Despite Health Impact Assessment (HIA), and its subsequent evaluation, forming a vital part of the planning process, there is a need to address issues of effectiveness. This was an evaluation of an HIA exploring the regenerative impacts of a major health service development in an urban area of the UK. Evaluation was carried out by using published criteria, a process of reflection by the assessors and an email questionnaire to members of the steering group to elicit their views of the HIA. The HIA made a useful contribution to raising awareness amongst the decision-makers of the positive and negative impacts of the proposals and wide-ranging health determinants that could influence these impacts. Whilst the decision-makers said that HIA was helpful, there was some uncertainty over how much influence it had. There is some way to go towards the effective evaluation of HIAs to an extent that they are helpful. The challenges and outcomes of evaluation are described.

Objectives: To conduct a health impact assessment (HIA) of the four 'Towards 2010' programme options under consideration. This is an innovative and visionary programme involving a E750 million capital investment to deliver modern and flexible healthcare services across Sandwell and West Birmingham in the West Midlands, UK. The HIA aimed to inform the Board which of the four options would be most beneficial for the local population.Study design: A prospective mini HIA.Methods: The study involved a desktop exercise using a combination of the Merseyside and West Midlands Directors of Public Health guidelines for conducting HlAs. Ten broad determinants of health including employment and economy, education, transport, housing, visual amenity (environment), access to services, crime, lifestyle, pollution, and family and social cohesion were selected. For each determinant potential positive and negative impacts were identified using readily available local information and professional knowledge.Results: Overall over 600 positive and negative impacts were predicted across the four options. These were summarized into 90 positive and 84 negative impacts for each of the ten broad determinants of health. The findings suggest that two out of the four options seem to offer maximum opportunity for improving the health and wellbeing of the Local population and for linking into the wider regeneration initiatives within the programme area.Discussion: Besides the obvious benefits that one would expect from brand new modern healthcare facilities, a wide range of other impacts were identified. This raised a level of awareness amongst the decision makers of the range of impacts that would need to be maximized or minimized to improve the health and wellbeing of the local population. (c) 2007 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.