Agenda item

Sue Mullin, Associate Director: Children’s Mental Health, K&M ICB, Mark Atkinson, Director of Commissioning, K&M ICB and Sara Warner, Engagement lead, NHS Kent and Medway were in attendance for this item.

1.    Ms Mullin introduced the item, providing a summary of the procurement work undertaken to date. Members had received an informal briefing on the topic in February 2024. There were three main elements to the future contract:

a.    Specialist (tier 3) (currently provided by NELFT)

b.    Education (tiers 1-2) (NELFT currently provide the mental health support teams in schools)

c.    Therapeutic services (tiers 1-2)

2.    A Member asked what additional support could be provided at the lower tiers to prevent young people escalating to tier 4. Ms Mullin reflected that improvements had been made and fewer young people were going into, and staying at, acute hospitals. Services in Medway had aligned investments in an integrated way which had resulted in a reduced demand for tier 3 services. It was proposed that the model be replicated across Kent.

3.    It was asked how primary care would be involved in shaping the specification of the tier 1 and tier 2.  Ms Mullin said there had been a considerable amount of engagement, including with primary care clinicians, and the ICB were committed to working with primary care throughout the process. It was noted that there would be grants available for local people to commission local services. This would sit alongside the children’s navigators and the mental health practitioners who were now available across Kent. Resources would be drawn from a range of partners including the NHS, local authorities, schools and others.

4.    National investment would result in budget growth of the Mental Health Support Teams in schools from £6 million to £9 million by 2028. A Member queried how that service would be delivered as they felt youth services were best placed. Ms Mullin responded that the schools element of the contract was delivered under a national framework and spend was ringfenced to that area. Future providers would be expected to engage with other services, including Family Hubs.

5.    A 13-year contract duration would allow data to be tracked across the lifetime of the contract. Ms Mullin confirmed there would be break clauses built in along with periodic reviews.

6.    A Member noted that certain groups of children were not specified as vulnerable, such as those from Gypsy, Roma and Traveller (GRT) communities, children in kinship relationships and foster children. Ms Mullin advised that there was not an adequate level of data available to understand where gaps in provision were but the new contract would support data collection. There would be work on providing alternatives to enable GRT children to access support following feedback.

7.    Members were concerned about performance against the 18-week target. Ms Mullin accepted that and noted an assessment of risk was conducted at a patient’s first point of contact and could be carried out again if their situation changed before their first appointment.

8.    Members noted the relevance of the update paper for other Council Committees, such as CYPE Cabinet Committee and the SEND Sub-Committee.

9.    Mr Streatfeild proposed and Mr Chard seconded that the Kent and Medway Children and Young People's Mental Health Services procurement represented a substantial variation for the residents of Kent. 

10.The Chair provided a summary of the main points of the discussion and the areas the Committee would like further information on. This included:

a.    the different ways of working across Kent and Medway once the Family Hubs model was rolled out,

b.    how care navigators would operate on a practical basis,

c.    how the young person’s voice was being heard,

d.    the involvement of primary care and how the council could support information sharing.

11.RESOLVED that

(a)  the Committee deems that the procurement of CYPMHS in Kent and Medway is a substantial variation of service.

(b)  NHS representatives be invited to attend this Committee and present an update at an appropriate time.