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

These will be part of Herefordshire’s approach to supporting families and providing early help for children and young people aged 0 to 19 and up to 25 for young people with a disability and/or additional health needs. This includes public health nursing (encompassing health visiting and school nursing) and an approach which supports greater integration with children’s centre services, early years and early help services together with wider family befriending, mentoring and third sector services from April 2018.

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 years, to commence on 1 April 2018 at a maximum cost of £13,070,700 over this term, be procured;

(c)  the director for adults and wellbeing, following consultation with the directors for children’s wellbeing and public health, be authorised to take all necessary operational decisions, including award of contract, to implement the above recommendation within the budget set;

(d)  family mentoring services be procured for a period of up to two years at a maximum cost of £166k for 2018/19, with an option to extend for a further year, subject to continued funding being available;

(e)  pending the procurement referenced at recommendation (d) above; existing service delivery arrangements, across the county, for family befriending services provided by Homestart and Vennture be extended to the end of March 2018 at a cost of £167k in 2017/18; and

(f)   the director for children’s wellbeing be authorised to take all necessary operational decisions including award of contract to implement recommendations (d) and (e) above.

1.    Combine all elements into a single competitive tender: this would create potential risks around flexibility for the council in terms of the offer for children and families or where there are changes to funding, policy direction or the council’s approach. In response to a soft market testing exercise in 2017, ten provider organisations expressed an interest in delivering some elements of an integrated service. The soft market test showed a number of providers with sufficient experience to deliver individual elements, but only one provider with sufficient experience across all elements. Having only one potential provider could make it more difficult for the council to change the service if it needed to apply a different approach or had to reduce funding. By contrast, a number of organisations would be capable of delivering the public health nursing service. The results of the market engagement exercise therefore support a procurement approach involving separate lots.

2.    All services could be brought in-house: this would create clinical, financial, legal and statutory risks in relation to health visitor and school nursing services, since these require considerable specialist expertise, which is not currently available within the council. This could significantly increase the overall costs due to having to bring in specialist clinical expertise and potentially reduce the resource available to spend on front line delivery across the county. This option is not recommended at this time.