PHAST Health Impact Assessment on London Health Commission Recommendations

In September 2013 the London Health Commission (LHC) was established by the Mayor of London.  Lord Darzi – a cancer surgeon at St. Mary’s Hospital – was appointed by Boris Johnson to chair the London Health Commission. Over the past year, Darzi has led a panel of experts and involved 15,000 in developing the plan, called “Better Health for London”.
The LHC has conducted an independent inquiry into the following four themes and it has made recommendations from each:   

• improving quality and integration of care;
• enabling high quality and integrated care delivery;
• healthy lives and reducing health inequalities; and
• the health economy, research and education.

The recommendations include a series of measures, to combat the threats posed by tobacco, alcohol, obesity, lack of exercise and pollution which harm millions. 
The London Health Commission appointed PHAST (Public Health Action Support Team) to conduct an assessment in two stages.  The first stage consisted of a Health Impact Assessment (HIA) of the LHC’s draft recommendations to the Mayor, with an equity focus. PHAST find that the majority of the recommendations will have beneficial effects on health for people affected by the recommendations. The assessment also concludes that the majority of the recommendations will contribute towards reducing inequalities in health.
The majority of the recommendations are weighted towards health care services and related NHS issues in London. Whilst healthcare, and access to healthcare, is of critical importance for addressing disease and infirmity; for protecting health; and for reducing inequalities in health, the HIA team note that, as the strategy is implemented, it will be essential to emphasise the importance of actions on the social determinants of health in order to maximise the reduction in inequalities in health. The recommendations from the London Health Commission will inform the wider review that the Greater London Authority are undertaking of the Health Inequalities Strategy. The PHAST team support this link to the Mayor’s inequalities strategy and to initiatives such as to the London Living Wage.
In many cases the potential impact on inequalities, or on equality groups, is dependent on the way in which the recommendation is implemented. The second stage will include: facilitated discussions of the HIA with policymakers / implementers to discuss how to maximise the positive health and health inequalities impact of each recommendation; and preparation of a reflective report on the LHC process with regard to health impact and health inequalities.

PHAST TEAM _ Dr Cecilia Pyper, Professor Sue Atkinson, Ben Cave, Ryngan Pyper, Beandri Botha, Dr Torquil Pyper, Jenny Sawyer and Tasmin Harrison