This report is to set out the recommendations for recommissioning the Pharmacotherapy function of the Herefordshire Stop Smoking Service. 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. These diseases and other long-term conditions would otherwise take up a high level of health and social care resources. These are services mandated by Office for Health Improvement and Disparities, to be funded from the ring-fenced public health grant, for which responsibility transferred from the NHS to local authorities in 2013. The existing contract is due to expire in March 2025. The recommendations made take account of the evidence base, lessons learnt following review of current services, and available resources to ensure cost effective delivery to achieve good health outcomes

That:

(a) procure a targeted number of pharmacies across Herefordshire to provide stop smoking behavioural support to complement the county wide pharmacotherapy and community stop smoking service offer effective from 1 April 2025 up until 31 March 2029, This will not exceed expected cost of £15,000 per year;

(b) stop smoking pharmacotherapy is re-procured as the Multi Provider Multi Lot Framework and is effective from 1 April 2025 up until March 2029 with a maximum contract value of £70,000 per annum; subject to receipt of the annual government Local Stop Smoking Services Grant funding .

(c) direct award is made to PharmOutcomes system to support this delivery for a period up to 31 March 2029 with a maximum contract value of £24,000 (£6,000 per annum).

(d) the Director for Community Wellbeing and the Director for Public Health, are both authorised to take all necessary operational decisions to implement the above recommendations.

Allow the existing contract for stop smoking to expire on 31 March 2025, and the service to cease. This option is not recommended, as this service is key to improving the health of the local population and a condition of the Smokefree Generation Grant is that investment in Stop Smoking Services is maintained. According to the ASH economic assessment tool between 2021 and 2022 smoking related costs in Herefordshire were estimated at £128million. This included productivity losses (£78.8million), healthcare costs (£5.64million), social care costs (£42.4million), and fire related costs (£1.16million).