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Improving health
Previously NHS Health Scotland

What is an HIIA

Health Inequalities Impact Assessment (HIIA) is a tool to assess the impact on people of applying a proposed, new or revised policy or practice. HIIA goes beyond the public sector's legal duty of the Equality Act 2010 to assess impact (EQIA) by assessing the impact on

  • health inequalities
  • people with protected characteristics
  • human rights
  • socioeconomic circumstances.

In April 2018 legislation came into force called the Fairer Scotland Duty. It asks public bodies to 'pay due regard' to how they can reduce inequalities of outcome caused by socioeconomic disadvantage.

The Scottish Government guidance is still in the interim stage of a three year implementation period. However, we believe the HIIA considers potential financial and social impacts to meet this 'due regard.'

The HIIA prompts thinking about potential differential impacts based on income, employment, social and cultural status.

Why conduct an HIIA?

Many policies, plans, proposals or decisions have the potential to impact on health and potentially widen health inequalities. By conducting an HIIA the potential impacts can be considered and action taken to reduce those impacts.

Impact assessments help to

  • ensure we are not discriminating
  • widen access to opportunities
  • promote the interests of people with protected characteristics.

Do I need to conduct an HIIA?

Public bodies in Scotland have a legal responsibility to assess the impact of their policies and publish their findings.

You only need a full HIIA if your policy or practice change will have a potential impact on people, but you do not fully understand the impacts or know how to manage them. To find out if you need to do a full HIIA a desk based screening can be done, in collaboration with your project team.

To do this, you can work through the list of vulnerable groups and protected characteristics in the Workbook summary considering who your policy or practice change might impact.

If no potential impacts are identified during your screening process you can publish your HIIA screening as an HIIA, there is no need to do a full HIIA.

You can publish your HIIA screening as an HIIA, if during screening you:

  • identify that your work will have potential impacts
  • are confident you have identified all such impacts
  • understand how to manage them effectively.

If potential impacts are identified but you do not fully understand them or know how to manage them effectively, then you should conduct a full HIIA to explore them further with a range of stakeholders. This can be done by conducting a HIIA workshop. The workshop can also be used to generate ideas (as an action plan) to mitigate these potential impacts.

When to conduct an HIIA?

The HIIA should be conducted when the policy or plan is still in draft. It should be well enough developed that you can understand the potential impacts, but not so far developed that you can’t make changes to it as a result of the assessment.

Further support

Our Learning and Improvement team are available to discuss any part of the process and share examples of practice. They can also provide copies of any of our HIIA reports.