Agenda item

To receive a report from the Deputy Leader and Cabinet Member for Strategic Commissioning and Public Health and the Director of Public Health, and to consider and endorse or make recommendations to the Cabinet Member on the proposed decision to enter into new contractual arrangements to deliver a range of public health services.

Ms K Sharp, Head of Commissioning Transformation, Mr V Godfrey, Strategic Commissioner, and Mr G Singh, County Council Barrister, were in attendance for this item.

1.            Mr Godfrey introduced the report and explained the rationale for the way forward which was being proposed and for which the committee’s support was being sought.  He assured the committee of the past and ongoing excellent performance across a range of services of the key strategic partner, Kent Community Health NHS Foundation Trust (KCHFT), with whom the County Council was proposing to enter into contractual arrangements prior to reviewing its commissioning plans in 2020.

2.                   Ms Sharp added detail of the transformation programme and reiterated the good relationship KCHFT had with the County Council and the confidence with which the proposals were being put to Members for their support. Previous contracting activity with KCHFT had been reported to and supported by the former Adult Social Care and Health Cabinet Committee. Ms Sharp emphasised that the new organisational arrangements would allow flexibility through a period in which the market would be changing in response to the STP and would allow the County Council to focus on implementing the STP. She assured Members that the County Council would retain the ability to give notice to the provider, if performance were to fail to reach the required standard, and to re-trigger the procurement process if necessary.

3.            Ms Sharp responded to comments and questions from Members, including the following:

a)    performance measures, required outcomes and the method used to monitor these would all be clearly set out in the contractual arrangements and would be rigorously enforced;

b)    the provider’s performance would be measured against a series of five developmental checks, with performance targets being linked to payment. Any underperformance by a provider would attract a  financial penalty, as part of the conditions built into the contract;

c)    in response to a concern that performance indicators measured the number of checks made rather than the quality of those checks, Ms Sharp explained that the County Council had a statutory duty to measure and report the number of checks made in each quarter but would also monitor the quality of those checks and, in addition, would seek to find out the reasons for any parent not taking up the opportunity to have checks done. Developmental checks were a vital way by which a health visitor could make contact with and get to know a family and this relationship could be a way of identifying other issues with which new parents or the wider family might need support.  The health visitor service had capacity to undertake more than the 60,000 visits per year currently being made; and

d)    current work to closer integrate health and social care services was welcomed, and the significant role of GPs in this process  was emphasised.  However, surgeries were under much pressure and it was vital that they receive support to maintain their role.  

4.            Mr Carter thanked Members for their comments and agreed with the need to invest in and support good local care and support GPs’ surgeries.  Workforce issues in the NHS presented a major challenge, and more doctors needed to be encouraged to become GPs.  In an era characterised by austerity, investment in the health visitor service had in fact doubled.

5.            RESOLVED that the decision proposed to be taken by the Deputy Leader and Cabinet Member for Strategic Commissioning and Public Health, to authorise the County Council to enter into contractual arrangements with Kent Community Health NHS Foundation Trust, pursuant to the relevant exemptions in the Public Contract Regulations 2015, for (i) NHS Health Checks, (ii) the National Childhood Measurement Programme, (iii) open access sexual health services, (iv) Public Health advice to NHS clinical commissioning groups, (v) provision of health protection advice and information and (vi) universal health visitor reviews at five key developmental stages, be endorsed.