Decision details

This decision follows on from decision number 18/00071 to end the current Section 76 agreement and establish a new agreement which reflects KCC as the commissioning lead for the KCC elements of the CYPMHS service.

In 2017, KCC jointly commissioned the CYPMHS with the local NHS. KCC invested £2.65m into the NHS contract via a Section 76 agreement. The new service has resulted in a significantly different clinical model, a large restructure and upskilling of the workforce and the implementation of a new data management system. However, demand for the specialist and targeted interventions have been significantly higher than expected and this impacted on the initial stages of the service transformation. A greater capacity has been allocated to the management of this demand and associated high waiting lists, particularly those across the neurodevelopmental pathway. Significantly this has impacted upon the delivery of the Local Authority funded services particularly the early intervention elements of the contract.

Whilst CCGs are now seeing improvements in the performance of the overall service, it has been apparent that some of the KCC funded elements are not achieving the desired outcomes.   These challenges have included; significant underperformance in relation to numbers of young people receiving a service through the Early Help pathway and Kent Health Needs Education Service; lack of available performance data and dispute in relation to payment for the contract.

KCC remains committed to working in partnership with the NHS to manage the challenges and improve the contracting arrangements. Progress has been reported back to SCB and CYPE Cabinet Committee and a full options appraisal will be presented to CYPE Cabinet Committee on 15 November 2019.

The recommended option is to split the KCC investment in the contract as follows:

·   £1.217m retained in the current contract for the LAC Priority Assessments and Harmful Sexual Behaviour interventions. These elements of the service require clinical interventions and oversight. Changes to the Section 76 agreement will enhance the oversight that KCC has on the performance of these services.

·   £1.2m refocussed through a range of evidence-based and resilience-focuses interventions.

·   Reduce the funding for the Kent Health Needs Education Service from the current £240k arrangement to ensure a focused approach to meet the needs of the school.

Other options considered were:

• Business as Usual - Retain the current service model and continue to work with the NHS to improve the contracting arrangements

• Recommission a new service - Withdraw KCC’s investment in the contract and re-commission a new service

• Align KCC Early Help workforce to the current contract and invest the funding within KCC provision