarding the required criteria for conducting and completing an HIA and ensuring this takes place in a robust, interdisciplinary and intersectoral manner. Therefore, this QA review framework should fit into existing HIA practice and complement other tools such as best practice guidance to sustain the global reputation of HIA.

The physical health inequalities experienced by people with severe mental health problems are now well recognised. Lifestyle factors, in particular high rates of smoking, have been identified as a major contributor to the raised mortality and morbidity in this population. A programme was developed in West Surrey to address smoking cessation support needs in people with mental health problems. Mental health workers were trained to deliver stop smoking support and a pilot programme of oneto-one stop smoking support was established. An evaluation was conducted using semi-structured interviews to explore clients' experiences of receiving the one-to-one suppor t. Service users positively evaluated the support they had received: in particular, the needs-led, flexible approach.The study provides further insights into the views and experiences of people with mental health problems undertaking a smoking cessation programme.

No abstract

No abstract