KCC will work with the CCG to review and vary the existing contracts, potentially terminating the section 76 agreement and putting in place arrangements which allow KCC to directly manage the KCC funded NELFT contracts.
Background
KCC, Children, Young People and Education (CYPE) Directorate, Public Health and the 7 Clinical Commissioning Groups (CCGs) across Kent have worked together since 2015 to implement a county wide Children and Young People Mental Health service partnership model. This model includes the provision of universal education services, early intervention services for children and young people experiencing early stage wellbeing difficulties, targeted services for those with a high complexity of need and specialist services for those young people with complex and serious mental health conditions.
To work together in the integrated model the Council entered into a Section 76 (S.76) arrangement with West Kent CCG (North, West and East Kent) and Thanet CCG (East Kent), for the NELFT contract to provide services to support:
• Priority assessment for Looked After Children;
• Work in Early Help Units, to intervene early and stop escalation into Tier 3 mental health services;
• Children at risk of, or subject to, the effects of harmful sexual behaviour; and
• Kent Health Needs Education Service (KHNES)
In April 2017, NELFT were awarded the contract to run CYPMHS for 5-years from 1st September 2017 with a total contract value of £82,504,977 over 5-years (£15,964,287 p.a.). Of this KCC fund four key areas; Early Help (£1.2m); Children in Care (£1m); Kent Health Needs Education Service (£240k); and Children at risk of or subject to harmful sexual behaviour (£217k) total £2.657m p.a. over 5-years.
Other options were considered in terms of how best to better manage the KCC elements of the CYPMHS. These included:
- Setting up additional contract management processes, with support from the CCGs,
- Establishing an alternative model of provision and ending the current arrangements.
Having considered the above options, including discussing them with Cabinet Committee, working with the CCG to vary the contract, with the potential for terminating the s76 agreement so that KCC would be managing NELFT directly for the Council’s new model of contracts, as proposed in this forthcoming decision, was identified as the most appropriate option to progress.
KCC is committed to working in partnership with the NHS and the provider to manage the challenges that are facing mental health services for children and young people. KCC wishes to retain a partnership approach with the NHS and to review how to make the model work in the interests of children and young people.
However, KCC also has to ensure that the contribution it makes to the contracts in place are delivering the expected outcomes that the Local Authority is responsible for.
By reviewing the contract KCC can make the necessary changes to ensure that the people of Kent get the best outcomes and receive more effective services.
Decision type: Key
Reason Key: Expenditure or savings of more than £1m;
Decision status: Recommendations Approved
Notice of proposed decision first published: 17/12/2018
Decision due: Not before 24th Jan 2019 by Cabinet Member for Children, Young People and Education
Reason: In order that the proposed decision can be published for a minimum of 28 days, in accordance with statutory requirements
Lead member: Cabinet Member for Children, Young People and Education
Lead director: Stuart Collins
Department: Education & Young People's Services
Contact: Karen Sharp, Head of Commissioning for Public Health Tel: 03000 416668 Email: karen.sharp@kent.gov.uk.
Consultees
CYPE Cabinet Committee have received several reports on the subject:
CYPE Cabinet Committee – 10 July (as part of a report on Emotional Wellbeing and Mental Health Services for Children and Young People in Kent)
CYPE Cabinet Committee – 29 November
(The three options detailed above were presented for consideration to Cabinet Committee and further discussed via a Member briefing)
The final draft proposed decision was presented to the CYPE Cabinet Committee for consideration on 11 January 2019, prior to the decision being taken by the Cabinet Member for Children, Young People and Education.
Financial implications: The KCC element of the CYP Mental Health Service contract is worth £2.657m over 5 years. The proposed decision would allow KCC to manage the payment to the provider directly. There is existing capacity within the service to undertake the variation and manage the contract going forwards. Whilst there is no cost associated with terminating the Section 76 Agreement, there may be costs incurred in seeking advice from Legal Services. Further financial information was provided in the report to Cabinet Committee on 11 January 2018.
Legal implications: We have a duty, under Section 22 of the Children Act 1989, to safeguard and promote the welfare of each child we look after. Under Section 27 of the Act, local authorities are entitled to expect other authorities and certain NHS bodies to assist them in discharging their functions to children in need, looked after children and their parents and carers. The Children Act 2004 introduced a new duty (Section 10) to co-operate at a strategic level on local authorities, CCGs and other relevant children’s services partners. The same partners were also placed under a duty (Section 11) to make arrangements to ensure that they take account of the need to safeguard and promote the welfare of children in the discharge of their own functions. Any change in approach would need to be agreed jointly between the Council, CCG and NEFLT further legal implications were included in the report to CYPE Cabinet Committee on 11 January 2019.
Equalities implications: It is not expected that the contract variation will have a negative impact on directly service delivery. However, the Equalities Impact Assessment from the original contract will be reviewed as part of this work.