Issue details

19/00064 - Kent County Council and Kent Community Health NHS Foundation Trust collaborative partnership - delivery and transformation of Public Health services

Proposed Decision:

 

To agree the extension of collaborative partnership arrangement with Kent Community Health NHS Foundation Trust (KCHFT) until at least March 2025 and ongoing delivery of Public Health services through this approach. Public Health services included within the current arrangement are listed below:

·         Health Visiting

·         School Health Services

·         Sexual Health Services

·         Lifestyle Services and NHS Health Checks

·         Oral Health Services

·         Postural Stability Services

 

Background:

 

Kent County Council took the decision to enter into an innovative partnership with Kent Community Health Foundation Trust (KCHFT) in September 2017, with the aim to maximise the opportunity to improve the health of Kent residents, deliver common objectives and accelerate delivery of the Sustainability Transformation Plan (STP), known as the Sustainability Transformation Partnership.  This arrangement was also designed to offer the flexibility to align to new local care arrangements.

 

This decision recognised that KCHFT was integral to the delivery of the STP and recognised that both KCC and KCHFT faced significant challenges which could be better managed through a joint open and transparent approach. The original decision put procurement in “abeyance” until at least March 2020 and a further decision is required on how best to deliver these services in the future. Legal advice taken at this time confirmed that the approach was permitted within the Procurement Regulations.

 

The Kent and Medway Sustainability and Transformation structures are more advanced than in 2017 and local leaders are working to deliver the local plan, Case for Change. This includes a series of commitments which have been supported by KCHFT. Kent and Medway STP is developing a five-year plan in response to the national LTP and is required to become an Integrated Care System (ICS) in the coming months. Services and health providers will need to align to these changes and work with commissioners to determine how they can best integrate and support acceleration of local care.

 

Kent continues to face a series of significant demographic pressures alongside budget constraints and pressures, e.g. long-term clarity on national NHS pay and uncertainty on future funding arrangements for the Public Health grant.

Decision type: Key

Reason Key: Expenditure or savings of more than £1m;

Decision status: For Determination

Division affected: (All Division);

Notice of proposed decision first published: 03/09/2019

Anticipated restriction: Part exempt  - View reasons

Explanation of anticipated restriction:
the supporting paperwork contains information relating to the financial and business affairs of the authoritry and information in respect of which a claim to legal professional privilege could be maintained inlegal proceedings.

Decision due: Not before 3rd Oct 2019 by Cabinet Member for Adult Social Care and Public Health
Reason: In order that the proposed decision can be published for 28 days, in accordance with statutory requirements

Lead member: Cabinet Member for Adult Social Care and Public Health

Lead director: Andrew Scott-Clark

Department: Social Care, Health & Wellbeing

Contact: Vicky Tovey, Public Health Senior Commissioning Manager 03000416779 Email: victoria.tovey@kent.gov.uk.

Consultees

This item was discussed by the Health Reform and Public Health Cabinet Committee on 24 September and the proposed decision endorsed. The minute of the discussion is as follows:

 

64.         19/00064 - Delivery and Transformation of Public Health Services.

(Item. 8)

 

The Chairman advised the committee that, as this and the exempt report later in the agenda (item 12) contained much detailed information, he was minded to take both reports together in a closed session at the end of the meeting.  It was important that Members have the opportunity of a full understanding of the issues before being able to comment on them and consider the recommendations, and to do this they would need to be able to have a frank discussion and explore all of the available information. This could only be done effectively in a closed session.

 

EXEMPT ITEM (open access to minutes)

 

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69.         19/00064 - Delivery and Transformation of Public Health Services.

(Item. 12)

 

Mrs V Tovey, Public Health Senior Commissioning Manager, was in attendance for this item.

 

1.             Mrs Tovey introduced the reports for agenda items 8 and 12 and responded to questions of detail from the committee, including the recruitment and training of new nurses and retention and re-training of experienced nurses to take on new roles, for example, as health visitors and school nurses, to offer a new career pathway. The Care Quality Commission’s recent rating of Kent Community Health NHS Foundation Trust (KCHFT) as ‘outstanding’ would help to retain and attract new staff. Other questions included clarity of the conditions that were required to be met for the County Council and KCHFT to enter into this agreement. Mrs Tovey confirmed that the conditions were set out in section 12(7) of the Procurement Regulations and also referenced within the exempt report. Mrs Tovey informed the committee that independent legal advice confirmed the arrangement met these criteria for the delivery of public health services and advised that this would be subject to review during the five years to ensure the conditions continued to be met.

 

2.            It was RESOLVED that:-

 

a)    the context, risk and assurance associated with the proposed procurement approach for public health services be noted; and

 

b)      the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to authorise the County Council to extend the collaborative arrangement with Kent Community Health NHS Foundation Trust, for the services listed in the report, until March 2025, be endorsed.

Financial implications: The spend of Public Health services across the 5 years will be in the region of £187,109,535. However, values will be subject to annual review and will fluctuate based on demand and any external investment e.g. through Health partners. Additional income through Health Partners enables delivery of HIV treatment services and targeted work for NHS Health Checks as set out as part of the STP. The estimated value for 2019/20 is £37,421,907 with anticipated income of £860K from NHS England and the Kent and Medway STP. Services included are Health Visiting, School Nursing, Postural Stability, Sexual Health, Lifestyle services, including Smoking, and NHS Health Checks and Oral health. A number of services are open-access and, as such, actual spend will be dependent on demand.

Legal implications: Regulation 12(7) of the Public Contracts Regulations 2015 enable this type of co-operation between contracting authorities where certain conditions are met. Independent legal advice has supported the legality of the approach in relation to the public health functions which are the subject of the partnership. This form of arrangement builds on duties that already existed to exercise functions with a view to integrating the provision of care and support provision, under the Care Act 2014 (“CA 2014”), with health provision (section 3, CA 2014). Both parties are also under a duty, under s.82 of the NHS Act 2006, to co-operate with one another to secure and advance the health and welfare of the people of England and Wales.

Equalities implications: Equalities implications: Equality Impact Assessments will be completed at a service level as required. Data Protection implications: KCHFT is IG Toolkit compliant and Data Process Impact Assessments will be completed at a project level as required.

Decisions

Agenda items