AGENDA ITEM

REPORT TO CHILDREN AND YOUNG PEOPLE’S

HEALTH AND WELLBEING COMMISSIONING GROUP

17 APRIL 2014

REPORT OF STRATEGIC COMMISSIONER/HEALTH IMPROVEMENT SPECIALIST OF PUBLIC HEALTH

STOCKTON ON TEES HEALTHY WEIGHT SERVICE REVIEW 2014-2015

APRIL 2014 UPDATE

SUMMARY

This paper provides the group with an overview of the process to be undertaken regarding review of services that are commissioned by the Local Authority to prevent and provide tier 2 intervention regarding overweight and obesity. It also provides a summary of the steps to be taken to consult with the public and stakeholders about how the needs of the population are best met.

This paper is the first project update to the group following the initial paper presented in December 2013. This paper describes project activity and defines timescale and consultation methods.

BACKGROUND

  1. As described in December 2013, Stockton Borough Council Public Health is responsible for the commissioning of non-specialist prevention and treatment services for obesity
  2. “It is clear that the financial costs of obesity are high and rising rapidly as the prevalence of obesity increases. We have argued that the costs are probably much higher than previously thought because of significant employment effects associated with obesity. Making precise or comprehensive estimates of the costs is difficult but they certainly amount to many billions of pounds per year. Healthcare costs are a minority of the total costs associated with obesity, which underlines the need for co-ordinated action that extends beyond the NHS in tackling obesity.”[1]
  3. A project has been implemented that plans and delivers service reviews, public consultation, service model design and procurement
  4. The Policy, Engagement and Improvement and the Procurement teams are working closely with public health to guide and quality assure the process
  5. The project aims to have in place a new service specification / model for Adult & Children’s Tier 2 Weight Management by the 1st April 2015

RECOMMENDATIONS

  1. That the group notes and approves the updated programme of work described in this paper
  2. That the group notes the renaming of the project to “Healthy Weight Service Review 2014-2015”
  3. That the group note the recommendations of the MoreLife Service Review – See Appendix B

DETAIL

  1. PROJECT APPROACH: The Stockton on Tees Healthy Weight Service Review is applying Prince2 project management methodology to complete a programme of work. A project structure is in place led by a steering group that contains representatives of SBC and HBC Public Health teams, the North of England Commissioning Support service and Public Health England. The steering group is chaired by Emma Champley (Strategic Commissioner)
  1. SCOPE & MILESTONES: The current services commissioned by Public Health and directly included in this review are:

Figure 1.

Commissioned Service / Provider / Current Contract End Date / Value
*Health Trainer Service
Tier 2 / North Tees & Hartlepool NHS Foundation Trust / 31 Mar 2015 / £443,449
*More Life – Children & Young Persons Weight Management Service
Tier 2 / More Life / 31 Mar 2015 / £48,096.33
*Lite 4 Life – Adult Weight Management Service
Tier 2 / Tees Active / 31 Mar 2015 / £106,000

Figure 2.

Milestone / Timescale / Status
Convene Project Steering Group / FEB 2014 / COMPLETE
Convene Project Task Group / JAN 2014 / COMPLETE
Briefing to Cabinet Member (JB) / FEB 2014 / COMPLETE
Communications & Consultation Plan Completed / FEB 2014 / COMPLETE
Service Review – Adult Weight Management Service / MAR 2014 / COMPLETE
Service Review – Children’s & Young People Weight Management Service / MAR 2014 / COMPLETE
Service Review – Health Trainer Service / APR 2014 / ONGOING
Service Review – Specialist Weight Management Service / COMPLETE / COMPLETE
SBC Resident & Stakeholder Consultation / MAR – MAY 2014 / ONGOING
Market Engagement Event / 29 APR 2014 / On Track
  • Consultation Findings
  • Service Review Findings
  • Draft service specification / pathway / model
  • Procurement Options
Recommendations to AHWCG / 24 JUN 2014 / On Track
Commence Procurement / JUL – AUG 2014 / On Track
Contract Award / 01 DEC 2014 / On Track
Service Start Date / 01 APR 2015 / On Track

KEY AREAS FOR CONSIDERATION

Through analysis of ward level data and MOSIAC profiles it is evident that in order to engage with certain identified communities a more targeted approach to consulting these communities should be used. Wards that have been identified are Mandale and Victoria, Newtown, Norton South, Parkfield and Oxbridge, Billingham East. Hardwick, Roseworth and Stockton Town Centre. Public health have funded NEMS market research will consult with 400 residents through face-to-face interviews at the resident’s home. The sample profile would replicate the demographic profile of the 18-64 year old adult population and Quotas will be set on gender, age and ethnicity to help ensure a representative sample.

CONSULTATION

  1. Consultation has been planned and implemented with support from the Policy, Engagement and Improvement team of SBC
  2. SBC consultation process is being adhered to and a summary of consultation aims, methods and audiences can be viewed in Appendix A

MARKET ENGAGEMENT

  1. A market engagement event has been arranged for the 29th April 2014. The event will be advertised through the SBC ProContract system which will ensure a wide range of local and national providers are made aware

FINANCIAL IMPLICATIONS

  1. With the intention of a new service / pathway commencement 1 April 2015, the current commissioned services (see figure 1) directly affected are subject to a new Public Health contract for a 12 month period from 1 April 2014 until 31 March 2015
  2. The 2014-2015 costs for these services are recurrent and accounted for within the public health budget
  3. The Specialist Weight Management Service, as described in the paper that came to the group in October 2013, is to be decommissioned and has been given notice. The responsibility for commissioning this Tier 3 service now sits with the local Clinical Commissioning Group
  4. Through the process of service mapping, design and public consultation, the financial impact will be assessed. A service / model cost will be presented in June 2014
  5. The project does not aim to request additional investment above and beyond current contract values of the services involved
  6. It is hoped that financial savings can be achieved through either service development and streamlining / market testing / market competition
  7. Current Contract Values – see figure 1

LEGAL IMPLICATIONS

  1. All decisions must be made in line with contractual obligations
  2. Any TUPE implications must be considered and discussion with SBC HR has commenced to assess risks
  3. Stockton Borough Council procurement process with be adhered to
  4. Support for the project around procurement is being provided by the SBC procurement team

RISK ASSESSMENT

  1. A risk log is in place and is to be maintained for the life of the project. All risks are reviewed by the steering group
  2. risk and will require negotiation with both provider and fellow commissioners

NEXT PROGRESS UPDATE – 24 JUNE 2014

Name of Contact Officer:Claire Spence

Directorate: Public Health, SBC

Telephone No: 01642 528475

Email Address:

APPENDIX A

Healthy Weight Services Review 2014-15

Consultation Summary

Background:

Stockton on Tees Public Health is responsible for the commissioning of Tier 2 Weight Management Services. These services must meet known local need and prevalence.

As per SBC procurement method, the services should be considered for market testing if appropriate.

The Joint Strategic Needs Assessment (JSNA) for Stockton tells us that there remain some significant health and wellbeing challenges for Stockton-on-Tees:

  • Levels of deprivation are higher and life expectancy is lower than the England average
  • There are some marked differences in ward areas where these issues are more pronounced
  • Levels of heart disease, cancer and respiratory illness remain high leading to early death
  • There are a number of 'unhealthy' lifestyles which leads to preventable disease.
  • Health inequalities continue to exist with the gap in life expectancy between wards continuing to increase”

From the same JSNA, for children and young people, we know that:

  • Levels of obesity are similar to the England average with 10% of children in Reception and 20% of children in Year 6 classified as obese
  • Estimates of adult “healthy eating” and obesity are worse than the England average.
  • Known levels of obesity are higher than the England average

Therefore, within the health & wellbeing strategy we state what we will do:

  • Improve the rates of childhood obesity
  • Reduce levels of obesity

SBC Public Health is running the Healthy Weight Services Review 2014-15Project which includes:

  1. A mapping exercise of the current commissioned services – Due to be complete March 2014
  1. A 12 week consultation running 3rd March 2014 until 31 May 2014, engaging with residents and providers in Stockton on Tees for their views on how we can challenge and address obesity in a way that reflects local need and is well designed for future sustainability.

Proposed methods of consultation:

  • General Resident Survey – whole population
  • Face to Face & Telephone Surveys – targeting a minimum of 400 individuals from within groups identified utilising mosaic data and Viewpoint findings
  • Stakeholder Focus Groups – Convening stakeholders with interest in Adult and / or Children & Young People’s weight management

Key Stakeholders / Groups / Targeting / Consultation Method
General Public – Residents of Stockton on Tees / Media
Social Media
Networks / Online Survey
Hard Copy Survey
Access to online / hard copy surveys in Libraries
From 3rd March 2014
General Public – Residents of Stockton on Tees / 400 residents from four mosaic groups that are identified at greatest risk / hardest to engage in weight management / Face to Face Survey delivered by NEMS (provider)
Due for completion by end of April 2014
Children and Young People (including Young Residents) / Loud and Clear: Young Peoples Sounding Board
Members for Youth Parliament
Young Inspectors
LAC
School aged children
Young People with complex needs
Young Carers / Focus group – Young Peoples Sounding Board meeting scheduled for May 2014 - TBC
Focus Group with ERT / Youth Group – scheduled for May 2014 - TBC Face to Face
Online Survey
Parents and Carers / Eastern Ravens Trust
SBC supported youth focus group / Online Survey
Hard Copy Survey
Attendance at focus group for young people with complex needs – May 2014
Access to online / hard copy surveys in Libraries
From 3rd March 2014
Schools / Head teachers
Governors
PSHE Leads / Send update email raising awareness of online and hard copy survey - via quarterly head teachers meeting (May 2014)
Online Survey (complete or circulate)
Providers of Adult Services and Children and Young Peoples Services / Adult Service Providers with weight management interest
GPs / GP Practices
Social Work Managers / Social Workers
LSCB Lead
Adult Safeguarding
CAF Lead
Children’s Centre Staff
Educational Psychologists
Targeted Youth Support Workers
Health Visitors
Education Welfare / Attendance
Inclusion Service
Therapies (e.g. Speech and Language)
Therapeutic Services (e.g. TaMHS / CaMHS)
Youth Offending Service
More life / STASH / Sexual Health Services
School Nurses / Attendance at practice managers / GP Lunch & Learn Event (April / May – TBC)
Online Survey (complete or circulate)
Adult & Children’s Stakeholder Focus Group
Invite to go out Friday 14th March 2014
Event Booked for May 1st 2014
Voluntary Sector / Catalyst
Media
Social Media
Networks
Email / Online Survey (complete or circulate)
Adult & Children’s Stakeholder Focus Group
Invite to go out Friday 14th March 2014
Event Booked for May 1st 2014

APPENDIX B

Morelife service review recommendations

  1. The Provider should continue to raise awareness of the service to amongst current referrers, potential referrers and the public.
  2. The Provider should improve the referral rates of young people (11-17yrs).
  3. The Provider should increase the percentage of families who complete the core programme.
  4. In the context of mainstream service the Provider should make reasonable adjustments, when required, to offer an inclusive service for children, young people and parents who have a physical or learning disability/difficulty. The provider should be able to evidence the reasonable adjustments made.
  5. The Provider should consult with previous and existing families about how the service could be improved, specifically regarding the young people’s element, service literature and long term support.
  6. The Provider should improve the collection of follow-up monitoring at 6 and 9 months.

Recommendations for Commissioners

  1. It is recommended that the Commissioners of weight management services and mental health services meet to discuss referral criteria of specific mental health services and identify any potential areas for future development.
  2. It is recommended that Commissioners of tier 2 and 3 weight management services meet to discuss current pathways and identify areas for improvement in relation to the services interaction with each other.
  3. It is recommended that Public Health and the CCG review the support available for children and young people who engage in the tier 2 weight management service but continue to gain weight as this has been raised by the Stockton-on-Tees service as a concern.

[1]Economic costs of obesity and the case for

government intervention

B. McCormick, I. Stone and Corporate Analytical Team

Obesity reviews (2007) 8 (Suppl. 1), 161–164