ADD2082 Impact Assessment - London's Health Inequalities Strtaegy

Type of decision: 
Assistant Director's decision
Date signed: 
27 February 2017
Decision by: 
Amanda Coyle, Assistant Director, Health and Communities

Executive summary

The Mayor has a statutory duty to develop a Health inequalities Strategy. As part of this, the GLA Act 2007, the Mayor is required to conduct an Integrated Impact Assessment.
Approval is sought to procure a consultant to undertake an Integrated Impact Assessment (IIA) to support the development of the Health Inequalities Strategy. This will increase the £15,000 budget initially approved in ADD 2060 by £10,000 in order to reflect a broader scope and attract a wider pool of bidders.


That the Assistant Director of Health and Communities approves expenditure of £25,000, which is an additional £10,000 on the original ADD2060 approved, for the procurement of consultants to develop and deliver the integrated Impact Assessment of the Mayor of London’s Health Inequalities Strategy.

Part 1: Non-confidential facts and advice

Introduction and background

1.1 The GLA Act 2007 requires the Mayor of London to produce a Health Inequalities Strategy. The Mayor has indicated that he would like the new London health inequalities strategy to be produced as soon as possible. The London Health Board has agreed to share responsibility for oversight of the strategy’s governance. The Mayor and the London Health Board support the priorities outlined in section 1.2 below.

1.2 The Mayor’s overarching vision is for a healthier, fairer city for all Londoners, where nobody’s health suffers because of who they are or where they live. The proposed sections for the strategy are as follows:

•    Use City Hall’s reach to address inequalities in the social and environmental causes of ill-health - This part of the strategy will explicitly identify how City Hall’s existing work and direct policy levers are addressing the underlying drivers of health inequalities through a “health equity in all policies” approach.
•    2. Empowering Londoners to build healthy communities - This part of the strategy will focus on London’s vulnerable communities, neighbourhoods, clustering of unhealthy behaviours and social prescribing and will include HIV and TB.
•    3. Targeting shared specific priorities- The Health Inequalities Strategy Steering Group has recommended prioritising three topics:  
Priority 1: Give all London’s children a healthy, happy start to life - This is directly aligned with the first Better Health for London ambition. Areas for action will focus specifically on reducing inequalities as well as on improving public health.  
Priority 2: Reduce inequalities in mental health - This aspect of the strategy is being developed within the London Health Board’s Thrive programme and is aligned with the Better Health for London ambition to ensure the most mentally ill people lead longer lives.  
Priority 3: Enable all Londoners to have a healthy lifestyle - This is directly aligned with the Better Health for London ambitions to get London fitter, make work a healthy place to be, and help Londoners kick unhealthy habits.

The HIS is in development for 2017-21, with a planned publication date of October 2017. 

1.3 The Mayor is required to undertake Integrated Impact Assessments with legal duties to consider the following if likely to be relevant to the scope of impacts of the strategy in question:
•    Sustainability -Planning and Compulsory Purchase Act and Greater London Authority (GLA) Act 1999
•    Health - GLA Act 1999
•    Equalities - GLA Act 1999
•    Community Safety -Section 17 of the Crime and Disorder Act (as amended by the Police and Criminal Justice Act 2006) and GLA Act 2007
•    Environment -Environmental Assessment of Plans and Programmes (2004) 
•    Biodiversity -Appropriate Assessment (Habitats Regs applied to strategies Aug 2007)
•    The Natural Environment and Rural Communities (NERC) Act – Section 40 (The Biodiversity Duty)
•    Climate Change - GLA Act 2007
•    Health inequalities - GLA Act 2007

1.4 The Health Inequalities Strategy IIA process will consist of:
•    Screening – determining the type of IIA required
•    Scoping – establishing the scope, framework and evidence base
•    Considering alternative policy options as part of policy development
•    Publishing an IIA report (alongside draft strategies)
•    Conducting consultation on the IIA report (alongside draft strategies), followed by a post adoption statement if necessary
•    Monitoring (alongside strategy implementation) 

1.5 The project team has consulted TfL legal and has been advised that unlike many of the other strategies, the Health Inequalities Strategy is not required to include a Strategic Environmental Assessment or Sustainability Appraisal . There is no requirement for a scoping document to be published or sent for external consultation; however an internal scope will be produced by GLA officers. 

Policies which are led by GLA policy teams other than the health team are outside the scope of the Health Inequalities Strategy IIA, since these policies will be assessed as part of the IIAs for other statutory strategies. However, the Health Inequalities Strategy IIA will signpost and cross-reference these other impact assessments as appropriate. 

1.6 Approval is sought to appoint independent specialist consultants to undertake the IIA for the London Health Inequalities Strategy. The original budget stated in ADD 2060 was for £15,000. This is to be increased to £25,000 as the original tender process failed to secure the services of a consultant from the TfL framework. This higher sum reflects a new scope. The budget for the IIA will be met from the Statutory Strategies budget in the Governance Directorate.

Objectives and expected outcomes

2.1 We intend to procure a consultant to undertake the London Health Inequalities Strategy IIA development and assessment and produce the IIA report and statement. 

2.2 Objective: the consultant will be expected to:
•    Facilitate an internal IIA group which will have oversight of the process and will sign off the IIA.
•    Assess the scoping document and assessment framework, devised by the IIA group, for use in testing the strategy against the IIA objectives.
•    Write the IIA drafts and final version, supplying an appraisal of the potential positive and negative impacts of the Health Inequalities Strategy by assessing the policies against the set of objectives and prompt questions. 

2.3 Outcome: We expect the consultants to produce a written review of the policy appraisal that will confirm a preferred approach and ensure that the strategy meets the IIA objectives.

Equality comments

3.1 The Integrated Impact Assessment includes an Equalities Impact Assessment which will evaluate the likely potential impacts, both positive and negative, of the Health Inequalities Strategy on those with protected characteristics (age, disability, gender, gender reassignment, pregnancy and maternity, race,  religion or belief, sexual orientation).

3.2 We strive to comply with GLA responsible procurement policy which includes a commitment to encouraging equality and diversity.

Other considerations

4.1 The public consultation on the draft Health Inequalities Strategy and draft IIA could lead to amendments to the strategy. If the amendments are extensive, this could require undertaking an additional project of up to a month’s duration. .

b) links to Mayoral strategies and priorities

4.2 The IIA is a requirement for the preparation of the Health Inequalities Strategy.

4.3 An internal GLA steering group was set up with the purpose of developing a framework which is to be applied to the IIAs for each strategy. The framework includes a common set of IIA objectives to be used for the assessment stage of the IIAs for each strategy. The guide questions which sit underneath each of the IIA objectives will be relevant and specific for the individual strategies. The Mayor’s Transport Strategy (MTS) has already been tested against the IIA objectives and the outcomes of this testing is being used to inform the process for the other strategies. The Scoping Report for the IIA for the London Plan will form the basis of the Scoping Report for the Health Inequalities Strategy. A group of topic experts will form an IIA group to oversee the IIA process.

Financial comments

5.1    Approval is being sought for expenditure of up to £25,000. ADD2060 previously approved expenditure of £15,000 which is yet to be utilised. This will be redirected to part fund this expenditure and the balance of £10,000 will be funded from the Governance Team’s Statutory Strategies budget for 2016-17.

Planned delivery approach and next steps



Procurement of contract [for externally delivered projects]

February 2017

Announcement [if applicable]


Delivery Start Date [for project proposals]

Early March 2017

Main milestone -  Assess existing evidence and conduct policy appraisal

Early March 2017

Main milestones - Draft IIA

Mid - end March 2017

Final evaluation start and finish (self/external) [delete as applicable]:

Early April 2017

Delivery End Date [for project proposals]

Early April 2017

Project Closure: [for project proposals]

April 2017

Appendices and supporting papers

IIA Project Specificatio

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