Purpose

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
1st 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 31st 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 1st 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.
 

Content

Adopt a 2-year fixed model with an annual cost of
£7,676,596 from 1 April 2024. The proposed model
includes a greater skill mix of staff whilst also ensuring the
clinically safe delivery of service. A procurement
exercise would commence in the two year period to ensure a new
service is commissioned from 01/04/2026.