Purpose

Proposed decision:
 
A) Retrospectively
contract with the East Kent Hospitals Trust and the Kent Community
Health Foundation Trust for 1 April 2023 to 31 March 2024 for the
provision of SEN Therapies
 
B) Contract with the
East Kent Hospitals Trust and the Kent Community Health Foundation
Trust for 1 April 2024 to 31 August 2025 for the provision of SEN
Therapies
 
C) Agree to the review
of the Kent and Medway Communication and Assistive Technology
service and to incorporate into the wider recommissioning of SEN
Therapies
 
D) Agree for the
exploration of joint commissioning with the NHS for the wider
provision of SEN Therapies to include in the re-procurement of NHS
Community Services
 
E) Delegate authority
to the Corporate Director of Children, Young People and
Education, in consultation with the Cabinet
Member for Education and Skills and the Corporate Director of
Finance, to take relevant actions, including
but not limited to, entering into and finalising the terms of
relevant contracts or other legal agreements, as necessary, to
implement the decision
 
 
Reason for the decision
 
To
continue with annual contracts, issued by NHS Providers, for the
current Special Educational Needs (SEN) Therapy services. The
future commissioning intentions are to align with the NHS Kent and
Medway timeline to re-procure their Community Services, and
specifically jointly commission an Integrated Therapy Contract for
1 September 2025.
 
The
current annual contract values are £752,905 with East Kent Hospital University
Foundation Trust (EKHUFT) and £1,526,586 with Kent Community
Health Foundation Trust (KCHFT).
 
This
requires agreeing a retrospective contract for the financial year
2023/2024 and a future contract for 17 months from1 April 2024 to
31 August 2025.
 
Decision is also sought to review and bring the Kent and Medway
Communication and Assistive Technology service into the new jointly
commissioned Integrated Therapy Contract, under the NHS Kent and
Medway Community Services re-procurement. 
 
Background
 
The 2015 Special
Educational Needs and Disability (SEND) Code of Practice, sets out
that Speech and Language Therapy, Occupational Therapy,
Physiotherapy and Assistive Technology should be jointly
commissioned.
 
KCC is working towards
a jointly commissioned Integrated Therapy Service, which will
include the Kent and Medway Communication and Assistive Technology
Service (KMCAT), to maximise the use of finite resources from local
authorities, schools, colleges and the NHS improving outcomes for
0–25-year-olds with SEND and their parents/carers.
 
The joint aim is to
establish a new jointly commissioned service by September 2025, to
fall in line with NHS Kent and Medway’s broader
recommissioning of a unified Community Service Offer.
 
Significant
transformational activity is underway with the NHS providers who
are working in partnership with KCC and NHS Kent and Meway to
develop new ways of working.  
Implementing a more proactive and preventative tiered approach to
the provision of therapy support, that will maximise use of finite
resources and ensure a more coherent county-wide offer.
 
Securing
Kent’s Future – Budget Recovery Strategy
 

KCC has agreed with the Providers that there will be
no increase to the contract price for 2023/2024, however, the
Providers have stated that this position will not be sustainable
for 2024/2025, and therefore negotiations continue. 

The contract values for 2024/2025 will be agreed
alongside Finance colleagues and the Director for
Education.
The longer-term joint
commissioning project will meet the ambitions of Framing
Kent’s Future as follows:
 
Priority 4: New models of care and
support demand for our social care services has out stripped
funding year on year. Our commitment is to seize the opportunity of
integrating our planning, commissioning and decision making in
adult, children’s and public health services through being a
partner in the Kent and Medway Integrated Care System at place and
system level.
 
It meets the aims of Securing
Kent’s Future by holding Best Value at the centre of all
joint commissioning opportunities.
 

Financial Implications

These contracts are for the provision of Therapy
staff and are only a proportion of the overall Therapy services
purchased by the Council. A high-level reconciliation has been
undertaken to be able to justify the level of spend in commensurate
with the level of service provided, given that vacancies have been
held to compensate for the lack of inflationary uplift. 

KCC has been in negotiation with the Providers for
this year’s fee increase and have agreed in 2023/2024 there
will be no fee increase, this has meant the providers have held
frozen vacancies.

Both Providers have stated that continuing without a
fee increase into the new financial year 2024/2025 will not be
sustainable, and therefore negotiations continue. 

The current contract values are £725,905 for
EKHUFT and £1,526,586 for KCHFT, contract values for
2024/2025 will be agreed alongside Finance colleagues and the
Director for Education.

This contract is funded from the Dedicated Schools
Grant: High Needs Block, an annual grant provided by the Department
of Education.

 
 
Legal
Implications  
 
The procurement strategy is to
align existing Therapy services required by KCC, with the service
commissioned by the NHS Kent and Medway and to jointly commission
the service, with the NHS Kent and Medway as the Lead Commissioner
and KCC as a Joint Commissioner. 

 
As a Joint Commissioner, it is
expected that KCC will be a full partner of the contract with the
provider(s) and will have the ability to participate in performance
contract management and monitoring, with NHS Kent and
Medway.  This will strengthen existing
contract performance monitoring and management, given the scale and
value of the proposed contract.

 
The Provider Selection Regime
(PRS) came in to force on 1 January 2024. PSR is a set of rules for
procuring health care services, by NHS England, Integrated Care
Board, NHS Trusts, NHS Foundation Trusts and Local
Authorities.

 
There are three Provider
Selection processes:

Direct
Award processes (A, B, and C). These involve awarding contracts to
providers when there is limited or no reason to seek to change from
the existing provider; or to assess providers against one another,
because:

the
existing provider is the only provider that can deliver the health
care services (direct award process A)
patients have a choice of providers and the number of providers
is not restricted by the relevant authority (direct award process
B)
the
existing provider is satisfying its existing contract, will likely
satisfy the new contract to a sufficient standard, and the proposed
contracting arrangements are not changing considerably (direct
award process C).

Most
Suitable Provider
Competitive Process

 
For the 2023/2024 contract, the
Public Contract Regulations (PCR) 2015 would have applied, however
as PSR is now in force, this is the regulation that covers the
provision of Therapy services, and it is therefore recommended that
the route followed to sign these contracts is under Direct Award
(C).
 
For any other meaningful
commissioning using this Regime would require developing
specifications, detailed outcome frameworks and key performance
indicators, quality assurance mechanisms and contract management
schedule.  This would also not allow for
the necessary coproduction with Children, Young People, and their
Families/Carers, as required by the SEND Code of Practice and our
commitment to the SEND Co-production Charter.
 

Equalities implications
 

A full Equalities Impact Assessment
(EqIA) will be completed as part of the
Joint Commissioning Strategy, to help us to consider the potential
impact of a proposal, and how to make things as fair as possible
for anyone who is likely to be affected. The level of detail
required for an EqIA depends on how
complex the proposal is, and to what extent people are likely to be
affected by it.  We believe this will
have far reaching implications and therefore full EqIA will be required.

DPIA (if relevant)

A DPIA checklist will be completed in due
course as part of the commissioning plan to ensure KCC and partners
ability identify and minimise the data protection risks within this
commissioned activity. As this is a major project which requires
the processing of personal data, the DPIA Assessment will
therefore:

describe the nature, scope, context and purposes of the
processing;
assess
necessity, proportionality and compliance measures;
identify and assess risks to individuals; and
identify any additional measures to mitigate those
risks.

 

Decision

As Cabinet Member
for Education and Skills, I agree to:
 
A) Retrospectively contract
with the East Kent Hospitals Trust and the Kent Community Health
Foundation Trust for 1 April 2023 to 31 March 2024 for the
provision of SEN Therapies
 
B) Contract with the East Kent
Hospitals Trust and the Kent Community Health Foundation Trust for
1 April 2024 to 31 August 2025 for the provision of SEN
Therapies
 
and
 
C) Delegate authority to the
Corporate Director of Children, Young People and Education, in
consultation with the Cabinet Member for Education and Skills and
the Corporate Director of Finance, to take relevant actions,
including but not limited to, entering into and finalising the
terms of relevant contracts or other legal agreements, as
necessary, to implement the decision.