Salim Vohra
The best thing about consultancy work is the variety of work that you can get involved in over what can be a few weeks and months (and sometimes years!). The outputs also tend to feed quickly into active policy and decision-making processes and actions.

This page shows one project per theme, where there is a link at the bottom of each theme section click to see more projects under that theme. Only consultancy reports I have written/helped write that are in the public domain are shown here.

Capacity building

Stoke-on-Trent HIA Training and Mentoring Programme

Stoke-on-Trent City Council and NHS Stoke-on-Trent, 2011

This programme of work involved taking a group of eight people through four HIAs in groups of two.

The objectives were:
  • To individually or in groups of two or more support participants to undertake a rapid desktop HIA (no community consultation would be undertaken) and produces a HIA report on a policy, plan or project of the participants choice.
  • To set up a HIA learning set that meets regularly e.g. once a month for at least a year to discuss the challenges faced, provide advice and support to resolve those challenges and to create the core of what could potentially become a long term HIA network across Stoke-on-Trent and the North Staffordshire Region as a whole.
  • To disseminate and publish the final HIA reports and follow them up to see what influence they have had.
  • To provide some formal teaching on basic epidemiology, developing community profiles, reviewing evidence, analysing health impacts using causal pathway diagrams, involving communities and health risk communication.


Putting Health in the Policy Picture:review of how health impact assessment is carried by government departments

Department of Health England, 2010

This evaluation, which I led, is the first of its kind internationally to systematically consider how Health Impact Assessment is being used within Impact Assessment, and whether it can affect policy making. It developed an innovative approach to evaluate policy impact assessments.

It was undertaken in England and showed that:

  • While systematic HIA is seldom done as part of the IA process, some basic level of considering the possible health impacts is relatively widespread.
  • When health impacts are considered there is a tendency to: focus on negative health impacts at the expense of positive health impacts; focus on a small number of the determinants of health; not consider health inequalities; and not use public health evidence to back up statements.

Twelve recommendations were made to improve the consideration of health in policy-making.

Guide development

Health Impact Assessment of Greenspace: A Guide

greenspace scotland, Health Scotland, Scottish Natural Heritage and Institute of Occupational Medicine, 2008

This writing project, for which I was lead writer and project manager, involved developing a overarching summary of a literature review of evidence undertaken by the University of York and key questions to ask when dealing with new greenspace policies, strategies, plans, frameworks, programmes or projects.

  • provides background information on greenspace and current greenspace policy context in Scotland
  • contains a summary of a review of international research evidence on greenspace and health
  • suggests questions to help apply this evidence to specific greenspace or greenspace-related proposals
  • outlines how to use this evidence to do a HIA including creating causal pathway diagrams
  • provides short case studies of some completed HIAs of greenspace
  • highlights sources of data and further information on greenspace

Tool development

Integrated Impact Assessment Model and Tool for Sub Regional Development Frameworks in London

London Health Commission, 2004

I was a member of the team that developed this Integrated Impact Assessment Model and Tool. This IIA model is based on three domains: environment, society and economy. These in turn have cross-cutting themes: sustainability, health and diversity. Impact assessment methodologies have been reviewed and incorporated into this integrated impact assessment model specifically the learning from the LHC’s, and other, health impact assessments.

Working through this model will enable the team working on the SRDF to:
identify potential positive and negative effects of the SRDF;
develop measures to reduce potential negative effects and enhance positive effects; and
produce a report which is SEA compliant i.e. content and process of this model are SEA compliant.

We suggest that the IIA team should have expertise which spans the domains and cross cutting themes. The process involves three stages of consultation: each round of consultation involves a wider group. The first is restricted to members of the appraisal team and the policy team. The second involves statutory and strategic partners and looks at the scope of the IIA. The third stage involves consulting on the draft IIA report so that the recommendations and the policy decisions can be subjected to public scrutiny.


Economic Development Strategy Sustainability Appraisal

London Development Agency, 2009

I led the health assessment component of this sustainability appraisal which was coordinated by Entec. See Appendix E on page 75.

The key questions asked were:

  • Will it help reduce poverty and the impact of income inequality?
  • Will it help reduce health inequalities?
  • Will it help improve mental and emotional health?
  • Will it help improve access to high quality public services (including health facilities)?

The key strengths of the revised Economic Development Strategy included:
  • Strong support for maintaining a strong and diverse economy that creates the conditions for supporting economic growth and achieving the objectives of the revised EDS.
  • A strong, comprehensive approach to tackling climate change notably through mitigation of emissions and creation of green infrastructure. The proposals include actions to taking advantage of the economic opportunities presented by these activities.
  • A wider approach to economic development that includes a commitment to improving the quality of life of Londoners that addresses key aspects of poverty and exclusion.


Rose Energy Biomass Fuelled Power Plant HIA with HRA

Rose Energy, 2008

I was project managed and conducted this Health Impact Assessment incorporating a Human Health Risk Assessment of a proposed biomass (poultry litter) fuelled power plant. The HIA concluded that:
  • Power plants and incinerators are in a class of developments that are almost universally unwanted by local residents.
  • The cumulative lifetime cancer risks from the emissions of the power plant, through direct and indirect exposures, are so extremely small as to be effectively zero when considered alongside the other more important personal, lifestyle and social factors that influence health and wellbeing. Similarly the cumulative hazard levels from the emissions of the power plant, through direct and indirect exposures, are less than 25% of the safe or tolerable/acceptable exposure level.
  • The plant is likely to have a moderate positive impact at regional level and a minor to moderate negative impact at the local level. The intensity of the negative impacts will be dependent on both the proximity of residents to the proposed site and how well the mitigation measures identified in this report, and in the EIA, are implemented.
  • Overall, the major negative health impacts on local people are likely to be nuisance level and quality of life impacts. These are important considerations but they are not effects that are likely to cause disease or ill health in local residents.

Health and social care

Review of the Special Personal Medical Service (SPMS) in Hounslow

Hounslow Primary Care Trust, 2006

I project managed and designed this evaluation which involved developing a staff questionnaire, helping to facilitate a workshop and some one-to-one interviews with key stakeholders.

The purpose of this review was five-fold:
  • To evaluate the achievements of the SPMS in relation to its original objectives and underlying values (explicit and implicit).
  • To identify the key learning points from the process of setting up and implementing the SPMS.
  • To assess the SPMS’s ‘fitness for purpose’ in light of the new ‘Patient-led NHS’ proposals.
  • To assess the extent to which the SPMS provides value for money.
  • To develop options for the future of the SPMS and, depending on the
  • findings, make recommendations on the best way forward.

Overall, the development and implementation of the SPMS, albeit with some drawbacks, has overall supported and facilitated the changes that needed to take place to move closer towards achieving the vision of a patient-led NHS.


Good Practice Guidance on Health Impact Assessment

International Council on Mining and Metals, 2010

This writing project, for which I was lead writer, involved developing a state-of-art, flexible and holistic approach to HIA in the mining and metals sector that fits both the developed and developing country contexts of mining and metals projects whilst taking account of current HIA best practice. It used the guide developed for the oil and gas industry by IPIECA as starting point.

It takes a strongly social determinants of health approach and is innovative in developing:

  • the use of ‘first look’ in-house rapid HIAs during the early stages of new projects and changes to existing projects as a way of embedding HIA practice within mining and metals companies;
  • follow up of these rapid ‘first look’ HIAs with more in-depth commissioned specialist HIAs either as standalone HIAs or as part of ESHIAs (Environmental, Social and Health Impact Assessment);
  • the development of a hierarchy of enhancement alongside the established hierarchy of mitigation; and
  • a clear comptency framework for commissioning HIA consultants and developing in-house HIA expertise.


HMS Ganges Mixed Use Residential Development HIA

Central Suffolk Primary Care Trust and Haylink, 2007

This was the first HIA I led. The proposal to create a mixed development with a range of starter, affordable and other homes as well as space for retail amenities and community facilities will have positive health effects for the people who will move into the proposed development.

The people moving in are likely to be local people as well as people from outside the Peninsula. The existing community will benefit from the landscaped public green space and the increase in retail amenities and community facilities.

The development will regenerate and bring back into use a currently derelict and unused site. It will connect up Shotley village to the marina and its associated development creating a more integrated physical community at the end of the Peninsula that will allow more people to access the marina and the proposed museum by road, cycle-paths and walking routes.

Finally, it has the strong potential for improving the quality of community relationships and interactions (social capital) by creating a focal point for community activities through a village square that has a range of retail amenities and community facilities.

Healthy Urban Planning

Connecting Communities: Making Dart Street a Better Place for Local People

LondonPlay, 2007

In this project I was project leader and coordinated the community survey, on-street community engagement as well as the development of the Home Zone designs

London Play, a charity looking to improve children's outdoor play, funded this pilot work to explore how London streets can be improved to make them better places for local people and, especially, children.

The purpose of the Home Zones for London (HZfL) pilot programme is to encourage and empower local communities to work in partnership with local authorities in the designing of streets and the development of Home Zones.

A Home Zone is a set of principles by which new residential streets can be designed and existing ones re-designed to make them shared public spaces for everyone whether they are pedestrians, cyclists or public and private motor vehicle drivers.

This report details the planning, implementation and findings of this community planning project between December 2006 and March 2007. It also outlines the next steps for turning the ideas and vision of the local community into a reality.


Marsh Farm Central Area Regeneration Masterplanning HIA

Luton Borough Council and NHS Luton, 2009

I led and project managed this HIA which found that overall, the redevelopment of the Central Area is likely to have a significant positive health and wellbeing impact on existing and new residents of Marsh Farm. It will be a powerful demonstration that things can and have changed for the better on Marsh Farm.

However, there needed to some detailed planning in some key areas to ensure that the potential negative impacts are minimised and the positive health impacts maximised particularly on poor and vulnerable groups such children and young people, older people, women and those with young children and those with disabilities.

Key issues that still needed to be considered are the:
  • Standards to which the housing will be built .
  • Detailed design of the retail space and open and green space.
  • The mix of tenure in the new housing and the criteria for allocating new tenants.
  • Detailed planning for the relocation of health and other health/social services.
  • Continuity of the existing shops and outdoor market and the criteria used to select shops for the new retail space being developed.
  • Ensuring access to shops, the health and social services during the construction phase.
  • Ensure the appropriate relocation of existing tenants.


Northumberland Local Transport Plan 3 SEA HIA

Northumberland County Council, 2011

I led and project managed this HIA that was part of a Strategic Environmental assessment (SEA). Overall, the proposed set of objectives and interventions strongly aligned with public health and wellbeing objectives and are likely to have potential positive health and wellbeing impacts on most residents of Northumberland.

These positive health and wellbeing impacts are likely to be realised within the duration of the LTP3, 2011-2026 with a strong potential for these positive impacts to continue beyond this period. The potential impact of the interventions experienced across Northumberland is likely to depend on the final set of preferred interventions chosen from the proposed set. Prioritising the intervention themes as follows is likely to be most beneficial to the health and wellbeing: Non Motorised Users, Public Transport, Road Safety, Miscellaneous, Climate Change, Smarter Choice, Freight, and Highway Capacity.

The major negative health and wellbeing impacts are linked to the construction of new roads and rail links and generally occur during the construction phase and on residents who live near the new road or rail routes and the widening of existing road routes. These issues are best considered when more detailed proposals are developed through project-specific EIAs and HIAs. They are also generally short term, temporary and generally localised.


Wales 3 Regional Waste Plans Strategic HIA

Welsh Assembly Government, 2007

I led and project managed this Strategic HIA which supported the 3 Regional Waste Plan 1st Reviews and ensured that health was considered during the Regional Waste Planning process.

Untreated waste, in and of itself, has negative health and wellbeing impacts. Therefore, the overarching aim of the National Waste Strategy and the 3 RWPRs is to significantly reduce the total amount of waste being treated and disposed of in Wales by reducing, re-using and recycling waste i.e. moving up the waste hierarchy. This goal will take some time to achieve and in the meantime waste treatment facilities will be needed to appropriately treat and dispose of this waste.

Overall, the HIA finds that there is no single best public health Strategic Waste Management Option (SWMO). Options 2, 3 and 4, are good from a public health perspective but each has strengths and weaknesses. The Strategic (SWMO) Analysis points to further residual waste recycling rather than just energy recovery as the better option i.e. Options 3 and 4. In contrast, the Spatial Options Analysis, because of the numbers of facilities, size of sites, and the need for more waste lorry movements, points to Option 2 (fewer sites, though larger, and less waste lorry movements overall) as being better.