Transcript to the presentation (Powerpoint or viewer needed)

What’s hot and what’s not –
commissioning and delivering stop
smoking services in England
Melanie McIlvar, Director NCSCT
UKNSCC, Friday 13th June 2014
Presentation overview
• Commissioning of services – key findings from
national commissioner survey
• Delivery of services – key findings from provider
reviews
• What service users have told us
Acknowledgements
• Public Health England
• Tobacco control commissioners who responded
to the survey
• Stop smoking service providers involved in the
reviews
• Jo Locker, PHE
• Andy McEwen, NCSCT
• Jennifer Potts, NCSCT
Commissioning
Commissioning of services
National survey of tobacco control commissioners
undertaken in early 2014 to:
• Establish the nature of commissioning arrangements in
place for stop smoking services at present
• Investigate the range of different commissioning
models in place
• Identify the nature of targets set (2013/14), intentions
for 2014/15 targets and targets for priority groups
• Gain insight into payments awarded to providers
Commissioning of services
• Survey sent to every local area (n=152) via a Survey
Monkey link
• Open between 20th January – 26th February 2014
• Final response rate = 49% (n=74)
Survey responses by region
Current commissioning
Every responding area reported commissioning services for
2013/14
• 30% (n=22) through block contracts
• 31% (n=23) multiple providers individually commissioned with
specific targets
• 14% (n=10) large number of community providers directly
commissioned with no specific target
Commissioning intentions
The vast majority (85%, n=56) intended to go through a service
commissioning process for 2014/15
•Same provider and model = 51% (n=35)
•Same model but retendering providers = 7% (n=5)
•Different commissioning arrangements = 24% (n=16)
Reasons for not re-commissioning in 2014/15:
•Existing contract until 2015/16
•Integration with ‘lifestyle services’
Outcome measures
Outcome measures
Priority groups
Outcomes for priority groups reported by:
• 81% (n=59) 2013/14
• 82% (n=54) 2014/15 (intended)
• Black, Asian and Minority
Ethnic
• Routine and manual workers
• Unemployed
• Those living in deprived areas
• Young people
• People with mental heath
difficulties
• Prisoners
• Pregnant women
• People with long-term
conditions
Payment schedules
Outcome
Payment range Respondents
(£)
n (%)
Pre-quit assessment session completed
5 - 20
10 (14)
Quit date set
5 - 30
18 (24)
Post-quit sessions (3 weeks)
2.50 – 5 per session
3 (0.2)
Self-reported 4-week quitter
7.66 - 254
39 (53)
CO-validated 4-week quitter
5 - 254
40 (54)
-
35 (47)
Enhanced payments
Medication provision
1st line varenicline and
combination NRT
Combination NRT as standard
Potential developments
• Limiting access 11% (n=8)
• Harm reduction activities 35% (n=25)
Interventions for users of unlicensed nicotine containing
products
• 24% (n=17) already commissioned services to provide
behavioural support
• 70% (n=50) do not currently commission support
• 6% (n=4) didn’t know
Delivery of services – key findings
from provider reviews
The “hot” and the “not”
NCSCT Service Provider Review
Patient data assessment
Involves accessing patient data to verify four-week quit rates and
measure customer satisfaction via a short telephone interview.
Provider assessment
Involves a self-completion questionnaire to be filled out by the
provider and signed off at manager level.
Report (review outcome)
Issued to the provider / commissioner
NCSCT Service Provider Review
Delivery of services
Amber / red rating
Session time
Staff training
Lost-to-follow up
Quit rate
CO rate
Number of sessions
% (n)
72.7 (8)
54.5% (6)
54.5 (6)
45.5 (5)
45.5 (5)
27.3 (3)
Delivery of services
Support based on
a protocol
Access to
medications
CO testing
Quit rate
Weekly
sessions
Likely to be very
satisfied with the
service
Client satisfaction
“My advisor was
incredibly helpful
and supportive”
“Lovely people…a
great service”
“Very happy, great
support, really liked
seeing the advisor
each week”
“It was an
excellent service
... all the advisors
were very helpful”
“Very
disappointed as
was ready to quit
but heard nothing
after being
referred”
“Very impressed
with the service”
“The guy I saw, he
left – and then the
service didn’t get
back to me”
Data verification
• 943 clients spoken to
• 71.6% contacts verified
• Verification rate ranged from 94% - 29%
Reasons for non-verification
Summary
• Remains variable and change continues!
• Stop smoking services, four-week quit outcomes and priority
groups are still a focus
• Services continue to be well regarded by their users
• Inconsistency in service delivery
• Good opportunity to revise what the local minimum standards
for service delivery are (commissioners)
• Providers need to consider how they can meet minimum
standards
• Data accuracy requires on-going assessment
• Importance of independent review
[email protected]
www.ncsct.co.uk