Issue details

25/00008 - Public Health Service Transformation Programme - Adult Lifestyle Services Recommission

Proposed Decision:

 

  1. APPROVE the Adult Healthy Lifestyle Service model and agree to the commissioning of the relevant services:

 

  • Stop Smoking Service: Three Year Contract (1 April 2026 – 31 March 2029) with an optional extension, up to 24 months.

 

  • Weight Management and Healthy Lifestyle Service:

 

  • East Kent: Three year Contract (1 April 2026 – 31 March 2029) with an optional extension, up to 36 months

 

  • West Kent: Three year Grant Agreement (1 April 2026 – 31 March 2029) with District and Borough Councils. Towards the end of the Three years, a decision will need to be made on whether KCC continues to provide the service in West Kent through Grant Agreements with the District and Borough Councils.

 

  1. DELEGATE authority to the Director of Public Health, in consultation with the Cabinet Member for Adult Social Care and Public Health to commission the relevant services and enter into contracts or other legal agreements with providers to deliver the Adult Healthy Lifestyle Service model; and

 

  1. DELEGATE authority to the Director of Public Health, in consultation with the Cabinet Member for Adult Social Care and Public Health, to exercise relevant contract extensions and enter into relevant contracts or legal agreements; and

 

  1. DELEGATE authority to the Director of Public Health, in consultation with the Cabinet Member for Adult Social Care and Public Health, to take relevant actions, including but not limited to, awarding, finalising the terms of and entering into the relevant contracts or other legal agreements, as necessary, to implement the decision

 

 

Background

 

Kent County Council (KCC) commission Adult Lifestyle Services (Stop Smoking, Weight Management and Healthy Lifestyles) as part of the service branded as One You Kent (OYK).

 

OYK commenced on 1 April 2017 and ends on 31 March 2026. The Service is currentlydelivered by Kent Community Health Foundation Trust (KCHFT) and six district, borough and city councils.

 

The overall aim of OYK, is to increase the number of people quitting smoking, managing their weight and living a healthy lifestyle in Kent, by engaging, motivating and supporting individuals to successfully achieve personal outcomes/goals. The service is also targeted at people from priority groups, such as people residing in areas of deprivation, in order to reduce health inequalities.

 

In July 2023, KCC commenced the Public Health Service Transformation Programme (PHSTP). The programme responded to a series of strategic developments, challenges, and opportunities in the commissioning landscape, and is underpinned by an evidence-based review of all internal and external Public Health funded services and grants. The Programme required the evaluation of existing service models and collaboration with key stakeholders to identify recommendations for future service delivery.

 

As part of the PHSTP, market, stakeholder and public engagement has been undertaken. All responses and contributions from engagement has been analysed and informed future service delivery. New service specifications will be developed, which encompasses learning from all the engagement undertaken.

 

Reason for Decision:

 

Under the Care Act, KCC is obliged to provide or arrange for services, facilities or resources which would prevent, delay, or reduce individuals’ needs for care and support. Within the Care Act statutory guidance, secondary prevention or early intervention is defined as more targeted interventions aimed at individuals who have an increased risk of developing needs, where the provision of services, resources or facilities may help slow down or reduce any further deterioration or prevent other needs from developing.

 

KCC also has a statutory duty to improve the health of the population and reduce health inequalities (Health and Social Care Act 2012). KCC receive a ringfenced Public Health Grant to meet this statutory duty and annually report to Government on how much of this Grant has been allocated on weight management, lifestyles and stop smoking services.

 

OYK plays a vital role in ensuring the effective and timely provision of preventative health and wellbeing services and can help meet key priorities:

 

·  Helping the most vulnerable and disadvantaged in society to improve their physical and mental health; with a focus on the social determinants of health and preventing people becoming ill in the first place

·  Helping people to manage their own health and wellbeing and be proactive partners in their care so they can live happy, independent and fulfilling lives; adding years to life and life to years.

The service achieves this by supporting residents of Kent to quit smoking, manage their weight, improve their diet, increase their physical activity, boost their mental wellbeing and reduce their alcohol consumption. The service is open access, but is also targeted at people from priority groups, such as people residing in areas of deprivation, in order to reduce health inequalities.

It is proposed Adult Healthy Lifestyle Services are recommissioned, with the aim of successfully selecting provider(s) to deliver the services from 1 April 2026. The process will adhere to ‘Spending the Council’s Money’ and relevant procurement legislation.

Options (other options considered but discarded)

 

  • Discontinue / decommission services - Decommissioning the services was concluded as a non-viable option, due to the prevalence of unhealthy behaviours in Kent and demand for services. OYK supports the Council to achieve priorities set out in Framing Kent’s Future and Securing Kent’s Future and the Kent and Medway Integrated Care System to achieve key outcomes set out in the Integrated Care Strategy. The services play a key role in supporting KCC to reduce health inequalities and improve the health of the Kent population. It is also a requirement as per the Local Stop Smoking Service Support Grant (LSSSSG) that in order for local authorities to receive the funding, KCC must maintain its existing spend on stop smoking services

 

  • Reduce service offer - Reducing the services was concluded as a non-viable option, due to the prevalence of unhealthy behaviours in Kent and demand for services. OYK supports the Council to achieve priorities set out in Framing Kent’s Future and Securing Kent’s Future and the Kent and Medway Integrated Care System to achieve key outcomes set out in the Integrated Care Strategy. The services play a key role in supporting KCC to reduce health inequalities and improve the health of the Kent population. It is also a requirement as per the LSSSSG that in order for local authorities to receive the funding, KCC must maintain its existing spend on stop smoking services. 

 

How the proposed decision meets the priorities of New Models of Care and Support as set out in ‘‘Framing Kent’s Future – Our Council Strategy 2022 – 2026’’

 

Stop smoking, weight management and healthy lifestyle services supports the Council to achieve the following priorities set out in the Council’s Strategy 2022-2026 ‘Framing Kent’s Future’:

 

  • Priority 1: Levelling up Kent
    • To see significant improvements in the economy, connectivity, educational attainment, skills and employment rates and public health outcomes in deprived communities in coastal areas so that they improve faster than the rest of Kent to reduce the gaps
    • To work with our partners to hardwire a preventative approach into improving the health of Kent’s population and narrowing health inequalities
    • Adopt an unrelenting focus on reducing cardiovascular disease in our population by continuing to focus on healthier behaviours, stopping smoking, taking up exercise and healthier eating.

 

How the proposed decision supports Securing Kent’s Future

 

Stop smoking, weight management and healthy lifestyle services supports the Council to achieve the priorities set out in Securing Kents Future, by preventing people from getting long term health conditions linked to smoking, being overweight and living unhealthy lives, which increase’s demand and costs in Health and Social Care.

 

Financial Implications

The new service length will be:

  • Stop Smoking Service: Three Year Contract (1 April 2026 – 31 March 2029) with an optional extension, up to 24 months. This will align with the ending of the new services being commissioned utilising the LSSSSG
  • Weight Management and Healthy Lifestyle Service:
    • East Kent: Three year Contract (1 April 2026 – 31 March 2029) with an optional extension, up to 36 months
    • West Kent: Three year Grant Agreement (1 April 2026 – 31 March 2029) with District and Borough Councils. Towards the end of the Three years, a decision will need to be made on whether KCC continues to provide the service in West Kent through Grant Agreements with the District and Borough Councils.

Arrangements involving grant agreements between KCC and Districts and Borough Councils may be impacted by devolution and reorganisation. Future commissioning plans will be reviewed as the devolution agenda progresses.

The tables below outline the estimated costs to KCC Public Health and includes an estimated annual uplift that will be applied (with the exclusion of the first year). Final costs will be subject to negotiations and procurement outcomes.

Table 1: Estimated Costs to KCC Public Health (Stop Smoking Service)

 

Cost to KCCPublic Health

(Stop Smoking Service)

1 April 2026 – 31 March 2029

£7,184,878.04

1 April 2029 – 31 March 3031

(Optional Extension Period)

£4,910,464.97

Total Cost (Three year Contract + up to 24 month optional extension)

£12,095,343.01

The estimated annual costs to KCC Public Health will be consistent with current costs.

Table 2: Estimated Costs to KCC Public Health (Weight Management and Healthy Lifestyle Service)

 

Cost to KCCPublic Health

(Weight Management and Healthy Lifestyle Service)

 

1 April 2026 – 31 March 2029

1 April 2029 – 31 March 3032

Total

East Kent (Contract)

£5,448,122.53

£5,613,206.09

£11,061,328.61

West Kent (Grant Agreement)

£3,448,069.30

£3,552,549.24

£7,000,618.54

Total Cost

£8,896,191.82

£9,165,755.33

£18,061,947.15

 

 

Includes:

 

·         Optional extension (up to 36 months) in East Kent

·         Decision taken to continue to provide the service in West Kent through Grant Agreements with the District and Borough Councils for the same time period as the East Kent optional extension (Three years).

The estimated annual costs to KCC Public Health are lower compared to current costs. Cost modelling, including benchmarking with other local authorities has been undertaken to determine the estimated costs of the service post April 2026. This has determined that KCC can achieve improved value for money with no impact to the level or quality of support provided across Kent.

The above values can be funded from within the budget approved and will be funded from KCC Public Health ring-fenced grant.

 

Decision type: Key

Decision status: For Determination

Notice of proposed decision first published: 04/02/2025

Decision due: Not before 5th Mar 2025 by Cabinet Member for Adult Social Care and Public Health
Reason: To allow the required 28 notice period on the published list of forthcoming executive decisions

Lead member: Cabinet Member for Adult Social Care and Public Health

Lead director: Dr Anjan Ghosh

Department: Social Care, Health & Wellbeing

Contact: Vicky Tovey, Assistant Director of Integrated Commissioning Email: Victoria.Tovey@kent.gov.uk Email: victoria.tovey@kent.gov.uk.

Consultees

The proposed decision will be discussed at the Health Reform and Public Health Cabinet Committee meeting on 11 March 2025.

 

Financial implications: Please see detail above

Legal implications: Spending will be compliant with ‘Spending the Council’s Money’ and relevant procurement legislation, which is likely to be The Healthcare Services Regulations (Provider Selection Regime) 2023 for those where a contract bound by law is required. An assessment will be conducted to ascertain the applicable procurement legislation. TUPE regulations are likely to apply. During mobilisation, KCC needs to be conscious to mitigate the disruptive effect that this may have on current people accessing the service. Legal and Commercial advice will be sought as and when required.

Equalities implications: Equalities impact assessments (EqIA): An EqIA has been undertaken. The EqIA found the impact of this work to be positive, with no negative impacts. Services will continue to play a key role in supporting KCC to reduce health inequalities and improve the health of the Kent population. Services will continue to aim to increase the number of people supported from underserved groups, to tackle inequalities that exist among high-risk populations and areas of deprivation. The EqIA will be regularly reviewed. Data Protection Implications: A new Data Protection Impact Assessment will need to be undertaken and completed during mobilisation. Initial screening has already been completed and determined a full Data Protection Impact Assessment will need to be completed. The provider(s) will also be required to undertake a Data Protection Impact Assessment during mobilisation and support the completion of KCC’s Data Protection Impact Assessment.