To approve procurement of NHS Health Checks and Stop Smoking services.

NHS Health Checks and stop smoking services are public health services for early identification, treatment and interventions to prevent the onset of avoidable disease and development of long term conditions, which would otherwise take up a high level of health and social care resources. These are services mandated by Public Health England, to be funded from the ring-fenced public health grant, for which responsibility transferred from the NHS to local authorities in 2013. The existing contracts are due to expire in March 2018. The recommendations being made take account of the evidence base, lessons learnt following review of current services and available resources to ensure cost effective delivery to achieve outcomes.

That:

(a) a direct award is made to Taurus Healthcare to deliver NHS Health Checks for a period of up to two years effective from 1 April 2018 with a maximum contract value of £461,700;

(b) a direct award is made to ToHealth for software to support this delivery for a period of up to five years effective from 1 April 2018 with a maximum contract value of £95,000;

(c) stop smoking behavioural support is delivered in-house by the council’s Healthy Lifestyle Trainer Service effective from 1 April 2018 with an expected cost of £29,000 per year;

(d) stop smoking pharmacotherapy is re-procured under an any qualified provider contract effective from 1 April 2018 for a period of three years with a maximum contract value of £142,743;

(e) the Director for Adults and Wellbeing, following consultation with the Cabinet Member for health and wellbeing and the s151 officer, is authorised to take all necessary operational decisions to implement the above recommendations.

Allow the existing contracts for stop smoking and NHS Health Checks to expire on 31 March 2018 and these services to cease. This option is not recommended as both these services are key to improving the health of the local population and are mandated by Public Health England as a condition of the council receiving the ring-fenced public health grant. Smoking related illness costs the council £3.3m per year, according to the ASH economic assessment tool, due to social care costs required to meet smokers’ needs.

All the services could continue to be provided using the current delivery model of any qualified provider (AQP). This option is not recommended, with the exception of pharmacotherapy provision that can only be provided by qualified pharmacists. The model has not met expected targets as most of the approved providers were unable to market and deliver services in the county. For NHS Health Checks, this is due mainly to GP practice lists being the only available source for inviting the eligible population to a check. Nationally, it has not been possible to secure a suitable process for third party providers to access this information within data protection regulations. As a consequence, GP organisations are the only practical option for delivery of the service. For stop smoking, the cost of identifying and recruiting smokers to stop is not cost effective due to the number of alternative services and products available, therefore a targeted service to support the most vulnerable is recommended.

To contract with a single external provider for stop smoking behaviour change. This option is not recommended because evidence from the AQP universal model has shown that external providers have not been able to establish effective accessible services locally. The recommendation to support a more targeted number of individuals reduces the cohort and becomes less attractive to external providers to deliver the service. The most effective provider so far has been the council’s in-house Healthy Lifestyle Trainer Service (HLTS) working in conjunction with a number of local small volume providers, mainly pharmacies.