By extending the current contract for a further fixed period, the council will be able to continue to effect quality improvements within the finances known to be available. This will also give the council time to develop the options to secure a more integrated approach across early years services by encompassing children’s centre services. This would be in line with recent recommendations from the overview and scrutiny task and finish group and the direction set out and approved in the children and young people’s plan

1.         Go to open procurement now for an integrated school nursing and health visiting service to deliver the universal healthy child programme 0-19 years for a preferred contract term of up to five years with effect from 1 April 2017. This would require investment of up to £13.1m (£2.6m each year). This is not recommended as it would not enable the council time to consider the integration referred to in paragraph 4. In addition, given the uncertainty of the current financial situation for local government and in particular potential changes to the national funding formula for public health, this is considered high risk. A shorter term contract, running for a maximum of two years, is likely to reduce the number of bidders significantly as it would represent too great an uncertainty for any new provider. In addition, there are a number of large scale health visiting and children’s centre procurements running at the current time in other local council areas, seeking bidders from what is a limited provider market. Taken together, these factors mean there is no certainty that a costly procurement exercise at this time would engender any viable bids. There is also a national review examining the cost benefits of the current mandatory requirements of the healthy child programme, which may lead to changes in what is required.

2.         Continue with the statutory provision of health visiting and school nursing services under the existing contract with some disinvestment in the non-statutory elements of the current provision. This is not recommended as the current contract expires on 31 March 2017 and the council would fail to meet its statutory obligations. In addition, this is likely to significantly undermine health outcomes in children, young people and families, require significant change management and NHS redundancies and represent a false economy relating to increased demand on other services. 

3.         Transfer the full health visiting and school nursing service or only the workforce resource to the council. This is not recommended as there is insufficient time to undertake the due diligence in relation to this transfer or to establish the necessary clinical governance and safeguarding arrangements to affect such a change by 1 April 2017. The council would need to market test the insourcing of a workforce only approach to ensure there is a sufficient market in place to deliver the infrastructure arrangements.