Decision: To agree that Kent County Council enter into legal agreements (under the NHS Act 2006) for the purpose of jointly procuring a mental health service for children and young people including children in care and integrated provision within the heath needs pupil referral units, and to delegate authority to the Corporate Director of Social Care, Health and Wellbeing or other nominated officer to undertake the necessary actions to enter these agreements.
Reasons for decision:
Kent County Council and the seven Clinical Commissioning Groups (CCGs) across Kent have been working together since early 2015 to deliver a new whole system of support to improve children’s mental health. The current contract is due to end on 31 March 2017. A new service will be procured by West Kent CCG as the lead commissioner on behalf of all CCGs and KCC which will commence on 1 April 2017.
This work has delivered a collective understanding of the KCC and NHS resource available to support children and young people develop strong emotional wellbeing. The development of Kent’s Emotional Wellbeing Strategy for children, young people and young adults led to a new whole system and a new model for service delivery.
Children’s mental health has been the subject of many recent national documents and policy discussion (Department of Health and NHS England “Future in Mind”, “The Good Childhood report”, Department of Health 2014 “Closing the gap, priorities for essential change in mental health”).
Future in Mind – promoting, protecting and improving our children and young people’s mental health and wellbeing sets out a number of proposals the government wishes to see by 2020. These include:
• tackling stigma and improving attitudes to mental illness
• introducing more access and waiting time standards for services
• establishing ‘one stop shop’ support services in the community
• improving access for children and young people who are particularly vulnerable.
The new service model places Kent in an excellent position to achieve these objectives. There is a growing recognition of the link between emotional wellbeing and school attainment, and of the high prevalence of mental health problems in vulnerable groups such as young offenders and children in care.
The Early Help and Preventative Services Commissioning Diagnostic in July 2015 considered in detail the needs of children and young people and the services provided. The key findings from this included the need to address emotional health and wellbeing, behavioural difficulties, education / development issues (including school non-attendance), and poor relationships within families.
There is currently no integrated mental health and emotional wellbeing service at a community level that address these needs. The intention of the new service delivery model is to ensure the provision of a more accessible and responsive service, delivered in community settings and aligned to other children and young people’s provision.
KCC Strategic Procurement is leading the procurement of the child and young people mental health service. A Programme and Procurement Board has been established to oversee the procurement process which is jointly chaired by the, Accountable Officer for West Kent CCG and the Corporate Director of Social Care, Health and Wellbeing for KCC.
Financial Implications:
Funding for this procurement will be c£2.7m per year with Specialist Children’s Services committing £1.29m per year and Early Help and Preventative Services committing £1.44m per year.
Legal Implications:
West Kent CCG will be the lead commissioner on behalf of all Kent CCGs and KCC. West Kent CCG will enter into the contract with the successful provider following the procurement process. KCC, West Kent CCG and all the CCGs will be required to enter legal agreements to govern the relationship between the Council, the CCG and the Provider.
Equality Implications:
An equalities impact assessment has been completed for the KCC element of the mental health service. Actions noted within this are; (i) to ensure that there is data recording on the protected characteristics so that in future the uptake of the service by all groups of children and young people can be monitored and (ii) there will be service user involvement in the procurement process
The matter is referred to in the Business Plan/Medium Term Capital Programme.
Decision type: Key
Reason Key: Expenditure or savings of more than £1m;
Decision status: Recommendations Approved
Division affected: (All Division);
Notice of proposed decision first published: 13/06/2016
Department: Social Care, Health & Wellbeing
Contact: Carol Infanti, Strategic Commissioning Manager 03000 416294 carol.infanti Email: @kent.gov.uk.
Consultees
The Children’s Social Care and Health Cabinet Committee and Health Overview and Scrutiny Committee have been consulted and regularly updated on the development of the Emotional Wellbeing Strategy, CAMHS procurement and development of the service specification.
The proposed decision was discussed at the Children’s Social Care and Health Cabinet Committee meeting on 5 July 2016, and a summary of the proceedings is as follows:-
1) Carol Infanti, Commissioning Officer, introduced the report on the commissioning and procurement of the child and young people’s mental health service. She explained that this report sought the Committee’s endorsement to formalise the next step of the joint procurement process and enter into legal agreements with the CCGs.
2) Carol gave the following information in response to questions raised by the Committee:-
i) that she, colleagues in the Legal department and CCG colleagues did not foresee any problems in getting the legal agreements in place by the proposed timeline;
ii) it was also confirmed a lot of work had been done on the performance framework and that any potential provider would be asked to share with Kent County Council that performance data;
iii) that staff employed by the successful provider would be expected to work alongside current Kent County Council staff in Early Help Units; and
iv) in response to a concern raised, Mrs Infanti explained that the contract would be held by West Kent Clinical Commissioning Group. However, Kent County Council would have an agreement in place that would ensure there were clauses in the contract in regards to performance targets for the provider. This would involve Kent Performance Indicators having to be followed closely by the provider.
3) Andrew Ireland, Corporate Director of Social Care, Health and Wellbeing, reassured the Committee that the Health Overview and Scrutiny Committee had been following the progress of the commissioning and procurement of the child and young people’s mental health service in depth.
4) The Children’s Social Care and Health Cabinet Committee resolved to endorse the proposed decision:-
a) that Kent County Council will enter into such legal agreements that are necessary and appropriate to enable the joint operational delivery of this project between the County Council, West Kent Clinical Commissioning Group and the Provider for the purpose of jointly procuring a mental health service for children and young people, including children in care, and integrated provision within the heath needs pupil referral units; and
b) to delegate authority to the Corporate Director of Social Care, Health and Wellbeing, or other nominated officer, to undertake the necessary actions to enter into the agreements.
Other consultation planned or undertaken:
None
Financial implications: Carol Infanti Strategic Commissioning 03000 416294 carol.infanti@kent.gov.uk
Legal implications: 16/00052