Issue details

The Kirklees Integrated Heathy Child Programme (KIHCP) Service is currently commissioned by Public Health on behalf of Kirklees Council and Kirklees Integrated Care Board (ICB) (previously Kirklees CCG).

The service commenced on 1^st April 2017 and was commissioned for a duration of five years. The contract adopted a lead provider model with Locala being the lead provider who then subcontracted, South West Yorkshire Foundation Trust, Northorpe Hall, Home Start and Yorkshire Childrens Centre.

Currently the Healthy Child Programme (HCP) is into a three-year extension due to end on 31^st March 2025.  The annual value of the contract is £10,657m. 

The contract is funded through various sources, namely, Public Health Kirklees Council, Children Services Kirklees Council and the ICB.

Since the inception of the contract there have been a number of significant decisions that have re-shaped the contract from how it was originally commissioned.

Decisions to date are:

·       A total reduction of £360k from the Childrens budget from 01/04/24

·       A novation of £3,226m from the current contract from Kirklees Council to the ICB from 01/04/24.

·       Decision regarding removing Yorkshire Childrens Centre (now known as Fresh Futures) and Homestart from the existing Healthy Child Programme Contract and direct award under the new Provider Selection Regime (PSR) from 01/04/2024.

This leaves the contract in a fragmented state and in order to ensure effective and quality services continue post 1^st April 2024, discussions have been taking place with partners and providers on how this can be delivered.

There have been ongoing financial challenges with the Healthy Child Programme since the Contract commenced and considering the recent SEND review and focus on mandated contacts it has been decided to redesign and reprofile the remaining elements in the contract.

Through discussions between Public Health colleagues and Locala, Locala developed a number of options which have been considered and the preferred option is to adopt a 2-year fixed model with an annual cost of £7,676,596 from the 1 April 2024.   The costings of the proposed model have been evaluated by finance colleagues from the Council to provide feedback on the structure. 

The proposed model includes a greater skill mix of staff whilst also ensuring clinically safe delivery of service.   

Contract management will pick up where the KPI’s and specified performance standards are not being achieved and officers will work with Locala in order to develop action plans as necessary.  Officers will be working to ensure that this new model has clear expectations, with relevant KPI’s and outcomes specified within the Contract. This will ensure that we are assured as commissioners of the safe delivery of the Contract and are able to robustly performance manage Locala over the period of the contract.   Officers will make sure that this is supported in accordance with the Contract Terms and Conditions which include operational standards, national quality requirements, performance measures and reporting requirements.

It is expected we will find the additional money from the ring- fenced Public Health Grant.

Officers are also planning the longer term sustainability of the Healthy Child Programme which would include the option of a competitive tender process.

Engagement

This has gone through the following engagement processes:

Existing provider (Locala). Detailed conversations around what the provider is able to deliver within an agreed financial envelope, with a specific emphasis on the Healthy Child Programme 0-5 mandated contacts and ensuring appropriate Safeguarding for children aged 0-19.

Kirklees Health and Care Partnership SLT.  Discussion with colleagues from across the ICB system in order to ensure systems working and identify gaps and opportunities. 

Individual engagement across a range of internal and external colleagues This includes current provider (Locala), ICB colleagues, Childrens, Early Support. Procurement and Safeguarding in order to gain feedback on the model of delivery.

Portfolio holders for Health and Social Care, Childrens and Education. 

Through this process, the following themes have been raised and considered:

·       Ensuring the cost-effective delivery of a contract which meets mandated requirements for the 0-5 Healthy Child Programme.

·       Ensuring that the most vulnerable families are effectively supported to prevent escalation into higher end costly services and are kept safe from harm. 

·       Ensuring the cost effective delivery of a contract which provides Safeguarding support for children and families aged 0-19. 

·       Ensuring the new pathways reflect changes to the service model and children, young people and families understand what the changes are and how to access alternative ways for support.

·       Ensuring that the Local Authority seeks input, advice and feedback from Kirklees ICB in order to ensure an integrated service.

Consultation

The following have been consulted as part of this process:

·       Kirklees Council Contract Assurance Board;

·       Portfolio Member Briefings – Health and Social Care, Childrens and Education;

·       Corporate Strategy, Commissioning and Public Health Senior Leadership Team;

·       Kirklees Health and Care Partnership SLT;

·       Individual informal consultation  across a range of internal and external colleagues including:  current provider (Locala)ICB colleagues, Childrens, Early Support. Procurement, Safeguarding.