URL: https://ealing.moderngov.co.uk/ieDecisionDetails.aspx?ID=941

Decision Maker: Cabinet

Outcome:

Is Key Decision?: Yes

Is Callable In?: Yes

Purpose:

Content: RESOLVED:   That Cabinet:   I. Agreed to procure a contract for the provision of the 0-19 Healthy Child Programme (HCP) service via a competitive process for an initial period of 4 years, with the option to extend for a further 2 plus 1 years (7 years in total).   II. Delegated authority to the Strategic Director for Children’s Services to award the contract and exercise the option to extend.     REASONS FOR DECISION AND OPTIONS CONSIDERED:   1.   Detailed contract negotiations which commenced in January 2025 have now halted as the pricing now requested by the current provider exceeds the current financial envelope available, despite additional service investment from the council. 2.. A direct award under the PSR (route C) is no longer permissible to the existing provider due to the material change in the financial envelope.   2.   A direct award under the PSR (route C) is no longer permissible to the existing provider due to the material change in the financial envelope.   3.   The pricing requested by the existing provider will not facilitate any future flexibilities in service design to meet ongoing demand as the pricing reflects the service as it currently stands with some further reduction to the Health Visiting Service.   4.   Anecdotal evidence suggests NHS Trusts, may be increasing contract costs to reduce deficits, potentially necessitating increased funding regardless of contract status.   5.   It is recommended that we prepare to carry out a competitive process to secure value for money and explore alternative service delivery models. Options include joint procurement with other local authorities to maximise efficiencies.   6.   Direct Award under PSR to current provider   7.   The PSR has introduced four direct award processes that relevant authorities can use to directly award contracts for health care services. These are as follows:   a. the existing provider is the only provider that can deliver the health care services (direct award process A) b. patients have a choice of providers, and the number of providers is not restricted by the relevant authority (direct award process B) c. the existing provider is satisfying its existing contract, will likely satisfy the new contract to a sufficient standard, and the proposed contracting arrangements are not changing considerably (direct award process C). d. The relevant authority is not required to follow direct award process A or B, the relevant authority cannot and does not wish to follow direct award process C, the relevant authority is of the view (taking into account likely providers and all relevant information available to the relevant authority at the time), that it is likely to be able to identify the most suitable provider (the most suitable provider process)   • Direct award process C can be applied when the current provider is performing well, and change would negatively impact on the current service delivery model and risk an increase in costs. However, restrictions under this direct award option limit the ability to make material contract changes, thus constraining financial and service design flexibility. NOT RECOMMENDED   8.  Decommissioning the Service  This is not an option as council has a statutory responsibility to provide the 0-19 Healthy Child Programme service under its public health duties. NOT RECOMMENDED   9. Direct Award via PSR – We have explored partnering with other NHS Trusts through PSR, which could shorten procurement times, strengthen established partnerships, and lower management costs. However, since initial costings obtained indicate this would require an investment of over 10% of the contract value, this option restricts market testing which may not deliver optimal value for money. NOT RECOMMENDED   10. Competitive Process The current market is a limited market, and there are challenges in the recruitment and retention of Health Visiting and School Nursing regionally and nationally. The programme includes mandated and non-mandated elements, with FNP and MESCH being non-mandated but critical to Early Help and the Think Family Approach. Carrying out a competitive process will help to facilitate new ways of working with more flexible service delivery options.   11. Two neighbouring boroughs have also chosen to explore a competitive process for their 0-19 Services which provides additional options of future joint procurement to maximise efficiencies and work collaboratively across boroughs.   12. It was recommended that we prepare for an open competitive process to secure value for money and explore alternative innovative service delivery models to meet the changing needs of the population. Options include joint procurement with other local authorities to maximize efficiencies. RECOMMENDED     Decision subject to call-in

Date of Decision: November 11, 2025