Purpose

This
report recommends the  variation of
a  contract with Wirral Community
Health  and 
Care NHS Foundation Trust for the delivery of the Healthy Child
programme, using Public Health Grant to the total additional sum of
£1,425,350, for the period April 2023
to January 2027. The funding will address recurrent staffing pay
awards arising from Agenda for Change uplifts and provide partial
support for additional pay pressures identified by Wirral Community
Trust in relation to the delivery of statutory services.
 

Decision

The Director of Public
Health has decided to vary the contract with Wirral
Community Health & Care NHS Foundation Trust for the
delivery of the Healthy Child programme, in the total additional
sum of £1,425,350 to cover recurrent
staff pay awards and support further pay pressures. 
 
 

Reasons for the decision

The recommendation
ensures continuity of a critical statutory service, mitigates risks
to safeguarding public health outcomes for children and families,
and addresses identified funding gaps in direct staffing costs
following nationally determined NHS pay uplifts.
 
During the lifetime of
the current Healthy Child contract, NHS Agenda for Change pay
awards, determined nationally, have increased staffing costs beyond
the original tender value.  Throughout
the contractual period, responsibility for decisions on funding
these nationally agreed staff pay uplifts transferred to local
authorities via Public Health during 2023/24.  Additional funding to support this has been added
into the baseline of the Ringfenced Public Health
Grant.  Public Health has previously
made one?off payments to address Agenda for Change inflationary
uplifts to NHS providers.  A recurrent
award this year will address a compounded funding gap for staff pay
costs experienced by Wirral Community Health & Care NHS
Foundation Trust. 
 
Following a financial
review of services and contracts, Wirral Community Health &
Care NHS Foundation Trust has identified further pay pressures in
relation to the direct delivery costs of the Healthy Child
programme.  Discussions have taken place
between Wirral Council and Wirral Community Health & Care NHS
Foundation Trust to understand these pay pressures, and to consider
options for mitigation.  Joint analysis
of the contract finances (current contract value and all direct
staffing costs) has confirmed the position regarding the funding
gap relating to staff pay pressures, associated with the direct
delivery of the Healthy Child programme. 
 

Alternative options considered

Alternative options
considered include not awarding any additional funding beyond the
agreed agenda for change pay uplift, however the outcome to this
would result in high risk of significant service disruption,
provider withdrawal, and breach of Council statutory
duties.  Alternative providers are
limited, and emergency arrangements would likely incur higher costs
and destabilise other key services for children and families
locally.  Therefore, this option was not
deemed appropriate.
 
Alternative options to
mitigate the impact of financial pressures within the service would
have a direct impact on the quality and effectiveness of the
contract, including statutory functions, therefore this option was
not deemed appropriate.