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REPORT OFTHE STRATEGIC DIRECTOR FOR CHILDREN’S SERVICES
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TO THE ASSISTANT MAYOR – SERVICES FOR CHILDREN & YOUNG PEOPLE
(25th March 2013)
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TO THE ASSISTANT MAYOR – FINANCE & SUPPORT SERVICE
(28th March 2013)
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TITLE:Extension of contract for 42nd Street from the 1st April 2013 to 30th September 2014 to enable the future development and commissioning of an integrated health service for children and young people from 1stOctober 2014.
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CONCLUSIONS
- TThe proposed 18 month contract extension for 42nd St (mental health) will enable it to be aligned with contracts for sexual health and substance misuse services in line with the Public Health ring-fenced grant allocation to meet responsibilities transferring to the City Council. The 18 month waiver for Public Health monies, in accordance with Contractual Standing Orders, will ensure continuity of service as part of the transition process.
- Aligning contracts will enable commissioners to focus time and resources on the development of the new integrated health service (including sexual health, mental health and substance misuse services), to be in place from October 2014.
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RECOMMENDATION:
That the Assistant Mayor, Service for Children and Young People:
- Approves the extension as detailed below.
That the Assistant Mayor,Finance and Support Service:
- Approves anException to Standing Orders to enable an 18 month contract extension for 42ndStreet from the 1st April 2013 to 30th September 2014 while a new integrated health service is being developed.
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EXECUTIVE SUMMARY:
As aforerunner for Integrated Commissioning Hub type activity, an innovative project has commenced to develop and commissionan integrated health service model for children and young people for 1st October 2014. This model will encompass tier 2/3 sexual health, substance misuse and mental health provisions that are currently commissioned individually.
A contract extension (to 30th September 2014) is required for the current individual contract with 42nd Street in order for it to be aligned with contracts with sexual health and substance misuse. Subject to approval, contracts for sexual health (Brook) and substance misuse (Lifeline) are to be extended to 30th September 2014 in line with the Public Health ring-fenced grant allocation to meet responsibilities transferring to the City Council. The 18 month waiver for Public Health monies, in accordance with Contractual Standing Orders, will ensure continuity of service as part of the transition process.
Aligning contracts will enable commissioners to focus time and resources on the development of the new integrated health service (including sexual health, mental health and substance misuse services) from October 2014, in conjunction with the restructuring of the Integrated Youth Support Service (IYSS).
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BACKGROUND DOCUMENTS:
(Available for public inspection)
Young people’s sexual health needs assessments (Salford PCT, 2008)
DAAT Under 25s review (2011)
Public Health report 2011 – section on children and young people’s mental health
Children and Young Peoples Health outcomes Strategy Briefing Feb 2011 DoH
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KEY DECISION:YES
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DETAILS:
A project has been initiated to join up the provision of sexual health, substance misuse and mental health services to create an integrated health service for children and young people.
Historically these services have been separately commissioned and monitored for the provision of early intervention/prevention activityfor children and young people, specifically focusing on:
- Sexual health/Teenage Pregnancy
- Mental / emotional health
- Drug and alcohol misuse
Local insight, research and knowledge from both commissioners and service providers suggests that these services are delivered to the same/similar groups of individuals, with particular vulnerabilities which lead them to be more likely to:
- Be sexually active (and have unprotected sex)
- Experience mental health problems
- Develop alcohol and drug problems that will accompany them into adulthood
Recently, individual commissioners have been keen to change service specifications to meet the needs of the population. For example, refocusing drug and alcohol services to specifically target identified, vulnerable young people; targeting sexual health services with under 19s (to reflect teenage pregnancy measures). In order to achieve KPIs and outcomes, we need to direct services to become smarter in targeting identified vulnerable groups earlier to prevent escalation of risk and to reduce negative life chances.
The proposal is to bring together and procure a single young people’s wellbeing service aimed at vulnerable young people under 25 (with a focus on under 18), responding to issues of sexual health, mental health and substance misuse, in a single affordable integrated service, as part of a wider young peoples system.
The initial focus of this project is on the services and areas described (ie. tier 3). However, the nature of the project will allow us to widen the scope to include other allied services as and when needed.
Historically, when there have been more resources, services have remained in silos, delivered partnership working sporadically, and spent energy and focus on attracting young people to premises and involving young people in the identification and promotion of these premises. It is the intention of commissioners to seek suppliers who build more structural relationships with those working with vulnerable young people, taking services to these young people and delivering work in an outreach way, and as part of a wider system of young people’s health services with strong links with universal (i.e. Integrated Youth Support Service and third sector youth organisations, primary care) and specialist services (Core Child and Adolescent Mental Health Service, Adult drug, alcohol and sexual health services.)
Current providers of individual services (contracts) are:
- 42nd Street - third sector provider commissioned to provide an easily accessible ‘community based’ mental health resource for young people (aged 14-25) under stress.
- Brook – third sector provider of sexual health services to young people (aged up to 25).
- Lifeline SMART (Substance Misuse Advice and Referral Team) -Lifeline is a national registered charity and company which manages drug and alcohol services.
A contract extension (to 30th September 2014) is required for the current individual contract with 42nd St in order for it to be aligned with contracts with sexual health and substance misuse. Subject to approval, contracts for sexual health (Brook) and substance misuse (Lifeline) are to be extended to 30th September 2014 in line with the Public Health ring-fenced grant allocation to meet responsibilities transferring to the City Council. The procurement timeline related to the proposed contract extension for 42nd St would follow that detailed by Public Health in their related report.
There is no further scope for savings in this current contract. A 10% reduction was made in 2012/13. This is a relatively small contract on an area of growing need (community based mental health support for young people aged 13-25 years). Further reduction would compromise the service as it stands. It is anticipated that the joining of mental health, substance misuse and sexual health contracts into an integrated health service in 2014 will result in savings, certainly in terms of reduction in ‘back office’ costs through one single contract.
There has been significant progress in terms of monitoring the contract with 42nd St, with regular quarterly monitoring meetings being established in 2012/13. The provider has demonstrated that they are meeting the outcomes of the contract and has reshaped their service provision to meet young people’s needs more appropriately. This service redesign reflects the type of provision we would hope to procure in the future for the integrated health service. Future monitoring meetings will be requiring continuous service improvements.
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KEY COUNCIL POLICIES:
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EQUALITY IMPACT ASSESSMENT AND IMPLICATIONS:
The young people requiring support and services around sexual health, emotional/mental health and substance misuse are some of the most vulnerable in the city. It is crucial that current services in these areas are maintained and contracts aligned while a new, integrated approach is designed and specified to enable the full benefits of such an innovative model to be realised.
A full Community Impact Assessment will be completed through the course of this development.
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ASSESSMENT OF RISK:Medium
Benefits to extending the contract / Risks to extending the contractTime and capacity can be concentrated on developing the integrated model. / Open to challenge by other providers.
Existing provider has experience working in Salford in their field. We can use this over the next 182 months and benefit from the learning in the development of the integrated model. / Potential new, more innovative / efficient ways of working out there that we haven’t used.
All 3 contracts relating to the new integrated health model will be aligned in terms of end dates. / New service provider may challenge/shape current understanding of provision in this area, informing the developments of the integrated service.
If the decision is delayed, we would be issuing the (third sector) provider with a shorter notice period, thus putting them at a disadvantage in terms of service planning.
If the decision is overturned, we would need to re-tender the individual mental health contract for a temporary period, which would reduce our capacity to fully develop and commission the integrated service.
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SOURCE OF FUNDING:
Current contract with 42nd St ends 31stMarch 2013. It is jointly commissioned and funded with NHS Salford.(It should be noted that the NHS Salford contribution can be extended.)
The value of 2012/13 contract = £97 706, funded by:
- LA - £46 800 and
- NHS Salford - £50 906
The proposed value of LA contribution to the18 month extended contract (1 April 2013 to 30 September 2014) is £70 200based on previous years contract value.
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LEGAL IMPLICATIONS Supplied by:Nicky Smith, Solicitor – Tel 0161 219 6315
Approval is sought for the extension of the contract to the 30th September 2014. The Council must comply with procurement regulations and its own contractual standing orders when commissioning goods, services or works. There is the risk that the proposed contract extension could be subject to legal challenge by an aggrieved provider because the usual tender process set out in the standing orders will not have been followed. However, exceptions to the standing orders may be authorised by the relevant Assistant Mayor, in this case the Assistant Mayor for Finance and Support Services.
In this case, the Council has sound reasons for taking this course of action, particularly the need to fully develop the new integrated health service. It would be hoped, therefore, that if the decision to extend the contract was challenged a Court would view the decision as reasonable, but it is important to be aware of the potential for challenge.
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FINANCIAL IMPLICATIONS Supplied by:Ian Johnson, Assistant Group Accountant T: 0161 778 0220
Funding for this contract is currently available from the CAMHS revenue budget.
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PROCUREMENT IMPLICATIONS Supplied by:Sharon Robson, Head of Procurement T: 0161- 686-6226
There is always a risk that any extension to an existing contract which is made outside of the full competitive processes, could be subject to challenge by an aggrieved supplier on the basis that it ought to have been advertised and put out to competition.
Whilst this risk cannot be eliminated it may be mitigated by the fact that the Council are clearly demonstrating a consistent and strategic approach to aligning commissioning and procurement strategies across all services associated with Public Health.
Challenge could be defended on the basis that the waiver is not intended as avoidance of a competitive process but delay to give us the opportunity to redesign the service specification to meet the needs of the client group (consultation with young people), align funding and commissioning strategies with Public Health and ensure the providers deliver value for money.
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OTHER DIRECTORATES CONSULTED:
David Herne – Deputy Director, Public Health
Geoff Holliday – Head of Sexual Health, Public Health, Community Health and Social Care
Gordon Adams – Acting Young People’s Commissioner Lead,Drug and Alcohol Action Team, Environment Directorate
Matt Dixon – Children’s Commissioning Manager – NHS Salford CCG
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CONTACT OFFICER:Jo Hannan
TEL. NO.0161 778 0536
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WARD(S) TO WHICH REPORT RELATE(S):
Citywide Service
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