Agenda item

(a)        Public Health Nursing Services

Report of the Chief Officer for Communities, Public Health, Environment and Prosperity on the procurement of public health nursing services,attached.

(b)        Re-procurement of Integrated Children’s Services

Report of the Chief Officer for Children’s Services (CS/17/13) on the process for a procurement exercise for new contract/arrangements for commissioning of children's social care services,attached 

The Cabinet’s attention is also drawn to the Report of the People’s Scrutiny Committee’s Spotlight Task Group (CS/17/11) on the above, attached.

The Cabinet considered the Report of the Chief Officer for Communities, Public Health, Environment and Prosperity on the procurement of public health nursing services and the Report of the Chief Officer for Children’s Services (CS/17/13) on the commissioning of integrated children's social care services.

The Cabinet also had regard to the Report of the People’s Scrutiny Committee’s Spotlight Task Group (CS/17/11) looking, in particular, at the future options for the provision of public health nursing services, which had favoured Option 3 namely bringing the service back ‘in-house’.

The Cabinet had previously acknowledged that in respect of existing services,  Commissioning Partners were committed to continuing strong working arrangements both as a commissioning partnership for children, young people and families and as part of the Devon Children, Young People and Families Alliance. 

Further and specifically relating to:

(a) Public Health Nursing Services

(Councillors Brazil, Dewhirst, Hannan, Julian, Randall Johnson and Westlake attended in accordance with Standing Order 25(2) and spoke to this item).

The Report of the Chief Officer for Communities, Public Health, Environment and Prosperity outlined the results of the consultation previously authorised by Cabinet before any determination of future arrangements, in line especially with the following options:

·          negotiating a 12 month interim contract(s) for the provision of children’s services to allow for a full procurement with a contract start date of 1 April 2019 incorporating 0-19 Public Health Nursing Services;

·          proceeding with independent procurement of 0-19 Public Health Nursing services; or

·          transferring the 0-19 Public Health Nursing Service to Devon County Council from 1 April 2018, under the management of the Director of Public Health (as the statutory Director) until such time as strategic discussions on the configuration of children’s services were complete and a decision made on future commissioning/provision arrangements.

While, at that time, it had not been anticipated there would be any need for substantive changes in service provision as a result of any of the above options the Cabinet had nonetheless endorsed the approach outlined above (and set out more fully in Report CS/17/6) in the interests of openness and transparency, to ensure the County Council determined the means of providing those services for which it was responsible.

As set out in the Chef Officer’s Report now submitted, Members noted that the consultation on the procurement of public health nursing services had revealed a clear majority among public, users, staff and practitioners for Option 1 above.  Further, and following those considerations and having regard to a subsequent review of all the facts (including the views of the Spotlight Task Group referred to above) the revised risk assessment and the importance of ensuring that local services were commissioned in accordance with a shared strategic approach, the Cabinet was now recommended to adopt Option 1. Members acknowledged that while that this option might not offer the greatest financial certainty for Public Health Devon, the continued benefits of working together with partners and maintaining a period of stability for a further year would provide the opportunity to plan more effectively with partners to best promote the health, wellbeing and safety of the children and young people of Devon and their families. In presenting her Report, the Chief Officer corrected the New Born visit statistics on page 7 of Virgin Care’s consultation response where the figure of 88.6% should have read 82.6%.  The Cabinet noted that the Health and Wellbeing Scrutiny Committee had also considered this Report at its meeting 7 March 2017 and had endorsed Option 1 while acknowledging the need to look more closely at Option 3 in the longer term.

The Chief Officer’s Report also incorporated an Impact Assessment relating to the possible impacts of the proposals for public health nursing, circulated previously for the attention of Members at this meeting. in order that might have full regard to the responsibilities placed upon it to exercise the Council’s Public Sector Equality Duty, where relevant, which recognised that no unmanageable impacts had been identified.

The matters having been debated and the options and/or alternatives and other relevant factors (e.g. financial, environmental, risk management, equality and legal considerations and Public Health impact) set out in the Chief Officers’ Reports and/or referred to above having been considered:

It was MOVED by Councillor Davis, SECONDED by Councillor McInnes, and

RESOLVED

(i)  that approval be given to the course of action at Option 1 set out above namely entering into a 12-month interim contract (with partners) to allow for a full procurement for a longer term contract with a contract start date of 1st April 2019.

(ii) that accordingly the County Council continues to commission public health nursing services jointly with the Clinical Commissioning Groups (CCG’s), funded through the Public Health Grant, for a period of one year 2018/19 via a Section 75;

(iii) that, as lead commissioner, NEW Devon CCG award a one year contract for 2018/19 to Virgin Care Ltd.

(b) Procurement of Integrated Children’s Social Care Services

(Councillors Brazil, Hannan and Dewhirst attended in accordance with Standing Order 25(2) and spoke to this item).

The Report of the Chief Officer for Children’s Services (CS/17/13) on the procurement of a range of care services for children with additional needs was considered, acknowledging as referred to at (a) above, that Cabinet had previously acknowledged the current contractual arrangements for Integrated Children’s Services (currently provided by Virgin Care Limited) were required to be reviewed to facilitate further consideration and determination of these matters at this meeting.

The Chief Officer’s Report summarised the outcome of the Contract Review process against which the delivery of services within ICS had been evaluated. This had resulted in the recommendations now outlined for the shape of future delivery of services.

The Review had identified areas of good performance and areas for improvement, relating in particular to waiting times for CAMHS,  delivery of the ‘Local Offer’, provision of short breaks for carers and families and managing the key shift to personalised and tailored services.  The Review had concluded that there had been improvements in those areas and/or there was confidence the provider would continue to improve against the priorities in the Local Transformation Plan. Members further acknowledged that whilst it might take some time to improve performance in some areas the process had begun and the change process underway would again benefit from a period of certainty and continuation of the service through a one year contract would provide the best opportunity to integrate service delivery, deliver change and therefore improve outcomes for children and families.

The Chief Officer and Interim Head of Service for Children’s Social Work and Child Protection also commented upon the Impact Assessment circulated prior to the meeting relating to the decommissioning of the DISC Plus Service - provided by the current provider as part of the reprocurement of integrated children’s services - for the attention of Cabinet Members at this meeting, in order that they might have full regard to the responsibilities placed upon them to exercise the Council’s Public Sector Equality Duty, where relevant. The Assessment had not identified any unmanageable impacts.

The Chief Officer’s Report further acknowledged that the review referred to above had concluded that there were no specific equality, public health or sustainability implications arising from the proposed course of action: those services were necessarily predicated on the basis of providing an equitable service for all users and there were no unmanageable outcomes.

The matters having been debated and the options and/or alternatives and other relevant factors (e.g. financial, environmental, risk management, equality and legal considerations and Public Health impact) set out in the Chief Officers’ Reports and/or referred to above having been considered:

It was MOVED by Councillor McInnes, SECONDED by Councillor Davis, and

RESOLVED

(i) that the Local Authority (the County Council) continues to commission jointly with the Clinical Commissioning Groups (CCG’s), Children and Adolescent Mental Health Services (CAMHS) and community health and care services for children with additional needs: with delivery of services monitored through the commissioning governance arrangements of the Children, Young People and Families Alliance, jointly funded through a pooled budget for the period of one year 2018/19 via a Section 75;

(ii) that, as lead commissioner, NEW Devon CCG award a one year contract for 2018/19 to Virgin Care Ltd;

(iii) that the Local Authority (the County Council) work jointly with CCG’s throughout the next year to determine a strategy to shape service delivery with a view to tenders for services being invited during 2018 for a longer term contract(s) from 2019 onwards.

[NB: Any Impact Assessments referred to above may be viewed alongside Minutes of this meeting and may also be available at:  http://new.devon.gov.uk/impact/].