Health Impact Assessment (Wales) Regulations 2025: supporting information

What the Regulations are

The Health Impact Assessment (Wales) Regulations 2025 come into force on 6 April 2027. They require certain public bodies in Wales to carry out a health impact assessment when proposing to make a decision of a strategic nature about how they exercise their functions.

The Regulations are secondary legislation made under the Public Health (Wales) Act 2017. They support a "health in all policies" approach across the public sector.

Purpose of the Regulations

The Regulations encourage public bodies to consider how their decisions may affect health and health inequalities.

They aim to ensure that health and wellbeing are considered systematically as part of public sector decision making across all policy areas, not just health services.

Public bodies subject to the Regulations

There is strong alignment between the Regulations and the ambition of the Well-being of Future Generations (Wales) Act 2015 to maximise public bodies contributions to the 7 national well-being goals. 

The Regulations apply to:

• Welsh Ministers
• local authorities
• corporate joint committees
• NHS health boards and trusts
• special health authorities
• national park authorities
• Welsh fire and rescue authorities
• Qualifications Wales
• Natural Resources Wales
• Commission for Tertiary Education and Research
• Arts Council of Wales
• Sport Wales
• National Library of Wales
• National Museum of Wales
• Social Care Wales
• Welsh Revenue Authority
• Transport for Wales

Relationship with other legal duties

The requirement to carry out a health impact assessment is designed to complement other duties placed on public bodies, including the Well-being Duty and the Socio-economic Duty.

Public bodies will be responsible for understanding how they comply with all relevant duties and may choose to integrate health impact assessments into their existing assessment and decision-making processes.

Implementation and compliance

Public bodies will be legally required to carry out health impact assessments for relevant decisions from 6 April 2027.

A public body that fails to comply with the Regulations may be subject to legal challenge.

Health impacts

A health impact is the likely positive or negative effect of a decision on physical or mental health in the short or long term.

Health impact assessments

A health impact assessment (HIA) is a structured way of assessing the health impact of a proposed decision or action.

An HIA considers the potential positive and negative effects of a decision before it is made. It identifies how negative effects may be avoided, reduced or mitigated, and how positive effects may be increased.

Under the Regulations, a health impact assessment is:

an assessment of the likely effect, both in the short term and in the long term, of a proposed action or decision on the physical and mental health of the people of Wales or of some of the people of Wales.

Benefits of carrying out a health impact assessment

Carrying out Health Impact Assessments will help public bodies make more informed and sustainable decisions by better understanding how a proposed decision may affect people’s physical and mental health. 

By identifying potential health impacts earlier in the decision-making process, Health Impact Assessments support prevention by helping to minimise harm, maximise positive outcomes and reduce health inequalities. 

The process aims to strengthen decision‑making by considering both direct and indirect effects on health, taking a whole‑system view of wider determinants of health and supporting collaboration across policy areas, organisations and stakeholders. Beyond regulatory compliance, this preventative and proportionate approach can help avoid costly unintended consequences, reduce future demand on health services, improve the efficiency of implementation, and contribute to long‑term social, economic and population health benefits, including potential downstream cost savings.

Decisions covered by the Regulations

The Regulations require a relevant public body to carry out a Health Impact Assessment when it proposes to make a decision of a strategic nature about how it exercises its functions. 

This is a minimum requirement, voluntary Health Impact Assessments are also encouraged to be used in other circumstances

Decisions of a strategic nature

In general, strategic decisions will be those which affect how the public body fulfils its intended statutory purpose (its functions in regard to the set of powers and duties that it uses to perform its remit) over a significant period of time and will not include routine ‘day-to-day’ decisions. 

For some public bodies, such decisions may only be taken annually, but in other cases they will come up more often.

Given the breadth of organisations subject to the Regulations, there is no prescriptive, one size fits all, descriptive list of what constitutes a “decision of a strategic nature”. The Regulations have been written in a way that lets the public bodies themselves decide what constitutes a decision of a strategic nature for their organisation.

Below are some examples (not an exhaustive list) of strategic decisions public bodies may make:

• strategic directive and intent
• medium to long term plans (for example, corporate plans, development plans, service delivery and improvement plans)
• setting objectives (for example, well-being objectives, Equality Act, 2010 equality objectives, Welsh language strategy)
• changes to and development of public services
• strategic financial planning
• major procurement and commissioning decisions
• strategic policy development

Relationship with the Socio-economic Duty

The requirement to carry out a Health Impact Assessment under the Regulations has been designed to complement some of the terminologies used in the Socio-economic duty. As such, if a public body identifies a decision as being one of a strategic nature and covered by the requirements of the Socio-economic duty, then it is very likely that a Health Impact Assessment will also be required.

Proportionality

Many public bodies already consider the health impacts of their decisions. The Regulations formalise that by introducing a minimum standard around when a Health Impact Assessment must be conducted.

Proportionality was a key part of the feedback on the consultation on the Regulations and is central to the final design of the requirements, with the Health Impact Assessment process being scalable and flexible. 

If they have not already done so, relevant public bodies should now begin to embed considerations engaged in the Health Impact Assessment process into their existing decision‑making processes and integrate with other impact assessments where appropriate. 

Public bodies should also ensure the level of assessment is appropriate to the scale and significance of the proposed decision and should seek to avoid duplication of work when collaborating with other public bodies, provided each meet the requirements set out in the Regulations.

Decisions outside the scope of the Regulations

The Regulations only require a Health Impact Assessment to be carried out by relevant public bodies when they make a decision of a strategic nature about how to exercise their functions. Many decisions therefore fall outside the scope of that threshold, such as routine ‘day-to-day’ decisions.

However, public bodies may still find it helpful to carry out a voluntary Health Impact Assessment for decisions not in scope of the Regulations to better understand potential health impacts.

What a health impact assessment must consider

Under the Regulations, public bodies will be required to do the following as part of carrying out a Health Impact Assessment:

• identify the decision to which the Health Impact Assessment relates
• identify any groups of the population whose physical or mental health the public body reasonably considers may be affected by the decision
• identify and assess any intended effects of the decision, and any unintended effects of the decision that the public body reasonably considers are likely, on the physical and mental health of any group of the population identified, having regard to the wider determinants of health and any health inequity factors
• identify and assess, in relation to any effects identified, any measures that the public body reasonably considers may prevent, reduce or mitigate any negative effects or increase any positive effects identified
• identify and assess anything else the public body considers to be relevant to the carrying out of the Health Impact Assessment

Health impact assessment process

A recognised health impact assessment process includes:

1. screening: deciding if a Health Impact Assessment is required
2. scoping: deciding the focus, scale and approach
3. evidence appraisal: gathering and analysing evidence
4. reporting: publishing the findings
5. review and reflection: learning from the process

The process is flexible and should be proportionate to the proposed decision being assessed. Please see guidance for further information

Stakeholder involvement

The Regulations do not mandate consultation or engagement with third parties when carrying out a Health Impact Assessment. 

However, it is recommended that all assessments include some involvement of stakeholders where it would be appropriate and proportionate to do so. In all cases, public bodies must comply with their obligations under the Well‑being of Future Generations (Wales) Act 2015.

Evidence and information

A mix of evidence can be used when carrying out a Health Impact Assessment, such as:

• local and national data
• research and published evidence
• stakeholder and community knowledge
• existing consultation findings

The types of evidence that can be used is not mandated in the Regulations meaning that public bodies have the flexibility to use the type and depth of evidence to match the scale and importance of the decision. The Public Health Wales website has a list of some sources of data and evidence which can be used.

Publishing health impact assessments

Public bodies must publish a Health Impact Assessment as soon as reasonably practicable after completing it and in such manner as they consider appropriate.

Using health impact assessments in decision making

Health Impact Assessments are intended to shape decisions, not just document them. 

Section 109(1)(b) of the Public Health (Wales) Act 2017 provides that where a public body has carried out a health impact assessment in accordance with the Regulations, they must take the assessment into account when exercising those functions in connection with which the assessment was carried out. For these purposes, when taking the assessment into account, the public body is required to act in accordance with the sustainable development principle, which is to be construed in accordance with section 5 of the Well-being of Future Generations (Wales) Act 2015.

Flexibility and integration

The Regulations were deliberately written with flexibility in mind given the varying nature of the functions of the public bodies in scope of the Regulations.

By giving this flexibility, organisations will have opportunity to consider how they can fit the requirements of the Regulations into their current processes, including as part of a wider integrated impact assessment. This means that not all organisations are likely to have the same processes in place to meet their requirements under the Regulations.

Available support

Public Health Wales NHS Trust has been instructed to provide guidance and training for public bodies covered by the Regulations.

Guidance has since been published by the Wales Health Impact Assessment Support Unit (WHIASU).

Training information is also available through WHIASU.

Quality assurance

Public bodies should be satisfied by the quality of their Health Impact Assessments using their own internal processes.