Issue details

Proposed decision:

The Cabinet Member for Integrated Children’s Services is asked:

a)    To endorse Kent County Council as the provider of the Designated Keyworker Programme for Kent and Medway and to permit the acceptance of the funding from NHS England (via Kent and Medway Integrated Care Board) for the financial year 2023/2024. 

b)    Delegate authority to the Corporate Director of Children, Young People and Education, in consultation with the Cabinet Member for Integrated Children’s Services, to negotiate, finalise and enter into the relevant contracts.

Reason for the decision:

Kent County Council successfully submitted an Expression of Interest to NHS England, on behalf of Kent and Medway Integrated care System, for early adopter status of the Designated Keyworker Programme in Kent and Medway and to act as the main provider. 

The programme is fully funded by NHS England, via NHS Kent and Medway Integrated Care Board, until March 2024.

As the programme funding for the financial year 2023/24 exceeds £1 million, the Council must take a formal decision to accept the funding for the continued delivery of the Kent and Medway Designated Keyworker Programme. Acceptance of this funding will also allow the Council to continue to make a difference to the lives of children and young people with learning disabilities and/or those with autism and their families in Kent and Medway.

Background:

The 'Keyworking’ function was developed in response to the NHS England Long Term Plan commitment that, by 2023/24, children and young people, aged 0-25, with a learning disability, autism or both, with the most complex of needs (hereafter referred to as ‘CYP’) will have a Designated Keyworker, as recommended in the Lenehan Report (2017).

The functions of ‘Keyworking’ are:

a)             to ensure that CYP and their families get the right support at the right time and that local services are responsive to meeting their needs in a holistic and joined up way.

b)             to prevent CYP being admitted unnecessarily to any form of acute mental health hospital or institutional care.

c)             where a CYP is unavoidably admitted to an acute mental health hospital, to ensure that their stay is as brief as possible and support plans are developed and in place for discharge into the community.

The ‘Keyworking’ programme ensures a personalised approach to supporting each CYP and their family in a time of crisis and ensures strategies and support are put in place to prevent further crises.

Options (other options considered but discarded):

•                For the programme to be hosted by the Kent & Medway Integrated Care Board.

•                For the programme to be hosted by the Kent and Medway Children & Young Peoples Mental Health Provider North East London Foundation Trust (NELFT)

How the proposed decision supports the Interim Strategic Plan:

The proposed decision supports:

•                Framing Kent’s Future Our Council Strategy 2022-2026, Specifically Priority 4 New Models of Care & Support 1.Explore all opportunities to integrate our commissioning of services to improve health and care outcomes, for example enablement and intermediate care, joined-up hospital discharge services, jointly commissioning care home services, and technology enabled services

•                The Council’s SEND Transformation Programme

•                NHS England Transforming Care Programme

Financial Implications:

The revenue funding for financial year 2023/24 for Kent and Medway is £1,434.000. There is no capital funding associated with this programme. The programme is wholly funded by NHS England, the money is passported to Kent County Council via the Kent and Medway Integrated Care Board. The revenue funding is held within the Disabled Children’s 0 -18 Commissioning budget line. 

Most of the funding is attributable to staffing including a grant to Kent PACT, to host the Peer Associates Team (although this is being re-tendered). The remainder is for programme planning and implementation, and staff training.

The spending plans are in accordance with the NHS England conditions of funding. NHS England have specified that the funding should be used to scope and develop a Keyworking Service which will complement existing universal services and/or offer new interventions in order to improve support to CYP and their families in Kent and Medway.

The programme funding from NHS England will cease in March 2024 and funding of the service will transfer to the Kent and Medway Integrated Care Board from April 2024.All redundancy costs, should that be required, have been accounted for to mitigate any financial risk for the Council.

Legal Implications:  

As the funding is made available following a successful Expression of Interest, a contract is created between Kent County Council and NHS England.  Matt Dunkley Corporate Director for Children, Young People and Education agreed and signed off the Expression of Interest in June 2020.  The obligations require Kent County Council to progress the scoping, development, and other activities of the Keyworking function in Kent and Medway during the life of the Programme.

NHS England monitors the progress of the programme development by requiring submission of quarterly reports. Specific information is requested in the reports including number of CYP being supported and outcomes, workforce headcount and roles, case studies of intervention and support, continuous improvement activities, challenges, and risks. 

A procurement exercise is currently underway to identify a suitable future provider for the Peer Associate Team, as the initial arrangement with Kent PACT expires at the end of June 2023.  This procurement will be completed in accordance with Public Contracts Regulations 2015 and TUPE will apply.