To approve the commissioning intentions for public health nursing and early help services.

The cabinet member for young people and children’s wellbeing introduced the report.

He noted that the first two priorities listed in the children and young people plan related to early help and 0 to 5 early years and that these proposals were about putting in place effective strategies to support these priorities.

The cabinet member thanked the children and young people scrutiny committee for the comments raised by them. He stated that it was regretted that some of the questions raised were not able to be answered at the time but confirmed that answers had since been provided on all matters. He stressed that consultation had taken place with partners in the clinical commissioning group (CCG) and elsewhere as this had been raised as a concern.

The director for adults and wellbeing stated that the proposals formed part of a wider package of early help for families and that responsibility for commissioning health visiting services (0 to 5’s) fully transferred from the National Health Service (NHS) to councils on 1 October 2015. There was a need to change the perception of the service from being a purely clinical service to working in partnership with other organisations in the broad context of the CYPP.

Due to reductions in the public health grant the new contract would have to deliver some efficiency savings. There could be some perceived losses in the transformation of the service but it was deliberate national policy that health visiting services be seen as part of the public health package and not as part of the NHS.

The director also noted that a significant amount of engagement had taken place with events held with parents, carers and staff. Consultations were ongoing with GPs.

The director for children’s wellbeing commented on the proposals for family mentoring services. He highlighted the preventative approach to be taken, seeking to prevent needs from escalating to higher levels by early intervention. The service would develop a sustainable approach going forward and continue to address the council’s priorities.

The chairman of the children’s scrutiny committee thanked cabinet members and officers for making the report available to the scrutiny committee. She highlighted the concerns which had been raised by the committee, including with regards to safeguarding, and commented that there would have been value in having a more detailed report available. The chairman confirmed that the information and responses provided since the scrutiny committee meeting had satisfied the committee going forward.

The cabinet member for young people and children’s wellbeing noted the comments made and confirmed that any service the council contracted would be expected to have safeguarding embedded at the heart of everything they did. He also confirmed that contractors would be made aware of the rural nature of Herefordshire and the challenges that posed.

Resolved that:

(a)  the responses to the recommendations of the children and young people scrutiny committee at paragraph 40 be approved;

(b)  a new 0 to 25 integrated public health nursing service for a period of up to five  ...  view the full minutes text for item 54

To preview the draft decision report concerning the commissioning intentions for universal and early help services for children, young people and families.

The committee considered a report from the cabinet member health and wellbeing and the cabinet member young people and children’s wellbeing concerning procurement of universal and early help services for children, young people and families. The report was introduced by Lindsay MacHardy, public health specialist, who advised the committee that the proposal contained in the report placed the family and child at the heart of the commissioning exercise. The commissioning exercise would enable further integration of the approach for early help and public health nursing services.

Hazel Braund, Director of Operations at Wye Valley Clinical Commissioning Group (CCG) spoke on behalf of the CCG and raised concerns regarding the procurement exercise. It was not felt that the proposal took account of safeguarding issues and no discussion with the safeguarding board had taken place. The principles of the commissioning exercise were supported but there was disappointment that the CCG had only been made aware of the proposals at a late stage and without sufficient detail on which to base a proper assessment. It was a significant paper that the committee was being asked to consider, proposing a very different model of operation to existing arrangements. There was concern that without an understanding of existing models it would be a challenge to scrutinise effectively the new arrangements proposed in the report.

Chris Baird, interim director for children’s wellbeing, said that the early help strategy had been to the Herefordshire Safeguarding Board (HSCB) and the board had considered the approach in Herefordshire. Commissioners and providers of children’s services had to ensure that the service had appropriate safeguarding in place and followed the HSCB’s procedures.

The committee made the comments below during the debate:

·         Concern regarding a lack of consideration of safeguarding issues in the proposals and the reported lack of engagement with the safeguarding board.

·         Concern regarding the reported lack of consultation with the CCG.

·         The redesign survey report attached to the draft cabinet report demonstrated that there was a lack of awareness of WISH in the local community. Very few respondents accessed the site for guidance and advice. Further work was required to raise the profile of the service and ensure that it was accessed more readily by the community.

·         There was not felt to be a sufficient level of evidence in the report to provide assurance that the contracts currently in place were providing value for money and effective service. However the committee was content to support the extension of the family befriending services, proposed in the draft cabinet report contracts up to March 2018 with Vennture and Homestart to ensure a consistency of service during the current year.

·         The committee required further detail of the services that would be procured in order to undertake effective scrutiny of the proposal. The draft cabinet report was not clear about tangible outcomes and quantifiable results sought through the procurement. The committee was unable to assess the terms of the proposed commissioning exercise to determine if it could realistically achieve its stated aims.  ...  view the full minutes text for item 13