North Yorkshire Council

 

Health and Adult Services Executive Member Meeting

 

Friday 14th August 2026

 

REPORT TO Director of Public Health in consultation with the Executive Member for Health and Adult Services

 

 

0-19 Healthy Child Section 75 Extension

 

1.0       Purpose Of Report

 

1.1         This report seeks approval for the Director of Public Health, in consultation with the Executive Member for Health and Adult Services, to exercise the available extension option within the Section 75 Partnership Agreement with Harrogate and District NHS Foundation Trust for the delivery of the 0–19 Healthy Child Service, for the period 1 April 2027 to 31 March 2029.

 

 

2.0          Summary

 

2.1          The 0-19 Healthy Child Programme Partnership agreement between North Yorkshire Council and Harrogate and District NHS Foundation Trust (HDFT) for the delivery of the 0–19 Healthy Child Programme commenced on 1 July 2021 for an initial term of 2 years 9 months to the 31st of March 2024. The first extension term of this agreement was approved for 1 April 2024 to 31 March 2027. There two further extension periods available within the agreement 1 April 2027 to 31 March 2029 (2 years) and 1 April 2029 to 31 March 2031 (2 years).

 

2.2          As per the Section 75 Partnership agreement, Section 2 (Commencement and Duration) sub section 2.4 states   The Partners may extend this Agreement for a further period of 2 years beyond the First Extension, (''the Second Extension") by agreement in writing, subject to the approval of the Partners. Extension will commence on the day after the expiry of the First Extension. It is recommended here that this partnership agreement is extended for a further term from 1st April 2027 to 31 March 2029.

The recommendation to extend this contract is based on evidence that the performance monitoring through the existing partnership governance arrangements indicates that the provider is delivering in line with agreed contractual requirements, with no current performance concerns. HDFT provides quality and safe services demonstrating a commitment to continuous service improvement in response to the changing needs of children and families across North Yorkshire and within the context of current national policy and commissioning reforms.

 

2.3          Extending the Agreement will provide continuity and stability for children, young people and families, support delivery of the mandated elements of the Healthy Child Programme and enable continued development of integrated preventative services aligned to local priorities, including Best Start Family Hubs and Healthy Babies, SEND, school readiness, emotional wellbeing and reducing health inequalities.

 

2.4          This report seeks approval from the Director of Public Health in consultation with the Executive Director of Health and Adult Services to exercise the available extension option and extend the current Agreement for a further two years from 1 April 2027 to 31 March 2029.

3.0          Background

 

3.1          The Section 75 Agreement between North Yorkshire Council and Harrogate and District NHS Foundation Trust (HDFT) establishes a formal legal framework for the integrated delivery of the 0–19 Healthy Child Service. It enables joint planning and delivery of services to improve outcomes for children, young people, and families aged 0–19 (up to twenty-five for SEND). The agreement supports a coordinated, prevention-focused system while ensuring compliance with statutory public health and safeguarding duties.

 

3.2          The strategic objectives of the Partnership are: 

§  To ensure the effective and efficient management and delivery of the Service. 

§  To ensure that the Service forms an integrated part of multi-agency children's and young people's services across North Yorkshire, with clear links and connectivity with early help and preventative services, children's social care, paediatrics, and other services.

§  Through sharing resources and working in collaboration, to improve service performance, quality and outcomes for families and children and young people.

§  To ensure that services are children, young people and family focused, and responsive to identified needs.

§  To deliver seamless services through effective multi-agency and multi-disciplinary planning, communication, and processes. 

§  To ensure value for money and efficient use of resources, maximising income where at all possible and avoiding duplication. 

§  To respond to gaps in service delivery through improved service design and inform commissioning intentions.

§  To increase the range of skills, professional and organisational, available for the provision of services and provide a diverse range of learning and development opportunities for staff.

 

3.3          The agreement covers a 0–19 Healthy Child Service including mandated health visiting contacts and developmental reviews, infant feeding, emotional health and resilience support, safeguarding, support for looked after children and the National Child Measurement Programme (NCMP). The model combines universal provision with targeted interventions for vulnerable groups.

3.4          HDFT is responsible for operational delivery of the service, while the Council retains statutory accountability. Governance is provided through the Healthy Child Board (strategic oversight) and the Healthy Child Operational Group (operational delivery). Regular quarterly and annual reviews ensure performance and risk management is overseen. In addition, there are further regular meetings to cover the operational delivery of the NCMP, as well as more informal, regular catch ups to discuss any issues arising.

3.5          The agreement includes provisions for service transformation and ongoing development, allowing partners to adapt services, integrate further, and respond to changing national and local priorities over time. This is particularly relevant currently as there are several national and local reforms which are expected to affect future service delivery across Best Start, SEND and Children’s Social Care, as well as locally identified need around early years lifestyle initiatives and mental health and wellbeing support.

 

4.0          Detail of Substantive Issues

 

4.1          The Section 75 agreement has been in place now since July 2021 after the initial term the first extension was issued and there is a further second and third extension period available. The first extension period will expire 31 March 2027 a formal key decision approval is required to enable the second extension to be used.

 

4.2          Current performance management and governance, and partnership monitoring are stable and there are no current concerns or risks associated with quality or delivery of the KPIs.

 

4.3          There are several national and local reforms which are expected to align with Healthy Child Programme delivery, in particular Best Start Family Hubs and Healthy Babies and a stable service offer will support this.

 

4.4          Nationally new 0-19 public health nursing services for babies, children and young people commissioning guidance was published in March 2026. This guidance reflects a shift in national reporting and KPI monitoring from April 2027. The guidance does not change the current mandated requirement to deliver five health development reviews across ages 0-5 alongside the delivery of the National Child Measurement Programme. The extension of the Section 75 Partnership Agreement allows North Yorkshire Council to work collaboratively with HDFT to enable these changes to be delivered in accordance with local families’ needs and address health inequalities appropriately.

 

4.5          Therefore, it is recommended here that the Section 75 Partnership Agreement is extended for two years, 1 April 2027 to 31 March 2029, and a variation to the agreement be issued detailing a refreshed specification to be developed within existing partnership governance. This will also include an update to Schedule 3 to reflect the the annual costs to date and for the whole life cost of the agreement to 31 March 3031.

 

5.0          Performance Implications

 

5.1          The existing provider is very experienced and has established a quality service that is continually scrutinised through internal improvement processes and the partnership governance. The existing provider delivers the Key Performance Indicators (KPIs) within the contract and works closely with the Council to address any areas of concern that may arise through a quarterly Performance Partnership meeting. There are no current performance concerns. In 2026 new commissioning guidance for delivery and implementation of the Healthy Child Programme was published; this introduced a change to KPI descriptions and national reporting from April 2027. These changes will be reflected within any new extension agreement.

 

5.2          The current service is being delivered within the agreed budget. This remains under continuous review due to annual pressures presented through NHS Agenda for Change pay award increase and increases in National Insurance Employer contributions.

 

5.3          There are quarterly Healthy Child Board meetings where performance and financial monitoring is reported, and any service or partnership issues are addressed. The performance of the service is regularly presented to both Public Health and Health and Adult Services Leadership Teams, HASEX and via corporate reports.

 

6.0          Alternative Options considered

 

6.1          The alternative to extending the existing contract would be to undertake a full procurement exercise. This is not the preferred option given that there is a realistic option for extension of the current agreement, which has a good track record of performance and is well-embedded in terms of partnership working and local delivery. However, there is an opportunity to refresh the specification in line with the new commissioning guidance, and this would be undertaken through the established partnership governance arrangements. A variation to reflect this would form part of any new extension agreement.

 

 

7.0          Financial Implications

 

7.1          The service is funded through the Public Health Grant. The financial contribution is paid by the Council to Harrogate and District NHS Foundation Trust under the open-book arrangements set out in the Agreement. Financial monitoring is undertaken through the established contract and partnership governance arrangements. The proposed extension is expected to be contained within the agreed Public Health budget, subject to the application of any Public Health Grant uplift provisions contained within the Agreement.

 

7.2          Each partner retains responsibility for managing financial risks, with mechanisms to address overspends and reinvest underspends outlined clearly within the agreement.

 

7.3          The table below shows the annual costs to date and for the whole life cost of the agreement to 31 March 3031.

 

Year 1

2021/22

£7,644,528

Year 2

2022/23

£7,709,949

Year 3

2023/24

£7,719,535

Year 4

2024/25

£7,837,837

Year 5

2025/26

£8,184,432

Year 6

2026/27

£8,375,948

Year 7

2027/28

£8,546,817

Year 8

2028/29

£8,713,480

Year 9

2029/30

£8,883,393

1.95% estimated inflation

Year 10

2030/31

£9,056,619

1.95% estimated inflation

 

8.0          Legal Implications

 

8.1          Section 75 of the National Health Service Act 2006 and the NHS Bodies and Local Authorities Partnership Arrangements Regulations 2000, S.I. 617 (“Regulations”) enable NHS statutory bodies and local authorities to collaborate across a range of local authority health-related functions and NHS health functions. This enables a Local Authority to delegate functions to an NHS Body (including a Trust) to exercise on its behalf, in conjunction with its own functions.

8.2          The proposed extension is provided for within the existing Section 75 Agreement and is therefore permissible under S72(a) of the Public Contracts Regulations 2015

 

9.0          Equalities Implications

 

9.1          The proposed extension is expected to support continuity of the 0-19 Healthy Child Service for children, young people, and families, including those who may experience poorer health outcomes or barriers to access. The service model includes targeted support for vulnerable groups and contributes to the Council’s duties to reduce inequalities and advance equality of opportunity. Any service specification refresh during the extension period will consider equality impacts through the established governance arrangements.

 

10.0       Climate change implications

 

10.1       An initial climate change impact assessment has been completed. The proposed decision relates to the continuation of an existing service and is not expected to result in significant direct climate impacts. Opportunities to support sustainable service delivery, including use of community-based provision, digital communication where appropriate, and efficient travel arrangements, will continue to be considered through contract management and service development.

 

11.0       Reasons for recommendation/s

 

11.1       The recommendation is made because the existing Agreement includes an available extension option; performance monitoring indicates that the service is being delivered in line with agreed contractual requirements; the proposed extension will support continuity for children, young people and families; and the extension period will allow the Council and HDFT to refresh the service specification in response to updated national commissioning guidance and local priorities.

 

12.0       Recommendation

 

12.1       That the Director of Public Health, in consultation with the Executive Member for Health and Adult Services, approves the extension of the Section 75 Partnership Agreement with Harrogate and District NHS Foundation Trust for the delivery of the 0–19 Healthy Child Service for a further two-year period from 1 April 2027 to 31 March 2029. Also, that a variation to the agreement be issued detailing a refreshed specification to be developed within existing partnership governance. This will also include an update to Schedule 3 to reflect the the annual costs to date and for the whole life cost of the agreement to 31 March 3031.

 

 

Report author.

Emma Lonsdale – Head of Public Health Children and Families