Decision details

To consider the report of the Cabinet Member for Education and Skills in consultation with the Cabinet Members for Health and Sustainable Living and Children’s Social Care seeking the consideration of the options for achieving a more integrated offer of prevention and early help services for children 0-19 and their families and to give approval to progress with the preferred option, subject to appropriate consultation.

The aim of the 0-19 prevention and early help service offer is to bring together a range of health and local authority services to deliver a strengthened prevention and early help offer based around localities, schools and communities. By so doing, it is intended to provide families with a seamless journey of support (where they get the right information, the right help and the right challenge by the right person at the right time) that enables them to manage independently, thereby increasing family resilience, promoting the protective factors for children and young people and reducing the need to resort to expensive specialist or statutory intervention.
These services include a range of services some of which are delivered in house (Children's Centres and Families Matter) whilst others are commissioned through contracts (Public Health Nursing, Oral Health Promotion, Breastfeeding support and healthy settings promotion and awards).
The options for integrating this offer range from alignment and partnership working through to full integration of services under a single management structure and lead provider

(i)  To approve the preferred option (option 4) for integration which is a fully integrated offer achieved through provider integration underpinned by an arrangement between the Council and Solent NHS Trust either through a Section 75 (NHS Act 2006) Agreement or any other appropriate basis for such a partnership arrangement.

(ii)  To delegate authority to the Service Director, Children and Families, following consultation with the Cabinet Member for Education and Skills, the Director of Public Health, the Director of Quality and Integration and Service Director: Legal and Governance to do everything necessary to put in place the preferred option, including formal consultation with staff for whom there may be changes in line management, location or role and engagement with service users on the design of the integrated service.

1  There is a strong evidence base which demonstrates that effective early intervention is a cost effective approach and events that occur in early life affect health, wellbeing and outcomes in later life and children’s life chances are most heavily predicated on their development in the first five years of life. This is also evidenced in the Director of Public Health’s 2016 Annual Report "The first 1000 days of life". Effective early intervention is better delivered through an evidence based, single, coordinated approach focused on providing a continuum of support with a single set of outcomes. Feedback from families shows that they would support this approach. 

2  The preferred option for achieving this is through integrated provider arrangements and a pooled budget, underpinned by an arrangement between the Council and Solent NHS Trust, whether by way of a Section 75 (NHS Act 2006) Agreement or any other appropriate basis for such a partnership arrangement with a view to exploring a joint venture or alternative new models of integrated care in the future.  This option:

•  Brings together the full range of prevention and early help services, including those delivered and managed in house by Children's Services and those already commissioned from Solent NHS Trust by Public Health, into a single service offer, managed by a single lead, thereby facilitating integrated provision.

•  Enables the totality of resources (HR, buildings, back office support) to be brought together and considered as a whole, enabling efficiencies to be made.

•  Will create opportunities for both organisations, and service users to benefit more quickly from innovation and creativity.

1  This report details five alternative options for delivering the integrated offer.  These are:

•  Continued alignment of all the services in scope (no formal integration)

•  Integration of Public Health Nursing services only (to form a 0-19 public health nursing service) to align with the remaining in house services in the offer

•  Fully integrated offer achieved through procurement

•  Fully integrated offer achieved through provider integration underpinned by a an arrangement between the Council and Solent NHS Trust whether by way of a Section 75 (NHS Act 2006) Agreement or any other appropriate basis for such a partnership arrangement, with a view to exploring a joint venture or alternative new models of integrated care in future

•  Joint procurement with another local authority.

2  A description of each of these options and the criteria used to evaluate them can be found in Section 22-23.  The full option appraisal is also available on request.