Agenda item

Vicky Tovey (Assistant Director of Public Health) was in attendance for this item

1.    Mrs Tovey introduced the paper outlining the Public Health Service Transformation Programme (PHSTP), its progress, and planned work. The programme, which began in summer 2023, aimed to improve services funded by the Public Health Grant by targeting resources to those most in need, addressing health inequalities, meeting prevention obligations, and ensuring best value.

2.    The programme covered a broad range of mandated and statutory services, from early years health visiting and infant feeding to older people’s exercise. It followed the natural end of several partnership contracts, including with Kent Community Health Foundation Trust, creating an opportunity to review services collectively and maximise impact.

3.    Areas for improvement included low-level cannabis use, which was given greater focus within lifestyle and health visiting services. The paper detailed an evidence-based commissioning approach, including data analysis, best practice review, resident engagement, and market engagement.

4.    The programme had reached its implementation stage, involving procurement, transition to new models, and communication of changes to residents and the wider system. Service changes ranged from minor refinements to significant redesigns, such as moving community-based infant feeding groups out of health visiting into a separate place-based service and transitioning children and young people’s counselling to a therapeutic model aligned with ICB commissioning to increase capacity.

5.    Further to questions and comments from Members the discussion included the following:

(a)  In response to queries on the referral process for the Children and Young People’s Emotional Well-being Service, Mrs Tovey confirmed that referrals were accepted via multiple routes, including self-referrals, schools, and wider system partners. Communications had been issued to inform stakeholders. Services were also dual-run to avoid gaps, and young people on existing waiting lists were contacted to offer a choice between the current and new service.

(b)  With regard to comments made in relation to improving the transition for young people up to the age of 19, Mrs Tovey noted that this remained a key focus. The service provided mild to moderate support up to age 19 and worked closely with ICB services, which covered older age ranges, and Live Well Kent, which supported those from aged 17. Services collaborated to assess individual needs and determine the most appropriate provision, ensuring smoother transitions between children’s and adult services. Mr Waller (Chief Strategy and Partnerships Officer and Chief Delivery /Commissioning Officer(interim) – NHS Kent and Medway - Integrated Care Board) also confirmed that earlier in the year, the intention had been announced to move Children’s Mental Health Services, currently provided by North East London Foundation Trust, into a joint arrangement for children’s and adults’ mental health delivery within KMPT. The strategic driver for this change was to enable a single provider to manage the transition period, ensuring continuity of care for children and adolescents with more significant mental health needs.

(c)  Further information was sought on place-based prioritisation of the smoking cessation service, particularly in light of the high  smoking levels in Swale. Mrs Tovey advised that Public Health had received additional grant funding dedicated to smoking, aligned with the national strategy. This enabled commissioning of bespoke services, including an outreach-based, place-focused offer targeting high-prevalence areas such as Swale. Alongside traditional stop-smoking services, an organisation called Allen Carr’s Easyway was commissioned to deliver one-day seminars, which had proven popular and effective and a pharmacy-based offer was also available, all of which continued to provide choice and accessibility for residents.

(d)  In response to queries relating to Kent’s Family Hub programme and place-based infant feeding, Mrs Tovey explained that KCC supported the Family Hub initiative, which had received extra funding to promote Best Start in Life. Family Hubs operated across the county with both physical and virtual delivery. Providers of services such as health visiting and infant feeding were required to deliver from, or be aligned to, Family Hubs. Community-based infant feeding services formed part of that network, ensuring multi-agency working and clear access for parents. Mrs Palmer (Cabinet Member for Integrated Children’s Services) also confirmed that there were 52 Family Hubs in Kent, one of the highest numbers nationally. Kent had secured part of £550 million funding through the Family First initiative, with a significant portion allocated to Family Hubs for early intervention, enabling support for young children showing behavioural or learning difficulties. Family Hubs offered a wide range of services, including feeding clinics, health visitors, portage, and language therapy, and were regarded as a forward-thinking initiative.

(e)  With regard to what was being done to support children who were on the pathway to being diagnosed with neurodiversity and waiting for an EHCP, particularly those in mainstream education, Mrs Tovey explained that school health services supported neurodiverse children in several ways. They provided advice to schools and recognised that mental health and wellbeing were major challenges for young people awaiting assessment. Uptake of counselling and therapeutic services among neurodiverse children was high, and adjustments had been made to improve accessibility. Insight work showed that some preferred web chat over phone calls or face-to-face contact, so alternative contact methods were introduced. The therapeutic offer also allowed flexibility between one-to-one and group sessions to meet individual needs. Additionally, specific packages of care for parents were available to address behavioural and wellbeing concerns. All SEND-related services formed part of the local offer, which included public health prevention services.

(f)   Further information was sought on the targeted approach to adult weight management services and the use of digital solutions, amongst concerns that this could have a detrimental impact on service quality. Mrs Tovey confirmed that procurement was live and evaluation was underway. She explained that the targeted approach was based on needs assessments and learning from previous pilots, which highlighted the need for bespoke offers for certain groups, such as culturally tailored materials, support for people with learning disabilities, and alternatives for men who preferred options like football-led programmes over traditional groups. The new provider was asked to offer greater choice to encourage engagement while maintaining core services. On digital solutions, Mrs Tovey clarified these were intended to enhance services, not replace them, by introducing tools such as apps, text invitations, and virtual follow-ups. This aimed to improve accessibility and efficiency while preserving service quality.

6.    RESOLVED that the Health and Wellbeing Board note the information contained within the update report