Agenda item

Report for Decision

RESOLVED:

To agree to extend the Young People's Clinical Health and Wellbeing Service contract for up to 1 year until 31 August 2024 at a maximum cost of £540,145.

REASONS FOR DECISION

As the lead department responsible for the local pandemic response, The Public Health service has been heavily involved in the borough’s Covid-19 response since March of 2020. Public Health’s role has included  significant additional delivery, such as; creating and managing the City and Hackney Health Protection Board which met weekly to coordinate the response to the pandemic at a local level, developing the  local outbreak control plan and coordinating the targeted management of local outbreaks, setting up Covid-19 testing sites, setting up and running a local contact tracing system, creating a new Covid-19 data dashboard and leading key programmes to support the local pandemic response (notably mobilising a Public Health Community Champions programme and a new VCS grants programme). The initiatives, among other aspects of the local pandemic response, have been predominantly delivered using existing staff resources.

The demand that the pandemic response put upon the Public Health team meant that the service essentially went into business continuity in March 2020. Consequently, many day to day activities relating to commissioning and procurement were not able to take place.

The disruption of the Covid-19 period caused a significant backlog in commissioning activities which is still being worked through. Additional staffing resources have been recruited to support this work and where it is safe to do so, some contracts for non-core services have been allowed to end. However, even with these measures in place it has still been necessary to prioritise e.g., as a higher value contract the procurement of the Health Visiting service has been prioritised over CHYPS Plus (the Health Visiting Business Case Report was agreed by CPIC in October 2022).

CHYPS Plus provides a vital service to at risk children and young people, including access to appropriate clinical interventions related to substance misuse, sexual health, and mental and physical wellbeing. This extension will ensure that there is an appropriate legal framework in place for these services to continue.

The current strategy will be reviewed and resident and stakeholder engagement will be carried out in order to redesign a more responsive service specification, informed by the latest evidence and best practice guidance, for re-procurement next year. The one year extension will allow this review work to be undertaken and allow time for insourcing of all or part of the service to be fully considered and plans developed as appropriate. This will also enable the inclusion of the holistic specialist services for young people currently provided by CHYPS Plus to be considered as part of a broader integration project titled ‘Super Youth Hub’ (SYH).

The SYH aims to bring together a range of preventative and treatment services for school age children and adolescents including services for; wellbeing and mental health support, sexual health, substance misuse, primary care and training and employment. The SYH will be a place-based service with an ambition to improve young people’s autonomous and independent access to a range of services based on an assessment of need. Service planning will be informed through a community participatory research project led by young people. The services being considered for SYH are currently funded separately by departments in Hackney council, such as Hackney education and public health, and by health partners including primary care, the North East London Integrated Care Board and The City of London who are working together to redesign services based on the views and perspectives of young people and their specific needs. 

CHYPS Plus experienced a significant reduction in footfall to the Service during the Covid-19 ‘lockdown period’ when the Service moved from a ‘drop in’ service at a variety of locations to an appointment-only service at one central hub. Since services reopened in July 2021, footfall to the hubs have not returned to pre-pandemic levels and the Service has been underperforming on key performance indicators. Prior to the pandemic CHYPS Plus had also observed a drop in engaging new young people into the Service. The Service is making some immediate changes to the leadership of the Service including a change in governance from a ‘stand alone service’ to governance and oversight by the Clinical Leadership of the Homerton Healthcare NHS Trust Sexual Health Service. The proposed extension will enable time to work with the current Provider to improve performance and make adjustments to the outreach delivery model in the short term to improve access into the Service. This will also inform the SYH project in terms of increasing understanding of the service needs of young people in Hackney and The City post Pandemic.

This service is currently delivered by a local NHS trust and it is unlikely that the proposed extension will be challenged. NHS providers are under considerable pressure and are prioritising the delivery of existing services. In addition, following the passing of the Health and Care Act 2022 providers are increasingly focusing on partnership working with local commissioners. Changes to the provider selection regime for health, including Public Health services, are anticipated but the timetable is currently to be confirmed.

This procurement is part of a phased re-commissioning programme for all 0-19 year olds (up to 25 years where there is a statutory responsibility) that will deliver efficiencies and improved outcomes through integration. The initial contract period was two years with a further three additional years extension. During this period, work continues to identify future opportunities around integrating services as part of a comprehensive review and redesign process for a fully Integrated Children and Young People’s Wellbeing service for 0-25 year olds in the City and Hackney.

There is an ongoing business need for this service and the proposed extension will ensure that this can continue to be delivered on an appropriate legal basis. Substantial resources have gone into resolving the backlog of procurement activity that has built up but COVID-19 was a worldwide pandemic which prevented the Public Health service from delivering its planned procurement programme and this could not reasonably have been foreseen by commissioners.