Purpose

Proposed
Decision:
 
APPROVE the commissioning and
implementation of a new service model for physical activity for
older people and AGREE to enter into a Memorandum of
Understanding with Active Kent to administer the grants through
delivery organisations until March 2029.
 

Background

Since 2015, Kent County Council (KCC) have
commissioned aphysical
activity service for older people, known as the ‘Postural Stability Service’.

The service is for anyone aged 65 or older and those
aged 50-64 years who are judged by a health professional to be at
higher risk of falling.

The service aims to:

·        
Improve balance strength, mobility and confidence to
reduce the risk of falling

·        
Increase knowledge and awareness of causes of falls,
and potential resultant injury, and the benefits of exercise and
good nutrition

·        
Reduce hospital emergency admissions due to
falls.

The Service is delivered in recent years by two organisations. In East Kent,
the service was provided by Kent Community Health Foundation Trust
(KCHFT) (ceased in March 2025), and in West
Kent by Involve.

In 2024 a decision was taken by KCHFT to cease this
arrangement and not continue to offer this service post March 2025.
This means that until a decision is made on the future of the
Postural Stability Service, and the new model is in place,
residents in East Kent are being signposted to other providers of
local activities via links on the KCHFT
Falls Prevention Service
webpage. This includes links to KCC’s
‘Get
moving’ webpage,
Everyday Active Kent, Age UK, KCHFT
“One
You Walk and Talk" and
Active Kent and Medway, where people can see what is on offer in their district.
Residents also have the option to receive a DVD of exercises from
KCHFT or view an online (internet) exercise class.

In July 2023, KCC initiated the Public Health
Service Transformation Programme (PHSTP). The programme responded
to a series of strategic developments, challenges, and
opportunities in the commissioning landscape, and is underpinned by
an evidence-based review of all internal and external Public Health
funded services and grants.

As part of the PHSTP, market, stakeholder and public
engagement has been undertaken. All responses and contributions
from engagement has been analysed and informed future service
delivery.
 

Reason for Decision:

 
There
is a well-established and evidenced understanding of the need for
all adults, including older and frail adults, to maintain physical
activity for as long as possible to delay the onset of disability,
long-term health conditions, and remain independent as long as
possible.

Regular physical activity contributes to the key
determinants of healthy ageing:

·        
Good physical and mental function

·        
Opportunities for social interaction

·        
A sense of control over, and the responsibility for
one’s own health and well-being

·        
Managing or coping with disease symptoms and
functional limitations. 
 
Under
the Care Act, KCC is obliged to provide or arrange for services,
facilities or resources which would prevent, delay, or reduce
individuals’ needs for care and support. Within the Care Act
statutory guidance, secondary prevention or early intervention, is
defined as more targeted interventions aimed at individuals who
have an increased risk of developing needs, where the provision of
services, resources or facilities may help slow down or reduce any
further deterioration or prevent other needs from
developing.
 
KCC
also has a statutory duty to improve the health of the population
and reduce health inequalities (Health and Social Care Act 2012).
KCC receive a ringfenced Public Health Grant to meet this statutory
duty and annually report to Government on how this Grant has been
allocated.

Physical activity services for older people supports
the Council to achieve priorities set out in ‘Framing
Kent’s Future’ and ‘Securing Kents Future’
and plays a vital role in ensuring the effective and timely
provision of preventative services which can help meet key
priorities:

·        
Play a key role in the delivery of early
intervention and prevention strategies

·        
Reduction in health inequalities

·        
Reduction in the number of emergency hospital
admissions due to falls in older people

·        
Increase in the percentage of adults who are
physically active

·        
Increase strength, balance and exercise education
and activities for older people

·        
Enable people to remain independent for longer,
enjoy a better quality of life and delay the onset of
disability.
 
As part
of the PHSTP, a proposed new commissioning/service model has been
developed to better serve Kent’s changing
population.
 
The new
approach will include providing more classes in more locations
across Kent, particularly in communities that would benefit the
most.It is proposed to offer support to those
aged 50 and older and include shorter, more intensive courses to
increase the course completion rate. This will enable more people
to get onto the course and complete it and it is anticipated that
this will fit better with peoples’ lifestyles and commitments
outside of the course.
 
Instead
of commissioning two organisations to provide the service in the
East and West of the county it is proposed services are delivered
via a new grant system. This will allow various organisations to
apply for grant funding to provide evidenced based, desirable local
activities closer to where people live, contingent on meeting
service requirements.
It
is proposed to enter into a Memorandum of Understanding (MOU) with
Active Kent to administer and manage the grant process and ongoing
management of the service.

Options (other options considered but
discarded)

Keep current service the same -
Keeping the current service model was concluded as a
non-viable option, due to the service currently
havinga high drop-out rate attributable in
part to the length of the programme at 36 weeks, and the
age/health/vulnerability of the target population. The current
serviceis unable to meet current need and is
unable to support enough people to have a significant impact on
falls.

Discontinue all elements of the service
- Decommissioning the service was
concluded as a non-viable option, due to frailty and falls being a
key issue in Kent. Physical activity services for older people
supports the Council to achieve priorities set out in Framing
Kent’s Future and Securing Kent’s Future and the Kent
and Medway Integrated Care System to achieve key outcomes set out
in the Integrated Care Strategy. The service plays a key role in
supporting KCC to reduce health inequalities and improve the health
of the Kent population.

How the proposed decision meets the priorities of
New Models of Care and Support as set out in ‘‘Framing
Kent’s Future – Our Council Strategy 2022 –
2026’’

Physical Activity Service’s for Older People
supports the Council to achieve the following
priorities set out in the Council’s Strategy 2022-2026
‘Framing Kent’s Future’:

Priority 1: Levelling up Kent

To see
significant improvements in the economy, connectivity, educational
attainment, skills and employment rates and public health outcomes
in deprived communities in coastal areas so that they improve
faster than the rest of Kent to reduce the gaps
To
work with our partners to hardwire a preventative approach into
improving the health of Kent’s population and narrowing
health inequalities
Adopt
an unrelenting focus on reducing cardiovascular disease in our
population by continuing to focus on healthier behaviours, stopping
smoking, taking up exercise and healthier eating.

How the proposed decision supports Securing
Kent’s Future

Physical Activity Service’s for Older People
supports the Council to achieve the priorities set out in Securing
Kents Future, by improving balance strength, mobility and
confidence leading to reduced risk (reduction) of falling, which
will decrease the demand and costs in Health and Social
Care.

How the proposed decision
supportsthe Kent and Medway Integrated
Care Strategy
Physical Activity Service’s for Older People supports the
Kent & Medway Integrated Care System to achieve the following
outcomes set out in the Integrated Care Strategy:

Helping the most vulnerable and disadvantaged in society to
improve their physical and mental health; with a focus on the
social determinants of health and preventing people becoming ill in
the first place
Helping people to manage their own health and wellbeing and be
proactive partners in their care so they can live happy,
independent and fulfilling lives; adding years to life and life to
years.

Financial Implications

The new service length will be:

·        
Annual MOU with Active Kent, which will be reviewed
and agreed annually. This approach will be in place until 31 March
2029.

The estimated cost to KCC Public Health from 1 April
2026 – 31 March 2029 is £507,800. This will be funded
from KCC Public Health’s ringfenced grant.

Financial Year

KCC Public Health Funding

26/27

£169,400

27/28

£181,700

28/29

£156,700

Total

£507,800

 
 

Decision

As Cabinet Member for Adult Social Care and Public
Health, I agree to:
 

(a) 
APPROVE the
commissioning and implementation of a new service model for
physical activity for older people

 

(b) 
AGREE to enter into a
Memorandum of Understanding with Active Kent to administer the
grants through delivery organisations

 

(c) 
DELEGATE authority to
the Director of Public Health, in consultation with the Cabinet
Member for Adult Social Care and Public Health to review and agree
the annual MOU with Active Kent until 31 March 2029, providing it is on similar terms

 
(d) DELEGATE authority to
the Director of Public Health to take necessary
      actions, including but not limited
to entering into required contracts or other
      legal agreements, as
required to implement the decision.