The North Yorkshire Council

 

Health and Adult Services

 

Executive Member Meeting

 

31st March 2025

 

REPORT TO the Assistant Director of Resources, in consultation with the Executive Member for Finance and the Executive Member for Health and Adult Services

 

Smokefree generation funding – 2025 to 2029

 

1.0          Purpose Of Report (required)

 

To recommend that the Assistant Director -Resources in consultation with Executive Member for Finance and the Executive Member for Health and Adult Services confirm that the grant funding in the amount of £642,891 be accepted. Being the second year of North Yorkshire’s share of £70 million national funding to help to create a smokefree generation and support people to stop smoking. This funding has been identified to invest in local stop smoking services over a 5-year period starting in 2024-25.

 

Funding per Local Authority area has been calculated based on local smoking prevalence. North Yorkshire’s funding for 2025-26 has been identified as c£642k. A key decision is needed in order to enable the Local Authority to accept this grant funding.

 

 

2.0          Executive Summary

 

This Section 31 national funding supports the Government’s aims to create a smokefree generation and follows on from previous reviews undertaken to understand progress against previous targets (e.g., Smokefree 2030). A key decision is being sought to accept year 2 of the Smokefree Generation funding and utilise it locally.

 

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 maintain the current spend on the service based on the financial year 2022/23.

 

The year 2 investment plan for this funding will look to build on the first year of delivery in 2024-25, bringing additional capacity to both frontline advisors and staff focussed on priority population groups in the local stop smoking service, Living Well Smokefree.  We have also delivered work across directorates in North Yorkshire Council, to look at capitalising on opportunities post-LGR, in addition to regionally via the wider Humber and North Yorkshire Integrated Care System Centre for Excellence in Tobacco Control based in the Integrated Care Board.

 

Both the equalities and climate change impacts of this funding have been completed in 2024 using the North Yorkshire Council screening templates, as well as the full assessments where needed. This funding provides an exciting opportunity to engage with a cohort of smokers who have traditionally not linked in with stop smoking services, which in turn will hopefully help reduce the health inequalities experienced by these groups.

 

 

 

3.0          Background

 

This report is to be read in conjunction with the previous HASEX report from March 2024 to accept the initial grant funding. The report can be found here.

We are about to enter the second of five planned years of additional investment of £70million across England. Funding per Local Authority area has been calculated based on local smoking prevalence – with £642k being identified for North Yorkshire Council for 2025/26. This is an uplift of £10k from the current financial year’s allocation. The funding allocations are based on the average smoking prevalence over a 3-year period between 2021 and 2023.

Payments will be given to Local Authorities in two instalments across the financial year. Local Authorities are required to meet certain criteria to be eligible for this addition funding. This includes the need to maintain investment in the local stop smoking service from the Public Health grant at baseline level from 2022/23.

 

Work is underway to update the spend plan for this second year’s allocation to ensure that the funding can meet the overarching principles set by the DHSC of increasing capacity within services, building demand for these services and ensuring appropriate leadership is in place.

 

The ambition is to build on what has been a positive, yet incredibly busy, first year of utilising this additional funding within the local stop smoking service, Living Well Smokefree. The plan was to utilise this initial year to create a strong foundation of work, which could be built on moving forward. A summary of the work undertaken within 2024/25 includes:

·         Increased the specialist capacity to provide leadership across each of the priority population groups within tobacco control. A focus has been given to priority populations due to the known impact smoking can have on these groups due to higher-than-average smoking prevalence often associated with these groups. This can include, although not exclusively, people living with severe mental illness, those working in routine and manual occupations, smoking in pregnancy and those living in social housing.

·         Increased the number of Stop Smoking Advisors across the county to build in additional capacity for increased referrals and throughput into service.

·         Created capacity to be innovative in thinking about how we utilise the role of lived, and living, experience within the local stop smoking service to increase demand for the service and increase capacity in supporting interventions across the county.

·         Funded capacity within the Behavioural Science Unit to work with Living Well Smokefree and ensure we are meeting the needs of priority population groups as they seek to stop smoking, drawing on best practice, evidence and insights.

·         Purchased remote Carbon Monoxide monitors to support the delivery of a hybrid model of support to smokers across North Yorkshire in line with the National Centre for Smoking Cessation and Training (NCSCT) best practice.

·         Purchased Allen Carr Easyway licenses to offer an additional route of quitting for smokers who have previously gone through traditional support within local stop smoking services.

·         Connected with existing work underway around Cardio-Vascular Disease (CVD) and Health Checks within the Active North Yorkshire Service, recognising the links between these agendas and the opportunities to promote stop smoking services to target population groups.

·         Developed an infrastructure to formalise the delivery of Very Brief Advice training from the local stop smoking service to partner organisations to better upskill the system so that partner organisations can play their part in referring people to stop smoking services and supporting them on the journey to quitting.

·         Focused on workforce development within the local stop smoking service around trauma-informed working and basic Cognitive Behavioural Therapy interventions to help work with priority population groups.

·         Strengthened our approach to communication campaigns by creating a bank of resources aimed at increasing referrals into the stop smoking service.

·         Contributed to the work within the regional Centre for Excellence for Tobacco Control which includes targeted interventions, population-wide campaigns, and workforce development.

Work is starting to look at how this new funding for 2025/26 will be applied within North Yorkshire. The majority of the funding will be utilised to continue recurrent opportunities embedded within the first year of delivery. Work will be coordinated to ensure any identified underspend for 2025/26 can be apportioned appropriately to continue the high level of work delivered by the local stop smoking service and wider system.

 

4.0          Issues

 

A key decision is required to ensure that the Local Authority can accept this grant funding. We are still awaiting the full Grant Agreement outlining the terms of this funding, but it will be delivered to Local Authorities via a Section 31 grant. The implication that we are awaiting an ‘agreement’ also suggests that we can accept or decline this funding. One condition of the funding that we are already aware of is that if North Yorkshire Council agree to take this funding, we 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. Terms of the grant reflect that it should not be used to deliver enforcement activity.

 

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. This approach takes the total number of additional quit dates and distributes them as a proportion across each local authority area. It also factors in a gradual increase of set quit dates with an expectation of what these numbers will look like over 5 years of the programme. These figures are for local authorities to measure their performance against, whilst scaling up services and delivering quits needed to meet ambition.

 

A methodology has been applied to support understanding of what this ambition means for local areas. For North Yorkshire Council, this is modelled into the following trajectory of set quit dates:

 

 

Year 1 Total

2024/25

Year 2 Total

2025/26

Year 3 Total

2026/27

Year 4 Total

2027/28

Year 5 Total

2028/29

1,592

2,030

3,345

3,783

3,783

 

 

 

 

 

 

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 & 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 12 months to garner a range of views of how best to implement this funding locally to have maximum impact in the county. The plan for the second year of delivery remains in draft and 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, 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, we have already begun exploring the opportunities post-LGR with relevant directorates across the council, e.g., housing and leisure. This is in addition to redefining how we can work closely with voluntary and community sector (VCS) organisations. It is also widely demonstrated the impact that stopping smoking can have across the wider Local Authority and healthcare system through system’s savings.

 

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

 

The acceptance of this grant funding will continue to cover the expansion of the workforce within the local stop smoking service. These new posts have been appropriately costed into the application, as per standard corporate financial protocol. Any HR issues arising out of any future reduction in funding would be addressed through the Council’s usual Reorganisation and Redundancy policy.

 

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 4 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. An Equality Impact Assessment was completed for the initial acceptance of this grant funding in 2024.

 

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 (completed for the initial acceptance of this grant funding in 2024), 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

 

No additional impact on the ICT systems in place within North Yorkshire Council to support the local stop smoking service.

 

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 request approval from the Assistant Director of Resources, in consultation with the Executive Member for Finance and the Executive Member for Health and 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’.

 

 

 

 

BACKGROUND DOCUMENTS: HASEX Report 2024

 

 

Dan Atkinson, Public Health Manager

Naomi Smith, Head of Health Improvement