Issue details

Proposed decision:

A) Retrospectively contract with the East Kent Hospitals Trust and the Kent Community Health Foundation Trust for 1 April 2023 to 31 March 2024 for the provision of SEN Therapies

B) Contract with the East Kent Hospitals Trust and the Kent Community Health Foundation Trust for 1 April 2024 to 31 August 2025 for the provision of SEN Therapies

C) Agree to the review of the Kent and Medway Communication and Assistive Technology service and to incorporate into the wider recommissioning of SEN Therapies

D) Agree for the exploration of joint commissioning with the NHS for the wider provision of SEN Therapies to include in the re-procurement of NHS Community Services

E) Delegate authority to the Corporate Director of Children, Young People and Education, in consultation with the Cabinet Member for Education and Skills and the Corporate Director of Finance, to take relevant actions, including but not limited to, entering into and finalising the terms of relevant contracts or other legal agreements, as necessary, to implement the decision

Reason for the decision

To continue with annual contracts, issued by NHS Providers, for the current Special Educational Needs (SEN) Therapy services. The future commissioning intentions are to align with the NHS Kent and Medway timeline to re-procure their Community Services, and specifically jointly commission an Integrated Therapy Contract for 1 September 2025.

The current annual contract values are £752,905 with East Kent Hospital University Foundation Trust (EKHUFT) and £1,526,586 with Kent Community Health Foundation Trust (KCHFT).

This requires agreeing a retrospective contract for the financial year 2023/2024 and a future contract for 17 months from1 April 2024 to 31 August 2025.

Decision is also sought to review and bring the Kent and Medway Communication and Assistive Technology service into the new jointly commissioned Integrated Therapy Contract, under the NHS Kent and Medway Community Services re-procurement. 

Background

The 2015 Special Educational Needs and Disability (SEND) Code of Practice, sets out that Speech and Language Therapy, Occupational Therapy, Physiotherapy and Assistive Technology should be jointly commissioned.

KCC is working towards a jointly commissioned Integrated Therapy Service, which will include the Kent and Medway Communication and Assistive Technology Service (KMCAT), to maximise the use of finite resources from local authorities, schools, colleges and the NHS improving outcomes for 0–25-year-olds with SEND and their parents/carers.

The joint aim is to establish a new jointly commissioned service by September 2025, to fall in line with NHS Kent and Medway’s broader recommissioning of a unified Community Service Offer.

Significant transformational activity is underway with the NHS providers who are working in partnership with KCC and NHS Kent and Meway to develop new ways of working.   Implementing a more proactive and preventative tiered approach to the provision of therapy support, that will maximise use of finite resources and ensure a more coherent county-wide offer.

Securing Kent’s Future – Budget Recovery Strategy

KCC has agreed with the Providers that there will be no increase to the contract price for 2023/2024, however, the Providers have stated that this position will not be sustainable for 2024/2025, and therefore negotiations continue. 

The contract values for 2024/2025 will be agreed alongside Finance colleagues and the Director for Education.

The longer-term joint commissioning project will meet the ambitions of Framing Kent’s Future as follows:

Priority 4: New models of care and support demand for our social care services has out stripped funding year on year. Our commitment is to seize the opportunity of integrating our planning, commissioning and decision making in adult, children’s and public health services through being a partner in the Kent and Medway Integrated Care System at place and system level.

It meets the aims of Securing Kent’s Future by holding Best Value at the centre of all joint commissioning opportunities.

Financial Implications

These contracts are for the provision of Therapy staff and are only a proportion of the overall Therapy services purchased by the Council. A high-level reconciliation has been undertaken to be able to justify the level of spend in commensurate with the level of service provided, given that vacancies have been held to compensate for the lack of inflationary uplift. 

KCC has been in negotiation with the Providers for this year’s fee increase and have agreed in 2023/2024 there will be no fee increase, this has meant the providers have held frozen vacancies.

Both Providers have stated that continuing without a fee increase into the new financial year 2024/2025 will not be sustainable, and therefore negotiations continue. 

The current contract values are £725,905 for EKHUFT and £1,526,586 for KCHFT, contract values for 2024/2025 will be agreed alongside Finance colleagues and the Director for Education.

This contract is funded from the Dedicated Schools Grant: High Needs Block, an annual grant provided by the Department of Education.

Legal Implications  

The procurement strategy is to align existing Therapy services required by KCC, with the service commissioned by the NHS Kent and Medway and to jointly commission the service, with the NHS Kent and Medway as the Lead Commissioner and KCC as a Joint Commissioner. 

As a Joint Commissioner, it is expected that KCC will be a full partner of the contract with the provider(s) and will have the ability to participate in performance contract management and monitoring, with NHS Kent and Medway.  This will strengthen existing contract performance monitoring and management, given the scale and value of the proposed contract.

The Provider Selection Regime (PRS) came in to force on 1 January 2024. PSR is a set of rules for procuring health care services, by NHS England, Integrated Care Board, NHS Trusts, NHS Foundation Trusts and Local Authorities.

There are three Provider Selection processes:

For the 2023/2024 contract, the Public Contract Regulations (PCR) 2015 would have applied, however as PSR is now in force, this is the regulation that covers the provision of Therapy services, and it is therefore recommended that the route followed to sign these contracts is under Direct Award (C).

For any other meaningful commissioning using this Regime would require developing specifications, detailed outcome frameworks and key performance indicators, quality assurance mechanisms and contract management schedule.  This would also not allow for the necessary coproduction with Children, Young People, and their Families/Carers, as required by the SEND Code of Practice and our commitment to the SEND Co-production Charter.

Equalities implications

A full Equalities Impact Assessment (EqIA) will be completed as part of the Joint Commissioning Strategy, to help us to consider the potential impact of a proposal, and how to make things as fair as possible for anyone who is likely to be affected. The level of detail required for an EqIA depends on how complex the proposal is, and to what extent people are likely to be affected by it.  We believe this will have far reaching implications and therefore full EqIA will be required.

DPIA (if relevant)

A DPIA checklist will be completed in due course as part of the commissioning plan to ensure KCC and partners ability identify and minimise the data protection risks within this commissioned activity. As this is a major project which requires the processing of personal data, the DPIA Assessment will therefore:

• describe the nature, scope, context and purposes of the processing;
• assess necessity, proportionality and compliance measures;
• identify and assess risks to individuals; and
• identify any additional measures to mitigate those risks.