Development of a quality assurance review framework for health impact assessments

Figures & data

Table 1. Aims of the QA* review framework and the associated international and local context.

Provide a common framework and understanding of what a high-quality HIA looks like. Ensure that the evidence used to inform decisions that affect health and well-being is robust and inclusive. Ensure that people have opportunities to participate in decisions that affect their health and well-being via high-quality HIAs. Support decision-making in respect of policies, projects, plans, planning applications or the commissioning and reconfiguration of services. Ensure that health, well-being and inequalities have been considered in a holistic, systematic and robust manner. Provide resources to support international HIA practitioners and commissioners in their work.	Raise the standard of HIAs carried out in Wales so that they are carried out robustly.
	Support Welsh Government and other designated public bodies to meet any requirements of the Public Health (Wales) Act (2017) and the Well-being of Future Generations (Wales) Act (2015).
	Support Wales-wide commissioners, policymakers and practitioners in meeting their responsibilities to a high standard when they are required to undertake or review HIAs by providing a framework to critically appraise them.

* ‘Quality’ is defined as ‘the standard of something as measured against other things of a similar kind; the degree of excellence of something’ and ‘general excellence and standard level’.

‘Quality assurance’ is defined as ‘the maintenance of a desired level of quality in a service or product, especially by means of attention to every stage of the process of delivery or production’. The definitions are taken from the Oxford English Dictionary.

Figure 1. Development protocol for the QA review framework.

Table 2. Overview of sections included in the draft section and the sections included in the final QA review framework following the workshop discussions.

1. Report: Content, structure, accessibility and presentation. 2. Information about the project, policy, plan or proposal. 3. Methodology: Is it an HIA? Has it followed a recognised HIA methodology? 4. Principles and governance: Has it been conducted in a way that meets the principles and ethics of HIA? 5. Evidence: Is the evidence used to identify and assess impacts robust? 6. Appraisal, assessment and the identification of impacts. 7. Conclusions, recommendations and monitoring. 8. Additional criteria for capital and construction development type projects.

1. Information about the project, policy, plan or proposal. 2. Methodology: Is it an HIA? Has it followed a recognised HIA methodology? 3. Evidence: Is the evidence used to identify and assess impacts robust? 4. Appraisal, assessment and the identification of impacts. 5. Recommendations, conclusions and monitoring. 6. Principles and governance: Has it been conducted in a way that meets the principles and ethics of HIA?

Table 3. Key objectives and expected outcomes for individuals when using the QA review framework.

The purpose of the review is to carry out a critical analysis of the HIA in the context that it was undertaken.

Each HIA will be unique to a specific context, proposal and decision-making process.

The criteria are to be used as a tool for the process of critical analysis, review and discussion rather than as a scoring system. However, the grading should make providing feedback easier.

The outcome of the review process should be that the reviewer(s) has a better understanding of the HIA, the quality of both the HIA process and the report, and also how much confidence they can place in the findings.

The reviewer(s) can then form an opinion and provide comprehensive, informed and clear feedback.