1. Health Inequalities Impact Assessment (HIIA) Pauline Craig Head of Equality NHS Health Scotland What works for HIIA?

2. What is HIIA? An integrated approach to impact assessment based on an equalities and human rights framework to tackling health inequalities. Encourages consideration of the intersections of different characteristics and potential impacts on individuals, communities and human rights. The tool was developed following a recommendation in Equally Well (2008) and was piloted in 2010 with NHS Boards and the Scottish Government. Been in use since 2011: www.healthscotland.com/equalities/hiia/inpractice.aspx www.healthscotland.com/equalities/hiia/inpractice.aspx

3. Examples of recommendations implemented Distinction between HIIAs reviewing hospital builds/relocating services and those HIIAs carried out for health improvement programmes and national strategies. Hospital builds and relocating services Changed timings of sexual health clinics and developed a range of easy read materials to enable access to LGBT communities. Review of signage resulted in ‘you are here’ maps being located throughout the hospital.

4. Health improvement programmes/national strategies Local health and social care partnerships required to carry out impact assessments of local strategic plans. There are now designated workers promoting breast screening services to homeless people in local health boards.

5. Aids and challenges AidsChallenges Senior leadership buy-inSufficient time and commitment from participants to take actions forward Resources available to take actions forward (including staff capacity and budget) Limited resources (although this can be addressed if the right people are involved from the beginning) Effective communicationLimited co-ordinated communication Considering relevant evidence - enabling evidence informed actions and planning in future. Limited availability and use of data/evidence

6. HIIA Experiences ‘The HIIA partly changed the attitudes and understanding of equality issues related to our work, and this changed more positively throughout the year.’ ‘The HIIA process helped us in decision making for the build, and helped to consider ‘health’ of the population groups rather than focusing on justice of equality groups.’ For more information: HIIA: Answers to FAQ (June 2014) www.healthscotland.com/documents/23116.aspx