Proposed decision –. Approval of a revised Section 75 legal partnership agreement with Kent and Medway Integrated Care Board.

Reason for the decision

The current Section 75 Agreement underpinning the Better Care Fund (BCF) was established in 2015 and has successfully supported pooled funding arrangements between Kent County Council (KCC) and NHS Kent and Medway. Since then, legislation, national guidance and the scope of integrated working have evolved. Legal advice has confirmed that the agreement should now be updated to ensure it continues to provide an appropriate and robust legal framework for current and future integrated working arrangements.

Updating the agreement will strengthen governance, financial accountability, risk-sharing arrangements and decision-making between KCC and NHS Kent and Medway, ensuring that pooled funding arrangements continue to operate within a clear and robust legal framework.

The revised agreement will also provide the flexibility to support future integrated commissioning and pooled funding arrangements where appropriate, enabling both organisations to respond to national policy developments, including reforms to the Better Care Fund and the Government's ambition to deliver more integrated, neighbourhood-based health and care services.

Approving the revised Section 75 Agreement will provide greater assurance that public funds are managed effectively, roles and responsibilities are clearly defined, risks are appropriately managed and future collaborative arrangements can continue to develop within a robust legal framework

Background

The Better Care Fund (BCF) is a national programme that supports integrated health and social care through pooled funding arrangements between local authorities and the NHS. Each year, the BCF Plan is jointly developed by Kent County Council (KCC) and NHS Kent and Medway, with expenditure approved through the Health and Wellbeing Board.

The current Section 75 Agreement provides the legal framework for these pooled funding arrangements. Although the BCF Plan and financial contributions are reviewed annually, the underlying Section 75 Agreement has not been substantively reviewed since 2015.

Since the agreement was established, legislation, national guidance and best practice have evolved, alongside increasing opportunities for integrated working. Legal advice has confirmed that the agreement should now be updated to reflect these changes and ensure it continues to provide an appropriate legal and governance framework.

Revising the Section 75 Agreement will ensure it reflects current requirements, continues to support the existing Better Care Fund arrangements and provides a flexible legal framework for future integrated commissioning and pooled funding arrangements.

The revision relates solely to the legal framework underpinning the Better Care Fund and does not alter the scope of services currently delivered or the level of funding approved through the annual Better Care Fund planning process.

The revised agreement has been developed using the Department of Health and Social Care's updated national Section 75 template and guidance published in June 2025, ensuring it reflects current national guidance, legal best practice and the requirements of the Better Care Fund Framework.

Options (other options considered but discarded)

Retain the existing Section 75 Agreement without amendment.

The current agreement has successfully supported the operation of the Better Care Fund since 2015. However, it has not been updated to reflect subsequent changes in legislation, national guidance, the Better Care Fund Framework or the increasing scope of integrated working between Kent County Council and NHS Kent and Medway.

Retaining the existing agreement would mean continuing to rely on a legal framework that does not fully reflect current best practice or the evolving policy context. It would also miss the opportunity to strengthen governance, clarify roles and responsibilities, enhance financial accountability and provide greater assurance for future pooled funding and integrated commissioning arrangements.

How the proposed decision supports the Council’s Strategic Statement

The proposed decision supports the priorities set out in Reforming Kent by strengthening partnership working between Kent County Council and NHS Kent and Medway through a robust legal and governance framework for integrated working.

The revised Section 75 Agreement will support the Council's ambition to make the best use of public money by strengthening financial governance, accountability and oversight of pooled funding arrangements. It provides a clear framework for managing financial risk, ensuring public funds are used effectively, transparently and deliver value for money.

The agreement will also provide the flexibility to support future integrated commissioning and pooled funding arrangements, enabling partners to work collaboratively, reduce duplication, maximise the impact of shared investment and improve outcomes for Kent residents.

The proposal aligns with the Better Care Fund Framework 2026–27 and the Government's 10 Year Health Plan for England, which together support integrated working, neighbourhood health services and stronger partnership arrangements between local government and the NHS.

Proposed decision: Approve the recommissioning of a new Mental Health Assessment Service and confirm the current contractual arrangements, including the approved contract modification which will enable procurement and mobilisation of the replacement service.

Reason for the decision 

The current Mental Health Assessment Service Contract commenced on 1 August 2023 and is expired on 31 July 2026. A contract modification of up to nine months (1 August 2026 to 30 April 2027) has been agreed by Commercial and Procurement under the Provider Selection Regime to allow for the recommissioning of the new service. The current contract expires 30 April 2027.

The proposal is to undertake a competitive procurement exercise to recommission a new Mental Health Assessment Service. This approach will ensure best value for money and gives a balance of resilience, flexibility and quality of service and supports the Council’s statutory Deprivation of Liberty Safeguards (DoLS) function.

Background

Kent County Council is undertaking the recommissioning of its Mental Health Assessment Service to ensure the continued delivery of statutory responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The service provides timely, independent mental health and mental capacity assessments to support lawful authorisation processes for individuals who may be deprived of their liberty, many of whom are among the most vulnerable in the community. Demand for these assessments is increasing in Kent, reflecting wider system pressures, complexity of need, and the requirement to maintain robust, high-quality and legally compliant assessment processes.

The current commissioning approach has been shaped by a period of legislative uncertainty. Liberty Protection Safeguards (LPS) had been expected to replace DoLS, and this informed the decision to let the existing contract on a shorter-term basis, with flexibility to respond to anticipated reform. However, following the recent Supreme Court judgment, which has removed the previous legal framework (including reliance on the Cheshire West “acid test”), the national position has shifted and the introduction of LPS is no longer expected in its current form. In this context, the recommissioning focuses on ensuring a resilient and adaptable service model that can respond to the evolving legal landscape, maintain compliance with statutory duties, and provide stability and assurance while further national direction and guidance are clarified.

Following the procurement exercise, under the Provider Selection Regime (PSR), a new contract will be in place from 1 May 2027.

Options (other options considered but discarded)

Option 1 ‘Do nothing’ is unviable.

The council has a statutory duty to provide mental health assessments under the Mental Capacity Act 2005. Without a new contract in place to mental health assessments it will put the council at risk on both a financial basis and with regard to meeting statutory duties.

Option 2 - Spot purchase mental health assessments without a contract.

This would result in reduced control of quality, cost and supply meaning there might be occasions where there is insufficient capacity for a service to be provided.

How the proposed decision supports the Council’s Strategic Statement

The recommissioning of the Mental Health Assessment Service supports the Council’s Strategic Statement Reforming Kent 2025–2028 by strengthening the quality, responsiveness and sustainability of a core statutory Adult Social Care function, aligning with the aims of putting residents first, supporting residents who need help, reforming the Council, and building better communities.

The new service approach will improve timely access to assessments, increase capacity to meet rising demand, and ensure continued compliance with statutory duties, thereby improving outcomes and safeguarding for vulnerable adults. It also contributes to the Council’s transformation agenda by modernising delivery and improving efficiency and value for money.

Overall, the recommissioning is fully aligned to the Council’s strategic direction and supports improved outcomes for residents alongside financial sustainability.

Legal Implications

Deprivation of Liberty Safeguard (DoLS) assessments were introduced in 2009 to prevent breaches of article 5 human rights (“Right to liberty and security of person”)^[1], provide a procedure in law for those deprived in accommodation to access care and treatment, and to provide legal protection to determine the lawfulness of the deprivation. This service is a statutory responsibility for the Local authority.

Under the current arrangements a DoLS requires a mental health assessment, carried out by a mental health assessor. The Mental Capacity Act DoLS Regulations 2008^[2] stipulate this must be a medical doctor experienced in mental health and are section 12 approved, therefore approved clinicians under the Mental Health Act 1983. Furthermore, the local authority is responsible for ensuring that sufficient mental health assessors are available.

The Mental Health Assessment Service ensures that the Council can meet its requirement to ensure that a person subject to DoLS has received statutory Mental Health and eligibility assessments in a timely manner so as not to delay any outcome issued by the Supervisory Body.

The procurement will be undertaken in accordance with The Health Care Services (Provider Selection Regime) Regulations 2023^[3], which came into force on 1 January 2024. The regulations primarily apply to NHS England and Integrated Care Boards, and also to local authorities when arranging healthcare services. Kent County Council will use a Competitive Process to test the market and identify a suitable provider, in line with the methodology set out in Regulation 11.

Proposed Decision: Approve the commissioning of a Community Wellbeing Service for Older People, Physical Disability and Dementia and approve a six-month extension to the current Wellbeing Services in the Community contracts.

Reason for the decision

The proposed Community Wellbeing Service for Older People, Physical Disability and Dementia will replace the existing Wellbeing Services in the Community (older people (55+), people with dementia and their families, and people with physical disabilities). Wellbeing services are a key element of Kent County Council’s prevention offer, supporting people to maintain their health and wellbeing and independence, while preventing, reducing or delaying the need for statutory care and support services.

The current Wellbeing Services in the Community contracts expire on 31 March 2027 with no further extension options available. The proposal for a six-month extension (1 April 2027 to 30 September 2027) to the current contract will allow for procurement and mobilisation of the new service whilst maintaining service continuity. The new service will commence on 1 October 2027.

The current contracts are:

• Wellbeing Services in the Community for older people (55+)
• Wellbeing Services in the Community for people with dementia and their families
• Wellbeing Services in the Community for people with a physical disability

The new service will be commissioned through a single procurement exercise comprising four lots, operating under a Strategic Partner and Service Delivery Network model. It will provide support for people aged 55 and over, adults with physical disabilities, and people living with dementia and their families.

Background

Community Wellbeing Services aims to help people take a proactive approach to their health and wellbeing, increase independence, and prevent, reduce or delay the need for statutory services. This is achieved via support which includes, but is not limited to: peer groups, physical activities, providing information (e.g. about support in the local community and how to manage money and benefits), supporting people to live safely in their own home, and maintaining and adapting an individual’s home to their needs with low level trusted assessor equipment.

These services form part of Kent County Council’s (KCC) wider prevention offer and contribute to reducing demand for statutory services by intervening early and supporting people to manage their wellbeing before needs escalate.

It is estimated that these services supported around 41,500 Kent residents during 2025. Many people accessing the service have multiple and interconnected needs associated with older age, dementia, long-term health conditions, and physical disabilities demonstrating the importance of coordinated community-based support.

As demand for adult social care continues to increase, the Council must strengthen its focus on prevention, early intervention, community resilience and support people to remain independent for longer. Community Wellbeing Services will play a key role in delivering this ambition by providing accessible community support that helps prevent, reduce or delay needs for formal care and support, contributing to improved outcomes for residents and supporting the long-term sustainability and value for money of adult social care services.

The new Community Wellbeing Service for Older People, Physical Disability and Dementia has been co-designed with Voluntary, Community and Social Enterprise (VCSE) organisations, staff, partners, and Kent residents. Extensive market engagement has informed the service model, ensuring it reflects local needs, builds on community strengths and supports the Councils strategic ambitions for prevention and community support.

The recommissioning does not propose any reduction in eligibility, access or availability of support for current or future people who access the services.

Options (other options considered but discarded)

Option 1 Do nothing / allow contract to expire

This would risk non-compliance with the Council’s statutory duties and remove a key part of the Council’ s prevention offer increasing the demand on statutory adult social care services.

Option 2 Bring service in-house

While an in-house offer could provide greater direct control, it would require significant investment, workforce recruitment, infrastructure and operational capacity. It could also reduce VCSE sector capacity, flexibility and community reach.

Option 3 Re-procure as three standalone services with separate contracts

Not recommended for older people, dementia and physical disability services, as separate contracts could create confusing referral routes, duplication and hand-offs for people with overlapping needs.

How the proposed decision supports the Council’s Strategic Statement

This proposed decision supports the ambitions set out in Reforming Kent 2025–2028 by helping residents to live healthy, independent and fulfilling lives within their communities.

It also supports the Council's Prevention Framework by helping to prevent, reduce or delay the development of needs for care and support, reducing reliance on more intensive statutory services wherever possible by providing early intervention and preventative support enabling people to maintain independence, build resilience and remain connected to their local communities.

By investing in preventative services, the Council aims to improve wellbeing, reduce social isolation, support community participation and deliver value for money through earlier intervention and reduced demand for higher-cost services.

Financial Implications

The total estimated cost of recommissioning the new Service for Older People, Physical Disability and Dementia is £2.62m per annum. The contract will be awarded for an initial period of two years, with options to extend for two further periods of one year each, providing flexibility in response to Local Government Reorganisation. The lifetime value of the contract (2 years plus extensions) would be approximately £10.48m. This is within the Medium Term Financial Plan.

The cost of the six-month extension (1 April 2027 to 30 September 2027) to the current contracts is estimated to cost £1.42m.

Should additional external funding become available within the lifetime of this decision, it is proposed that authority be delegated to the Corporate Director, Adult Social Care and Health, in consultation with the Cabinet Member for Adult Social Care and the Section 151 Officer, to accept and deploy such funding to enhance the approved service.

Legal Implications

The Council has statutory duties under the Care Act 2014 to promote individual wellbeing and to take steps to prevent, reduce or delay the development of needs for care and support. The proposed Community Wellbeing Service for Older People, Physical Disability and Dementia contributes to the discharge of these duties by providing preventative support that helps people maintain independence and wellbeing.

The Council also has a duty to consider the sustainability of the care and support market when exercising its functions under the Care Act 2014. The proposed commissioning approach seeks to support a sustainable VCSE market whilst securing value for money and continuity of preventative services for Kent residents.

The proposed six month extension to the current contracts will be undertaken in accordance with Regulation 72 of the Public Contracts Regulations 2015 to support procurement and mobilisation of the new service. The subsequent recommissioning of the service will be undertaken in accordance with the Procurement Act 2023, with appropriate procurement and legal support to ensure compliance and mitigate risk.

Proposed decision

Approve the commissioning of a Community Wellbeing Service for Adults with Sensory Needs and approve a three-month extension to the current Community Wellbeing Service for Adults with Sensory Needs contract

Reason for Decision

Wellbeing Services are commissioned services which aim to help people take a proactive approach to their health and wellbeing, increase independence, and prevent, reduce or delay the need for additional care and support services. These services form part of Kent County Council’s (KCC) broader approach to prevention.

The Community Wellbeing Service for Adults with Sensory Needs supports people who are aged 18 and over with a sensory impairment, including people who are blind and/or deaf, including people that use British Sign Language (BSL). The services provide information and advice, equipment and training and rehabilitation. 

The proposal to recommission the Community Wellbeing Service for Adults with Sensory Needs separately from the other Community Wellbeing Service contracts allows for a standalone arrangement providing greater assurance that these specialist requirements remain visible, prioritised and appropriately resourced with the specialist expertise in visual impairment rehabilitation, Deaf BSL support, hearing loss support and Deafblind services.

The current Community Wellbeing Service for Adults with Sensory Needs contract expires on 31 March 2027, with no further extension options available. The proposal for a three-month extension (1 April 2027 to 30 June 2027) with the new service delivery commencing from July 2027. The extension will allow for procurement and mobilisation of the new service whilst maintaining service continuity.

Background

The Community Wellbeing Service for Adults with Sensory Needs will support wellbeing and independence. This is achieved by, including but not limited to: peer groups, physical activities, providing information (e.g. about support in the local community and how to manage money and benefits), supporting people to live safely in their own home, and supporting individuals to access and use relevant technology where appropriate. There is also recognition of the different levels of intensity, duration and specialist skill required for visual impairment rehabilitation, hearing loss support, Deaf BSL provision, Deafblind assessment and community-based support for people with combined or complex sensory needs. 

The provider will maintain the Vision Impairment Register on behalf of KCC, supporting the Council to meet its statutory duty under Section 77 of the Care Act 2014.

These services are part of Kent County Council’s (KCC) broader approach to preventing, reducing and delaying the need for care and support.

The service supported approximately 25,347 Kent residents in 2025/26 and provides a key element of Kent County Council's wider prevention offer for adults with sensory impairments.

The recommissioning does not propose any reduction in eligibility, access or availability of support for current or future people accessing the service.

Options (other options considered but discarded)

Option 1 Do nothing / allow contract to expire

This would risk non-compliance with the Council’s statutory or organisational duties, resulting in an immediate loss of provision as well having a significant impact on the Voluntary, Community and Social Enterprise (VCSE) sector.

Option 2 Bring service in-house

While an in-house offer could provide greater direct control, it would require significant investment, workforce recruitment, infrastructure and operational capacity. This option would carry a high financial and resource burden and would not offer the flexibility or value for money required at scale.

Option 3 Re-procure and bring the sensory wellbeing service into a single contract with other wellbeing services (55+, dementia and physical disability).

Whilst this option could reduce potential duplication and support consistency for people accessing wellbeing services, there is a risk that specialist sensory needs and expertise could be diluted within a broader wellbeing model.

How the proposed decision supports the Council’s Strategic Statement

The proposed decision supports the ambitions set out in Reforming Kent 2025–28 by helping residents live healthy, independent and fulfilling lives within their communities and supporting the Council’s commitment to improving outcomes for vulnerable residents by ensuring continued access to specialist support for people who are blind, partially sighted, Deaf, Deafblind or living with hearing loss.

It also supports the Council's Prevention Framework by helping to prevent, reduce or delay the development of needs for care and support, reducing reliance on more intensive statutory services wherever possible by providing early intervention and preventative support enabling people to maintain independence, build resilience and remain connected to their local communities.

By investing in preventative services, the Council aims to improve wellbeing, reduce social isolation, support community participation and deliver value for money through earlier intervention and reduced demand for higher-cost services.

Financial Implications

The proposed cost of recommissioning the Community Wellbeing Service for Adults with Sensory Needs is £1.03m per annum. The contract will be awarded for an initial period of two years, with options to extend for two further periods of one year each, providing flexibility in response to Local Government Reorganisation. The lifetime value of the contract (2 years plus extensions) would be approximately £4.12m. This is within the Medium Term Financial Plan.

The cost of the three-month extension (1 April 2027 to 30 June 2027) of the current Community Wellbeing Service for Adults with Sensory Needs contract will be £257,500, which is within the allocated budget.

Should additional external funding become available within the lifetime of this decision, it is proposed that authority be delegated to the Corporate Director of Adult Social Care and Health, in consultation with the Cabinet Member for Adult Social Care and the Section 151 Officer, to accept and deploy such funding to enhance the approved service.

Legal Implications

The Council has statutory duties under the Care Act 2014 to promote individual wellbeing and to take steps to prevent, reduce or delay the development of needs for care and support. The Community Wellbeing Service for Adults with Sensory Needs contributes to the discharge of these duties by providing preventative support which helps people maintain independence and wellbeing.

The Council also has a duty to consider the sustainability of the care and support market when exercising its functions under the Care Act 2014. The proposed commissioning approach seeks to support a sustainable Voluntary, Community and Social Enterprise (VCSE) market whilst securing value for money and continuity of preventative services for Kent residents.

The Council also has a specific duty under Section 77 of the Care Act 2014 to establish and maintain a register of adults who are sight impaired or severely sight impaired. The commissioned service will maintain the Vision Impairment Register on behalf of Kent County Council supporting compliance with this statutory requirement.

The proposed three-month extension to the current Community Wellbeing Service for Adults with Sensory Needs will be undertaken in accordance with Regulation 72 of the Public Contracts Regulations 2015 to support procurement and mobilisation of the new service. The subsequent recommissioning of the service will be undertaken in accordance with the Procurement Act 2023, with appropriate procurement and legal support to ensure compliance and mitigate risk.