To receive a report from the Cabinet Member for Specialist Children’s Services and the Corporate Director of Social Care, Health and Wellbeing, and to comment and endorse or make recommendations to the Cabinet Member on the proposed decision to extend the Children in Care element of the mainstream Children and Young People Mental Health service contract.
Mr T Wilson, Head of Strategic Commissioning, and Ms C Infanti, Commissioning Officer, were in attendance for this item.
1. Mr Wilson introduced the report and explained that it was proposed that the Children in Care element of the Children and Young People’s Mental Health contract and the current contract for the Emotional Health and Wellbeing service be extended for one year to align with the current mainstream Children and Young People’s Mental Health service contract. Both contracts would then come to an end at the same time. The clinical commissioning groups had taken this decision as the commissioners of the Children and Young People’s Mental Health service. The two services could then be remodelled jointly and re-commissioned. In discussion, Members made the following comments:-
a) the chance to review and remodel services was welcomed and, to start this, the County Council should first identify what was needed as part of the service. Responsibility for the service should move from NHS England to the County Council;
b) Kent’s Children in Care currently received a good Mental Health service, whereas it was seen that other young people did not, as there had been delays in accessing timely assessment and treatment from the mainstream service, so the recommendation to support and endorse the extension of contract did not have the universal support of the committee;
c) the issue should remain on the committee’s agenda for regular monitoring until the service was judged to be right. The issue should also be referred to the Health and Wellbeing Board for its attention;
d) the County Council needed to take a robust stance with the Secretary of State about the difficulties of commissioning suitable services. The four tiers of service were delivered by four different providers. There should be a single, coherent, unified commissioning service for local authorities to work with. The Cabinet Member for Specialist Children’s Services, Mr Oakford, undertook to write to the Secretary of State on behalf of the committee, and this offer was generally accepted. The Health Overview and Scrutiny had written to the Secretary of State in the past about the Children and Young People’s Mental Health service, as part of the in-depth review of the service that it had been asked by this committee and the Corporate Parenting Panel to undertake; and
e) although two speakers had expressed their lack of support for the recommendation in the report, it was pointed out that the proposed extension to the existing contract would allow more time for the challenges of the service to be worked through and for the service to be improved. The shortcomings of the service were well known and had been the subject of much past discussion at committee, and there was still much work to be done to address the historic lack of investment in the service. The consequences of not extending the contract were set out in the report, so there was no real alternative to supporting the extension and moving ahead with improvement work. Mr Wilson reminded Members that much work had been done to improve the performance of the service and waiting lists had been reduced, in line with the targets set out in the existing contract.
2. The recommendation set out in the report was then put to a vote.
Carried 11 votes to 2
3. RESOLVED that:-
a) the extension to the contract for the mainstream Children and Young People Mental Health Service, already agreed by the Clinical Commissioning Groups, be noted;
b) the proposed decision to be taken by the Cabinet Member for Specialist Children's Services, to extend the Children in Care element of the mainstream Children and Young People Mental Health Service contract, and the Emotional Wellbeing Service contract, be endorsed, taking into account comments made by this committee;
c) officers engage with service providers to update the contract specifications to reflect feedback from practitioners and young people;
d) the Cabinet Member for Specialist Children’s Services write to the Secretary of State, on behalf of the committee, to express the concerns set out in paragraph d) above; and
e) the report made to this committee be also referred to the Health and Wellbeing Board.