Ryngan Pyper & Ben Cave

Ben Cave Associates Ltd

ben.cave@bcahealth.co.uk

Introduction to Health Impact Assessment

The scope

The assessment

The draft results

The draft recommendations

Your feedback please

Health Impact Assessment (HIA) is a method of estimating the potential health effects of the 3Ts Programme.

HIA is required by B&H CC and NHS B&H.

HIA seeks to identify both the positive and negative effects on health.

HIA looks at the wider determinants of health for those: who use the hospital, who work at the hospital and who live close to the hospital.

From Hugh Barton and Marcus Grant, University of the West of England

Screening

Scoping

Assessment

Reporting/Feedback

Monitoring/Management

Establish relevance to health

Identify key issues*

Identify potential effects*

Present results

Ongoing action

*opportunities for wider involvement

... considered 44 potential health issues & 36 potentially relevant population groups.

... scoped in 29 health issues & 23 population groups.

identified three themes ... design features of the new buildings;

access arrangements in and around the site; and

disturbance from construction works.

... systematically evaluated each health issue, against each relevant population group.

... identified 16 potentially important positive health outcomes across 17 population groups.

... and 5 potentially important negative health outcomes across 13 population groups.

... sets out recommendations to improve the positive outcomes and reduce the negative outcomes.

Issue Mainly affecting:

Green space Patients and staff

Quality of facilities  Patients, staff and some equity groups

Equal access by all cultures  Patients, staff and some equity groups

Sunlight  Patients and staff

Visual impact  Patients and staff

Pedestrian and cycle routes  Patients and staff

Shift away from car use  Patients

Employment and skills migration  Staff

Access arrangements  Patients and visitors

Issue Mainly affecting:

Signposting  Patients and visitors

Accommodation Visitors

Educational facilities Staff

Commercial health outlets  Patients and residents

Patient social networking  Patients

Physical activity  Staff

Work environment  Staff

Issue Mainly affecting:

Air quality from operational traffic  Residents

Dust exposure from demolition and construction 

Residents

Noise and vibration exposure from demolition and construction 

Patients, staff and residents

Parking  (parking is currently under review) Patients, staff, residents and some equity groups

Travel time  Staff

Action Detail

1.   Maximise opportunities to view and access green spaces 

Green spaces should be: aesthetically pleasing  facilitate gentle to moderate exercise  planted to maximise use use materials which reduce impacts use materials that resist slips/trips

2.   Include design features that are linked to positive health outcomes

Review should report where measures: are included are not included and why can only be assessed once building complete

3.   Make the multi‐faith centre accessible and comfortable to all

Include: multi‐denominational and multi‐cultural consultation report on how consultation inputs addressed

Action Detail

4.   Maximise natural lighting throughout the hospital

Include: where practical views onto green space and the sea report where and why able, or not‐able, to achieve 

natural lighting5.   Create an aesthetically 

pleasing environment Review should report where aesthetic elements: are included are not included and why can only be assessed once building complete

6.   Make access arrangement as easy as possible.

Include: appropriate surfaces, lights and security doors that allow for wheelchairs and large prams a clear staffed reception point at the main entrance appropriate navigational aids for equity groups  screens showing public transport connection times

Action Detail

7.   Support a sustainable modal shift from cars to walking, cycling and public transport

Include: secure bicycle storage close to the hospital building  changing rooms with showers covered/enclosed seating for people waiting for public 

transport connections  bus stops located conveniently  pedestrian crossings matching desire lines

8.   Ensure that there is suitable quality and capacity in public transport services

Public transport should: be accessible for patients, visitors and staff who can 

reasonably use public transport  have connection points as flat and level as possible  be clearly advertised both in appointment letters as 

well as within and outside the hospital 

Action Detail

9.   Actively promote multimodal and active transport options

Promotion should: be started as soon as reasonably possible achieve results before the 3Ts programme completes be a component of a wider transport strategy that 

included addressing parking for staff acknowledge that this a process that will require 

ongoing engagement and take years to fully realise

Action Detail

10.  All reasonable endeavours should be made for air quality to not exceed national standards

Note: relates both to the hospital and surrounding areas where exceedances are unavoidable increases should 

be minimal. air quality should be monitored (EIA to inform)

11.  Demolition and construction dust should be minimised

Note: prolonged dust deposition levels that equate to a 

deposition rate of 200mg/m2/day or greater should be avoided

relevant PM10 and PM2.5 national standards should not be exceeded (see recommendation 10)

children and in particular the children’s hospital are important receptors with increased vulnerability 

dust levels should be monitored (EIA to inform)

Action Detail

12.  Construction noise and vibration should be minimised

Note: rigorously manage excavation and piling activity construction plant/vehicles specifications and 

operation should minimise noise impacts WHO standards should be met unless B&HCC and NHS 

B&H agree that these are impractical considerations should be given to the noise 

requirements of HTM 08‐01 (Department of Health) consider impact on the use of sensitive medical 

equipment (inc. MRI) and operating theatre function  consider the impact on the pupils and staff at the 

Hamilton Lodge School   contractor should establish a community liaison role noise & vibration should be monitored (EIA to inform)

Action Detail

13.  Patient and visitor parking provision needs to be appropriate 

Note: parking provision should be appropriate to a realistic 

and sustainable modal shift away from car use  a significant modal shift needs to be facilitated, 

supported and to a reasonable extend realised before completion of the 3Ts Programme

the site access plan should: maximise opportunities for pedestrian, cycling and public transport use

priority parking for those people who cannot reasonably use alternatives to private car transport 

Action Detail

14.  Parking provision for staff needs to be appropriate   

Note: staff require dedicated parking at a satellite location  shuttle bus should meet reasonable staff needs for: 

frequency, reliability, security, travel time & capacity staff should be formally consulted on such needs  priority parking provision at the RSCH site for staff 

within relevant equity groups physically active transport alternatives encouraged

where it would not reduce work performance

Action Detail

15.  An important opportunity should not be missed  to provide healthy food 

Hospital catering and retailers should provide: healthy food options where reasonable & possible locally sourced foods where reasonable & possible food appropriate to 

different cultures

Consultation is an important part of the HIA process, we welcome your views...

Thank you for your time.