North Yorkshire County Council
Health and Adult Services
Executive Members Meeting
10 March 2023
REPORT TO Corporate Director of Health and Adult Services (HAS) in consultation with the
Executive Member for Health and Adult Services
Provision of Community Mental Health Services
|
1.0 Purpose Of Report
Seeking approval to extend the Community Mental Health contract for an additional 24 months – to 30 September 2025 and begin work as soon as possible to explore the re-procurement of a new service, including considering a public engagement exercise
|
2.0 Background
In 2018, NYCC commissioned six providers to deliver Community Mental Health services across North Yorkshire. The initial term was for 3 years and there are 2 provisions to extend for terms of 2 years. The first of the two extension periods ends on 30 Sept 2023.
The main objectives of support delivered through the Contract are:
· To help prevent people from developing mental health issues.
· To support people with mental health issues to recover and stay well.
· To act as a local point of contact for people with mental health issues or concerns and their carers and family members.
· To support people with mental health issues or concerns to be able to access the support they need.
· Provide brief interventions on practical support for people with mental health issues or concerns.
· Provide social support and support social inclusion for people with mental health issues or concerns; and
· To promote self-management of mental health conditions
This service has 6 LOTS with different providers:
· Darlington Mind – covering Hambleton and Richmondshire.
· Next Steps – covering Ryedale
· Scarborough Survivors – covering Scarborough and Whitby
· Mind in Harrogate – covering Harrogate
· Pioneer Projects – covering Craven
· Horton Housing – covering Selby
Almost 4000 people with mental health needs were supported during Oct 21 to Sept 22 (the latest full year of the contract). Referrals are accepted from any source, including self-referrals and referrals from family members and carers, and professionals.
3.0 Issues
The Covid pandemic has had a significant impact on the mental and emotional health of people throughout North Yorkshire.
· People with mental health problems reported an increase in the severity of the challenges they faced.
· Health and economic / social inequalities appeared to increase
· Adults reported in increase in loneliness and feelings of isolation
The services have responded positively and made some successful changes since Covid which include
· more 1:1 support rather than group support where requested.
· Reduced numbers in each group activity
· Increased telephone support
Use of the services has improved since lock-down eased. Across all the providers – activity levels have improved and some state that they are busier than ever. Support continues to be delivered in ways that are responsive to users needs – providing a range of group and activity support including community café’s and supporting individuals with issues such as housing, finances, referral to specialist services.
During Covid there was a lighter touch contract management oversight which ensured that contractual obligations were met and monitoring reports were received. Formal contract review meetings will restart in March 2023 to ensure that there is opportunity to explore further any service development issues and provide narrative to the figures and reassurance about delivery.
4.0 Policy Implications
North Yorkshire’s Mental Health Strategy Hope, Control and Choice is under review alongside the JSNA – as part of the overall review of strategies co-ordinated by Public Health, following the recent Public Health re-alignment of portfolios.
5.0 Financial Implications
Four of the Six LOTS are jointly funded between NYCC and the Humber and North Yorkshire Integrated Care Board (ICB). Continuation of funding for Scarborough, Ryedale and Harrogate, Hambleton and Richmondshire has been confirmed and agreed for 2 years (1 October 2023 to 30 September 2025) by the ICB.
The total annual investment is £246,778.26 (including ICB contribution of £39,905.42). As part of contract monitoring meetings discussions will be held about financial stability and delivery for the duration of the extension.
The Contract Manager has not identified any financial risk association with the continuation of this contract as outlined in recommendations above. A financial assessment has been completed for the suppliers as part of the procurement governance (Gateway 4)
6.0 Legal Implications
The extension is permitted within the contract terms and conditions and is permitted in accordance with Regulation 72 (1) (a) of the Public Contracts Regulations 2015.
7.0 Risk Management Implications
The Mental Health landscape is changing, and Health are piloting some options. A 2-year extension could prevent joint commissioning, though there is the option to terminate. Risk can also be mitigated by ensuring that there is flexibility within the current contract; including any relevant contract variations.
8.0 Impact on other services/organisations
A recent change of Service Development governance has brought the community mental health contracts within the prevention portfolio. Some of the community mental suppliers are part of partnership arrangements to deliver the new Stay Healthy, Independent and Connected grant programme from 1 April 2023. As this is a new form of delivery, there is positive value in maintaining continuity of mature suppliers as this new programme is implemented.
Extending the existing provision for a further 24 months is likely to have a positive impact on the voluntary sector, ensuring that they are more tender-ready and able to compete for NYCC contracts on a level playing field with other service providers.
9.0 Equalities Implications
An EIA is not required to extend the existing service for a further 24 months. However, it is likely that an EIA will be required in advance of service user consultation and design of the new service specification.
10.0 Conclusion and reason for recommendation/s
The most cost-effective method of continuing the service is to extend within the current contract for the 2 years. This offers a continuation of the current delivery of the service with no disruption to individuals accessing the support. NYCC will continue to monitor, review and develop the services until the full Mental Health Review is concluded and new care models and specifications are available for procurement.
The Service Area wish to begin work as soon as possible to explore the re-procurement of a new service, including considering a public engagement exercise and they wish to continue explore collaborative commissioning opportunities with Health. The Service area will require a generous amount of time to explore the future of mental health support services in North Yorkshire and therefore it is recommended that a re-procurement exercise start as soon as possible to ensure a continuation of community mental health support post September 2025
|
14.0 Recommendation/s
Extend the Community Mental Health contract(s) for an additional 24 months – to 30 September 2025 and begin work as soon as possible to explore the re-procurement of a new service, including considering a public engagement exercise.
|
Sally Anderson – Strategic Service Development Manager – Prevention