COMMISSIONING A NEW STOP SMOKING SERVICE CONTRACT: Leicestershire and Rutland’s experience

Hello, my name is  Aaron W. Bohannon MPH, CHES  Senior Public Health Manager  Leicestershire County Council, Public Health Department. Also commission on behalf of Rutland County Council  Cancer and Tobacco Control lead

Background  Leicestershire County Council (LCC) is a rural two- tier county council. LCC commission services on behalf of Rutland County Council; which is also rural but a Unitary authority.  Like many (most?) health departments in England, LCC is still adjusting to life in the local authority (LA) and the budget situation before us.

Background con’t  As a result, we are engaging in a structured process of procurement for all contracts and planning for future commissioning.  As part of that planned procurement, the Stop Smoking Service contract was up for renewal.  We took this as an opportunity to make some changes to the contract.

A word from our sponsor…  Before I continue, let me just say that this presentation is aimed at, and intended for, commissioners. I understand there may be providers in the room and that is fine.  I also appreciate that there may be some strong feelings about aspects of this presentation.  I’m happy to answer questions but please let’s keep this professional.  Thank you.

Intent…  Lengthen the contract/ funding period  Reduce our financial vulnerability without putting it all on the provider  Improve value for money  Contribute to local market development

The “old” spec  100% Block*  Year on year  4WQs  No “teeth”

Changes…  The revised service spec had a few notable changes to previous LCR specs:  Moved from year on year to  Moved from 100% block contract to include an annually* increased Payment by Result (PbR) element.  Maintained 4 week quits as a measure and added 12 week quits. Linked 4 performance measures to PbR – 4WQ, 12WQ, HIQ and CO validation  Focused on robust CO validation  Required NCSCT accreditation within 12 months of award

Reactions were, um, mixed…

But not all bad…

The Process  As this was new for me/ us, we opted for a 2 stage process to manage potential interest.  In case you’re unfamiliar the 1 st stage was expressions of interest and the 2 nd was invitations to bid.  The first stage saw quite a bit of interest from both expected, and a few unexpected, providers.  The second stage we invited 6 of those to bid.

The Process con’t…  At this point something odd (to me anyway) happened. Not everyone who expressed an interest and was invited to bid ended up bidding.  Once bids were reviewed and scored, and following interview, an offer was made.  The new contract started 1 April this year.

The Transition  Most of the previous staff TUPE’d over.  I’m pleased to say that the previous provider worked well with the new provider to enable a relatively smooth transition.  Given that it’s a new provider, I would have expected a slight dip or at least a plateau in Q1.  Comparing April and May this year to same time last year, the numbers accessing the service and the number of quit dates set are up from the same time last year.

Food for Thought…  Know the market and your local needs  The market isn’t perfect but don’t be afraid.  Speak to other commissioners but make your decision locally  100% block contracts are no longer fit for purpose.  Our academic leaders really need to start giving us more evidence on 12 WQs  Appreciate Tobacco Control and cessation’s place within it

E: P: Aaron W. Bohannon MPH, CHES