Agenda item

This report is required to be  considered under General Exception Procedure Rules as set out in Part 4.2 Paragraph 16 of the Council’s Constitution.

RESOLVED:

To agree an award of the Enhanced Health Visiting Service contract to Provider A for a period of a maximum of five years (2+1+1+1) from the 1st of September 2023. The total value of the contract will be a maximum of £34,850,000 (An average of £6,970,000 per year).

Related Decisions

The Business Case Report for this procurement was approved by CPIC on 3 October 2022 (CE S123):

·  0-25 Recommissioning Programme -  City & Hackney Enhanced Health Visiting Service CPIC Report Business Case (2022)

Reason(s) For Decision / Options Appraisal

The ongoing provision of a universal health visiting service is essential to supporting the health and well-being of families and children at critical stages of development, to identify those families in need of additional support or with safeguarding concerns, and contribute to the wider benefit of society through enabling every child to have the best start in life. There is strong evidence in support of all aspects of the Healthy Child Programme.

The Enhanced Health Visiting Service has been designed to build on the strengths of the existing service currently provided by Homerton Healthcare Trust. The new enhanced service has been modernised to reflect the most recently published evidence and guidelines for the Healthy Child Programme. The enhanced model was developed following consultation  and engagement (see business case) and supported by the guidance and oversight of the Institute of Health Visiting (iHV).

The service model includes an additional fifth level over and above the four levels of service currently provided. This intensive fifth level (replacing the previously separate Family Nurse Partnership Service) will support vulnerable, complex families and will have a broader eligibility criteria so that families that require support are not restricted access due to the parent's age or if it is a second born child.

The Family Nurse Partnership programme model has a number of limitations:

It only works with first-time mothers under the age of 25. This does not align with the needs of the City & Hackney population, which has a reduced number of teenage parents, and an increasing number of older first-time parents.

The programme only works with the first child up to 2 years. This excludes families with more than one child and communities in the borough where the birth rate is high.

The programme does not address concealed pregnancies, as you cannot access the programme if you are more than 28 weeks pregnant.

FNP is a licensed model and therefore does not allow for any flexibility with regards to its enrolment criteria and delivery model.

The Enhanced service places an even greater emphasis on the autonomy of the specialist trained public health nursing workforce to provide services based on their clinical judgement and expertise. The new service model will enable the service to be more responsive to changing needs, stepping families up or down levels of intervention as circumstances change. This is not dissimilar to the current service offer except the new model offers a fifth level of service where the most experienced nurses are able to work more intensively with those families that require it and without restriction due to the age of the parent or number of children already within the family, thus widening the intensive level of service to more vulnerable families with a broader range of personal circumstances that would benefit from this level of intervention. 

The new model of service, as described in detail in the business case, will also provide increased opportunities for the health visitors and the wider skills mix workforce to work alongside early years to improve learning, development and health outcomes and to undertake targeted work with families on areas considered by evidence to have a high impact on health such as substance misuse, or domestic violence.