Public Health expenditure

For the financial year 2015/16, please list methods for assessing the efficacy of the following non-statutory public health functions of the Director of Public Health, including cost-effectiveness, for each of:

Smoking and tobacco – Stop smoking services and interventions Physical activity – adults Obesity – adults Substance misuse – Alcohol misuse

Each of these should specify:

Smoking and tobacco – Stop smoking services and interventions – net current expenditure by the local authority on public health interventions whose intention is to reduce or stop smoking. As part of this, please list:
Net current expenditure on the intervention Number of people who accessed the services Number of people who reduced their smoking or stopped smoking as a result of the intervention

The link to the budget book is here:

https://new.devon.gov.uk/finance-and-budget/budgets/

This sets out the Public Health budget spent within each of the categories that are being requested.

We do not hold information about the number of people who accessed the smoking and tobacco services and those who reduced or stopped smoking as a result. We do not hold information relating numbers of people accessing a service and calculation of cost effectiveness. This is well demonstrated by the smoking example below – spend on smoking covers the service for people quitting but also tobacco control.

Net expenditure on smoking cessation services and interventions, the intention of which are to help people reduce or stop smoking and which are funded or undertaken by Devon County Council,

In 2015/16 Devon County Council funded smoking cessation services in a variety of settings including primary care, pharmacy, maternity and through the specialist stop smoking service. Statistics on NHS Stop Smoking Services April 2015 – March 2016 are available here:

http://content.digital.nhs.uk/catalogue/PUB21162

In addition to the people who accessed stop smoking services in Devon and quit as a result many more will have quit due to tobacco control collaborations with partners locally, regionally and nationally. Expenditure on tobacco control provides good value for money: NICE estimates that for every £1.00 invested £2.37 is saved on treating smoking related disease and lost productivity.

The prevalence of adult smoking in Devon in 2015/16 was recorded as 12.2%, a reduction of 5.5% in a five year period. For further information please see the local joint strategic needs assessment on smoking:

http://www.devonhealthandwellbeing.org.uk/jsna/overview/jsna-2016/living-well/smoking/

Physical activity – adults – net current expenditure by the local authority on public health interventions whose intention is to lead to the taking up of sport on a regular basis. As part of this, please
list:
Net current expenditure on the intervention Number of people who accessed the services Number of people who took up sport on a regular basis as a result of the intervention

Obesity – adults – net current expenditure by the local authority on public health interventions whose intention is to lead to weight loss.
As part of this, please list:
Net current expenditure on the intervention Number of people who accessed the services Number of people who have lost weight as a result of the intervention

Substance misuse – Alcohol misuse – adults – net current expenditure by the local authority on public health interventions whose intention is to diminish alcohol consumption. As part of this, please list:
Net current expenditure on the intervention Number of people who accessed the services Number of people who have reduced their alcohol intake as a result of the intervention

Please also list the metric used to determine cost-effectiveness for each of the above four interventions. If a cost-effectiveness metric is not used, please list any alternative methods for each of the above four interventions.

We do not hold information about the cost effectiveness of the services compared with the number of people who took up the service. Much of our cost effectiveness information comes from national modelled data. Information about the cost-effectiveness on a range of Public Health interventions can be found on the Public Health England website:

https://www.gov.uk/government/organisations/public-health-england

Services locally provided are based on best practice including NICE guidelines and therefore it is reasonable to apply these nationally worked up cost effectiveness models to our interventions.

A big component of our behavioural change service is onesmallstep which people access on line. We do not get the feedback from that as to what changes people have made and the number of people who successfully maintain those changes. Much of the way we will be able to monitor impact will be through some of the ONS data which we report through the JSNA, and monitor through the Public Health outcome report (all available on our website)

The question about physical activity is also something that we can only monitor on a larger scale we do not hold information about number of people who accessed the services and number of people who took up sport on a regular basis as a result of the intervention. There are many funding streams designed to encourage physical activity and data is collected on the number of individuals regularly active, but it isn’t possible to say that a number of people have become more active because of the investment in physical activity – there are often many factors, and it might be that an individual becomes more active as part of a reducing alcohol plan, or losing weight plan.