North Yorkshire Council

 

Health and Adult Services

 

Executive Member Meeting

 

15th March 2024

 

REPORT TO: Executive Member for Health and Adult Services in consultation with the Director of Public Health and Corporate Director of Health and Adult Services 

 

Smokefree generation funding – 2024 to 2029

 

 

1.0          Purpose Of Report (required)

 

To seek agreement to receive North Yorkshire’s share of £70 million national funding to help to create a smokefree generation and support people to stop smoking. This new funding has been identified to invest in stop smoking services over the next 5 years, starting in 2024-25.

 

Funding per Local Authority area has been calculated based on local smoking prevalence. North Yorkshire’s funding for 2024-25 has been identified as c£632k. A key decision is needed in order to enable the Local Authority to accept this grant funding.

 

 

2.0          Executive Summary (required if report more than three pages)

 

This new funding has been announced by the Government as part of their wider ‘Stopping the Start: our new place to create a smokefree generation’. This funding follows on from previous reviews undertaken to understand progress against previous targets to support people to stop smoking. A key decision is being sought from HAS Executive to accept this funding and invest it across North Yorkshire.  

 

Confirmation is still required regarding the full terms of this funding via the grant agreement, although some conditions have been communicated to date. This includes the need to baseline the current spend on the service based on the financial year 2022/23.

 

Developing an investment plan for this new funding to deliver the ambition of the Government started some months ago and is continuing.  There have been cross directorate discussions in North Yorkshire Council, to look at capitalising on opportunities post-LGR with this funding. There have also been discussions with the wider Humber and North Yorkshire Integrated Care System Centre for Tobacco Control.

 

Both the equalities and climate change impacts of this funding have been reviewed using the North Yorkshire Council screening templates, as well as full assessments where needed. This funding provides an exciting opportunity to engage with a cohort of smokers who have traditionally not engaged with stop smoking services, which in turn will hopefully help reduce the health inequalities experienced by these groups.

 

 

 

 

 

3.0          Background

 

In April 2023, the Minister for Public Health, Neil O’Brien MP, delivered a speech outlining Government plans to cut smoking rates and tackle the use of vapes among young people. This speech provided an update on the work recommended in the Khan Review, which was an independent review commissioned in 2022 by the UK Government. This review considered UK smoking policy to date and assessed proposals, at the time, for how the UK Government would meet this challenge moving forward.

 

The Khan Review reflected that the targets set by the Government in their Smokefree 2030 to be at 5% smoking prevalence across the country by 2030 were unlikely to be met, as evidenced by modelling at the time. Estimates showed that this national smoking prevalence was not likely to be achieved within the UK until 2036 or 2037 at the earliest. However, in the areas of highest deprivation it was likely to be double that time.

 

This review also outlined a series of recommendations that included four critical ones, which outlined: the need for further investment in Tobacco Control; a change in the ‘Age of Sale’ policy; the embracing of e-cigarettes as a smoking cessation tool; and the re-prioritising of tobacco control prevention across the NHS, including Primary Care.

 

In October 2023, the Government formally announced intentions to act upon these recommendations with the publication of their ‘Stopping the Start: our new place to create a smokefree generation’ guidance. Within this the Government announced its intention to make the purchasing of tobacco illegal to any person born on, or after, 1st January 2009.

 

In addition to announcing this prospective change to policy, it also included two further announcements. One, a consultation focused on vaping amongst young people and this ran from October to early December 2023. And two, further funding for stop smoking services was also announced as part of this paper in an effort to try and reinvigorate the ambition to achieve the Smokefree 2030 target. The £70 million new funding has been identified for these services over the next 5 years, starting in 2024-25.

 

Funding per Local Authority area has been calculated based on local smoking prevalence, with additional guidance published in November 2023. North Yorkshire’s funding for 2024-25 has been identified as c£632k. Payments will be given to Local Authorities every 6 months, although in the first payment in April 2024, 70% of their allocated financial year’s funding will be provided to each Local Authority. They will then be expected to provide grant reporting to the Department of Health and Social Care’s grants team to receive the second payment. It’s anticipated that the funding will be allocated from 6th April 2024.

 

A key decision is being sought from HAS Executive in order to be able to accept this funding and utilise it within the local system to work towards 5% smoking prevalence in the county. Planning has been underway across Public Health, Service Development and Living Well Smokefree over the last couple of months to review how best to implement this funding. The ambition is to ensure that the funding is utilised as effectively as possible in line with the Government’s themes around this funding – one of which is to focus on priority populations who still retain high prevalence rates of smoking. North Yorkshire already benefits from the well-established Living Well Smokefree service so it’s very much about looking to build on that foundation.

 

4.0          Issues

 

A key decision is required to ensure that the Local Authority can accept this grant funding, though the full Grant Agreement outlining the terms of the funding is still awaited, but it will be delivered to Local Authorities via a Section 31 grant. The implication that an ‘agreement’ is awaited also suggests an option to accept or decline this funding. One condition of the funding that is known, is that if North Yorkshire Council agree to take this funding, there is the need to maintain the baseline funding from the Public Health grant as identified from the NHS Digital Returns at the end of 2022/23 (confirmed as £611,406).

 

Although it has also been explicitly stated by the Government that the funding has been identified for five years through to 2028/29, the Department of Health and Social Care, who are distributing the funding to Local Authorities, are unable to confirm the specific funding allocations to respective Local Authorities beyond 12 months at a time. This limitation is due to the annual Government spend review that is required to take place before any future allocations can be confirmed.

 

5.0          Performance Implications

 

Local Authorities will need to report data throughout the life cycle of the grant, which will take place through two methods. The first is via the existing method of reporting that is collated quarterly via the Stop Smoking Services Collection and uploaded via NHS digital returns. The second will be via a statement of grant usage to the Department of Health and Social Care that will start from the second payment and will describe the amount received, actual eligible spending and any reason for differences between the two amounts. 

 

The purpose of this investment is to support existing smokers to quit in England. As a result of the investment the Government wants to increase access to evidence-based behavioural support to quit and targeted support to people more likely to smoke, to reduce health inequalities. This investment should not replace activity delivered as part of the NHS Long Term Plan or the public health grant. It is intended to allow local authorities to deliver more, or enhanced, stop smoking support provision.

 

The provision of stop smoking services and support in England varies. In recognition of this, targets linked to funding will not be set for the first year of this investment. This position will be kept under review for subsequent years. The Government’s ambition for this investment is to see 360,000 people set quit dates, with 198,000 successful quits (measured as 4-week quits) in England each year. It is understood that local authorities will need time to commission and upscale local offers and generate demand for stop smoking support over time. A methodology has been applied to support understanding of what this ambition means for local areas. For North Yorkshire, modelling has been completed and shared with Local Authority staff. 

 

6.0          Policy Implications

 

There are no policy implications for accepting this new grant funding.

 

7.0          Alternative Options considered

 

The alternative not to accept this new funding has been considered and is not recommended given the potential for this funding to address the harm caused by smoking.

 

8.0          Financial Implications

 

The grant will be paid based on the understanding that the funding will be used to:

 

·         Invest in enhancing local authority commissioned stop smoking services and support, in addition to and while maintaining existing spend on these services and support from the public health grant. This should not replace other/existing programmes which support smokers to quit, for example the tobacco dependency programme delivered within the NHS Long Term Plan;

·         Build capacity to deliver expanded local stop smoking services and support;

·         Build demand for local stop smoking services and support; and

·         Deliver increases in the number of people setting a quit date and 4 week quit outcomes, reporting outcomes in the Stop Smoking Services Collection.

 

The grant will be paid in bi-annual instalments. The department’s presumption is that the grant will be spent in-year. The grant recipient will notify the department as soon as is reasonably practicable should an underspend be forecast. The department may consider reducing future grant amounts to local authorities that report significant and repeated underspends.

 

The full terms and conditions of the grant have not yet been seen by finance. Finance will check the terms & conditions of the grant agreement to ascertain whether there is likely to be any financial risk to North Yorkshire Council and advise accordingly.

 

Local Authorities have had their funding allocations determined based on local smoking prevalence data, with a three-year rolling average of most recent data being used to determine this. This means that the annual allocation of funding may fluctuate slightly each financial year dependent upon local rates.

 

The points highlighted in section 4 also reflect some of the potential issues surrounding this funding.

 

9.0          Legal Implications

 

If this grant funding is accepted, it will be transferred to Local Authorities from the Department of Health and Social Care via a Section 31 grant. This will require North Yorkshire Council agreeing to the terms of the grant. Any legal agreement required to be signed, will be reviewed by legal services and if any of the terms and conditions present unacceptable risk for the Council then the funding offer would be declined.

 

10.0       Consultation undertaken and responses

 

The terms of how to spend the grant will be defined in the final grant agreement. Work has been ongoing over the last few months to garner a range of views on how best to implement this funding locally to have maximum impact in the county. Whilst this plan is still in draft, work will continue with colleagues working in Living Well Smokefree, across directorates in North Yorkshire Council, as well as regionally with partners working in the wider Humber and North Yorkshire Integrated Care System for Excellence for Tobacco Control 

 

11.0       Impact on other services/organisations

 

The benefits from this funding will be felt across the wider tobacco control system and not only the Living Well Smokefree service within North Yorkshire Council. As the focus of the funding is to address prevalence rates within priority population groups, explorations have already begun into the opportunities post-LGR with relevant directorates across the council, e.g., housing and leisure. This is in addition to redefining how to work more closely with voluntary and community sector (VCS) organisations.

 

12.0       Contribution to Council priorities

 

This funding supports the delivery of the North Yorkshire Council plan, in particular the ambition around health and wellbeing for residents of the county.

 

13.0       Human Resources Implications

 

If this grant funding is accepted, this new funding is likely to be spent on expanding the workforce within the local stop smoking service, Living Well Smokefree. These new posts will be appropriately costed into the application, as per standard corporate financial protocols.

 

14.0       Equalities Implications

 

As previously mentioned, this grant funding will increase activity within Living Well Smokefree, the local stop smoking service, over the next 5 years to reduce smoking prevalence rates in North Yorkshire. This will enable a sharper focus on priority population groups where prevalence rates are higher than the general population, as interventions will be targeted and tailored to them to support in reducing inequalities.

 

15.0       Climate change implications

 

This funding is likely to have a negative impact on emissions from travel and air pollution moving forward. This is as a result of increased provision of in-person appointments and clinics across the county. Mitigations have been considered as part of the Climate Change Impact Assessment, including to counter any negative impact, including giving staff areas to cover that are close to where they live to minimise travel, as well as continuing to provide a hybrid service offer that includes online appointments.

 

As part of the delivery of e-cigarettes through Living Well Smokefree, the service does not provide any single-use devices therefore minimising the potential impact on the environment.

 

16.0       ICT implications

 

There will be the standard ICT implications resulting from the recruitment of new members of staff. This will be appropriately costed into the application, as per standard corporate financial protocol.

 

17.0       Reasons for recommendation

 

·         To deliver the vision of a ‘Smokefree Generation’, in line with national guidance for this funding and to help deliver North Yorkshire Tobacco Control strategy 2015-2025

·         To improve access to Living Well Smokefree, by expanding provision and support within communities across the county

·         To improve outcomes for priority populations, which in turn will have a positive impact on reducing inequalities within smoking prevalence, and subsequent health outcomes.

 

14.0     Recommendation

 

To seek approval from the Executive Member for Health & Adult Services following consultation with the Director of Public Health and Corporate Director for Health & Adult Services, to authorise the acceptance of the Section 31 grant funding from the Department of Health and Social Care to support the vision of creating a ‘Smokefree Generation’.

 

 

 

Name and title of report author

 

Dan Atkinson, Public Health Manager

Andrew Stewart, Public Health Officer

Katie Needham, Public Health Consultant