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County drops CCG from joint commissioning deal

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A county council has withdrawn from an agreement in which the NHS commissioned some child mental health services on its behalf, over concerns the expected outcomes were not being achieved.

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Kent CC is taking the contract management of the service in-house and may retender it if it does not see improvements within six months, Health Service Journal reports.

Currently, the contract for services the county council is responsible for is held by North East London Foundation Trust but managed by West Kent Clinical Commissioning Group under what is known as a section 76 agreement.

These include priority assessment for looked-after children, early help units to stop escalation into tier three mental health services, children likely to suffer the impact of harmful sexual behaviour, and Kent Health Needs Education Service which looks after children who are unable to attend school.

They are included in a wider contract with NELFT, worth £16m a year and including other CAMHs across Kent which the NHS is responsible for. The KCC element of the wider contract is worth £2.65m a year.   

Roger Gough, KCC’s cabinet member for children, young people and education, said in a BBC Radio Kent interview that the contract “had not worked out very satisfactorily”.

“We are simply taking over the contract management of it,” he said. “We found over time that there was not clear evidence that the services were being brought forward in the way that we thought was right…. we were not seeing the outcomes we needed.”

A report to a KCC committee highlighted problems with the contract including fewer children than expected receiving a service through the Early Help pathway, changes to workforce which had not been agreed by the county, a lack of performance data and a dispute over payment. 

The wider CAMHs contract was awarded to NELFT in 2017, with a start date of 1 September that year, but there has been concern over its performance. The January board papers for NELFT showed waiting lists as a red-rated risk, with the possibility of impact on patient safety and business continuity. Medical staff vacancies in Kent were also causing “service delivery issues”.

Adam Wickings, deputy managing director of West Kent CCG, said:“NELFT and Kent County Council (KCC) are both key partners in the delivery of mental health services we provide for children and young people in Kent. Over the last twelve months, we have been working in partnership together with all seven CCGs in Kent in order to improve services – this includes the setting up of a new service model.


“After careful review, we agreed with the council that KCC be best placed to directly manage the part of the contract that they fund. This includes an increased focus of how young people access the Early Services programme and a new model approach to helping those children that have been excluded from school.”

 

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