URL: https://democracy.croydon.gov.uk/ieDecisionDetails.aspx?ID=2545

Decision Maker: Corporate Director of Adult Social Care & Health

Outcome:

Is Key Decision?: Yes

Is Callable In?: Yes

Purpose: IMPORTANT: A decision notice was previously published on the forward plan, however due to internal governance and administration error, a decision to agree to proceed to consideration of the proposals by the Council’s internal Contract & Commissiong Board (which would make any recommendations to the Corporate Director) was erroneously published against the decision notice (PUBLIC HEALTH NURSING - EXTENSION OF THE SECTION 75 AGREEMENT Key Decision Number 3323RES).   This notice is being published via General Exception, so the error is transparently corrected. The original error will remain published (Key Decision Number 3323RES) however with an explanation, and link to the update decision and full report – Key Decision Number 3323RESa):   SUMMARY   This report seeks approval to extend the existing contract with Croydon Health Services (CHS) to 31 July 2027, which falls within the permissible period of the Section 75 Agreement.  To agree to taking advantage of the permitted extension allowance and extend the existing s75 Agreement arrangement with CHS to run until 31 July 2027.    Total value for the requested extension of August 2025 – July 2027 will be approximatively £14m plus annual Agenda for Change (AfC) salary uplifts.   This report provides an update on the contractual arrangements for services within the Public Health Nursing programme.   This report recommends the approval of the commissioning intentions and procurement strategy detailed in this report, that are in line with Croydon’s Tender and Contract Regulations and PCR 2015.     The extension requested is to work with the provider to implement the 0-19 model, whilst enabling the Council to carry out a thorough, open and transparent tender programme, leading to the award of a new contract in 2027.  This programme of services has not been subject to tender for some 10-years and is going through transformation to ensure alignment with other strategic plans, decisions and commissioning cycles, in particular, the implementation of the Family Hubs Delivery Plan plus allowing for the time required to carry out a 0-19 Health Needs Assessment and recommissioning process.

Content: IMPORTANT: A decision notice was previously published on the forward plan, however due to internal governance and administration error, a decision to agree to proceed to consideration of the proposals by the Council’s internal Contract & Commissiong Board (which would make any recommendations to the Corporate Director) was erroneously published against the decision notice (PUBLIC HEALTH NURSING - EXTENSION OF THE SECTION 75 AGREEMENT Key Decision Number 3323RES).   This notice is being published via General Exception, so the error is transparently corrected. The original error will remain published (Key Decision Number 3323RES) however with an explanation, and link to the update decision and full report – Key Decision Number 3323RESa):   SUMMARY   This report seeks approval to extend the existing contract with Croydon Health Services (CHS) to 31 July 2027, which falls within the permissible period of the Section 75 Agreement.  To agree to taking advantage of the permitted extension allowance and extend the existing s75 Agreement arrangement with CHS to run until 31 July 2027.    Total value for the requested extension of August 2025 – July 2027 will be approximatively £14m plus annual Agenda for Change (AfC) salary uplifts.   This report provides an update on the contractual arrangements for services within the Public Health Nursing programme.   This report recommends the approval of the commissioning intentions and procurement strategy detailed in this report, that are in line with Croydon’s Tender and Contract Regulations and PCR 2015.     The extension requested is to work with the provider to implement the 0-19 model, whilst enabling the Council to carry out a thorough, open and transparent tender programme, leading to the award of a new contract in 2027.  This programme of services has not been subject to tender for some 10-years and is going through transformation to ensure alignment with other strategic plans, decisions and commissioning cycles, in particular, the implementation of the Family Hubs Delivery Plan plus allowing for the time required to carry out a 0-19 Health Needs Assessment and recommissioning process. For the reasons detailed in the report the Corporate Director for Adult Social Care and Health AGREED:   To approve a permitted extension of the existing s75 Agreement arrangement with Croydon Health Services Trust to run until 31 July 2027.    To note the total value of the extension:August 2023 – July 2027 (4-years) being £28,351,907 plus annual Agenda for Change (AfC) salary uplifts and inflation rates at approximately 2% per year.   To note that previous years’ underspends have been reinvested by Public Health in other Healthy Child programmes   2022/23: £483,363 underspend 2023/24: £531,893 underspend 2024/25: £1 underspend due to CHS recruiting bank and agency staff   To note that the aggregated spend, inclusive of the extension, remains within the overall awarded contract value of £48.982m   The extension requested is to continue working with the provider to implement the 0-19 model, whilst enabling the Council to carry out a thorough, open and transparent review of the programme in the format of a Health Needs Assessment, which will inform the specification for 2027.    This programme of services has not been subject to competitive tender for some 10-years and is going through transformation to ensure alignment with other strategic plans, decisions and commissioning cycles, in particular, the commissioning arrangements for Croydon Best Start and the implementation of the Family Hubs Delivery Plan plus allowing for the time required to consider future commissioning intentions and undertake required market shaping.    Options Advantages Disadvantages Risks & Mitigations Option 1: Agree to permitted extension, taking this s75 Agreement to 31 July 2027   Revised 0-19 model – area based – which included decommissioning FNP service and replacing with an additional Enhanced Level to the Health Visiting service Recommended ·         Jointly designed new model / new way of working to address performance and the recruitment deficit. ·         CHS engaged a new, experienced lead that implemented changes, which had a noticeable impact, who led PHN through the new way of working model. ·         Working with a partner with a vested interest in ensuring the quality-of-service delivery during this period– reputationally and financially – continues to ensure the Council can influence pace and scale, utilising established channels. ·         The new way of working implemented 01 April 2025 allows the Council to continue monitoring and reviewing service delivery while the Health Needs Assessment is being carried out, which will inform the model and specification for the 2026/7 tender programme.  ·         This new way of working offers nurses the opportunity to work across Health Visiting and School Nursing, which is a developmental benefit. ·         Offering Croydon families the Enhanced HV Level enables the Council and provider to develop the HV service, which could be a recruitment attraction ·         Joint working continues between CHS PHN and Maternity Services.   Decommissioning FNP resulted in two FNP nurses not being qualified to move to the Health Visiting or School Nursing service.     The Council invested resource and worked closely with CHS, offering support through the decommissioning of FNP and implementation of the additional Enhanced HV Level.   National staffing challenges remain an issue    FNP nurses offered the opportunity of training and/or work in other areas   Mitigation – maintained regular engagements with staff, assuring no redundancies and ensuring that staff were aware of and felt included in the process Option 2: Bring the service in-house   Not Recommended Offering the Council greater oversight of service delivery and better ability to be flexible and responsive to strategic changes ·         These programme of services cannot be insourced as they provide services that are explicably commissioned to be independent from the Council    ·         Health visiting provides clinically based services.  Not financially or logistically viable to transfer these services   Making this programme of services in-house would place the Council at significant risk and does not provide independence Option 3: Do nothing   Not Recommended   Not viable as the current s75 Agreement expired 31 July 2023 and has included three permitted two-year extensions (to 31 March 2028), In order to ensure that the revised model in place will secure delivery of these services, an appropriate timeframe is required to carry out the procurement process. The current model is not attracting or retaining staff, and it can be accepted that maintaining the status quo will not improve matters   The Council would be at risk of not meeting its statutory obligations to deliver the Healthy child Programme.   It would undermine its commitment to the best start in life for all children and the delivery of linked programmes e.g. Family Hubs    

Date of Decision: August 8, 2025