Councillor Wendy Brice-Thompson, Cabinet Member for Adult Social Services and Health, introduced the report

It was reported that the London Borough of Havering (LBH) had worked in partnership with Havering Clinical Commissioning Group (CCG) and North East London Foundation Trust (NELFT) to design a new integrated Reablement and Rehabilitation service.

This was an excellent opportunity to re-design how reablement and rehabilitation are delivered to remove duplication in the system and ensure a joined up approach for the service user. The new model was expected to enhance the quality and effectiveness of the service and therefore be of benefit to service users, supporting them to remain independent in their own home.

It was explained that the chosen procurement route was a Prior Information Notice (PIN) for a period of 35 days, if there was no interest from other providers in the market then a Voluntary Ex Ante Transparency Notice (VEAT) would be issued with a direct contract award to NELFT. If other suitable providers do express interest, the process would switch to a full procurement exercise and Cabinet would be asked to consider the outcome of the tender process before award of contract.

The contract would be awarded for a period of 12 months allowing a full procurement process to take place.

The cost of the new integrated service would be met from existing budgets and the use of Better Care Fund funding.

Cabinet Members attention was drawn to the implications and risks section of the report, in particular the equalities implications outlined in the Equality Impact Assessment.

Reasons for the decision:

The Care Act 2014 (Part 1, Section 3) requires that Local Authorities exercise their functions with a view to ensuring the integration of care and support provision with health provision and health-related provision where it considers that this would:

(a) promote the well-being of adults in its area with needs for care and support and the well-being of carers in its area,

(b) contribute to the prevention or delay of the development by adults in its area of needs for care and support or the development by carers in its area of needs for support, or

(c) improve the quality of care and support for adults, and of support for carers, provided in its area (including the outcomes that are achieved from such provision).

Reablement services are provided under a statutory duty in Section 2 of the same Act which stipulates that Local Authorities must provide or arrange services, resources or facilities that maximise independence for those already with such needs, for example, interventions such as rehabilitation/reablement services

This decision was necessary to enable the Council to commission a new integrated Reablement and Rehabilitation service in partnership with Havering CCG through the mechanism of the Better Care Fund. This was an excellent opportunity to re-design how reablement and rehabilitation are delivered to remove duplication in the system and ensure a joined up approach for the service user. The new model is expected to enhance the quality and effectiveness of the service and therefore be of benefit to service users, supporting them to remain independent in their own home. Finally, the revised service model is expected to enable the Council to respond to emerging models of hospital discharge processes and a drive towards prevention in the community.

Other options considered:

1.         Do Nothing

This was not deemed as a viable option due to:

•           There would be continued lack of capacity resulting in pressures on the rest of the market, this impacts LBH’s ability to support effective discharge processes.

•           There would be a continued requirement for  emergency reablement which would result in financial pressure of approximately £260k until the end of the current reablement contract next November

•           People who were eligible for reablement were not receiving it due to lack of capacity

2.         Undertake full procurement process to re tender the reablement service

This option was considered and although it would provide an opportunity to re-design and re-commission the service there were some significant limitations:

•           A full procurement process could take up to 8-12 months which would mean that LBH would still suffer the effects of the lack of capacity

•           Commissioning a reablement service independently of the rehab service would mean that we continue to have a fragmented service resulting in duplication and inefficiencies across the system.

3.         Undertake full procurement process to re-tender the reablement service as a joint, integrated service with rehabilitation

This option was considered but was not deemed viable because NELFT are currently providing all community services across BHR including rehabilitation. It would therefore not be advisable to commission a separate provider to deliver the rehab element if it was integrated with reablement. NELFT would be unable to bid for the tender as a separate integrated service because of the way they are contracted by the BHR CCGs.

Cabinet:

1          Approved the waiver of  the Council’s Contract Procedure Rules (“CPRs”) to allow for a direct award contract to NELFT, should NELFT and no other bidders respond to the Council’s PIN Notice;

2          Agreed to authorise the Director of Adult Services,  after  consultation with the Directors of Finance, HR & OD and Legal and Governance to finalise contractual arrangements and make a Direct Award Contract with NELFT if they were the only bidder, for the provision of Reablement services, such contract to have an estimated value of £1.51m for a contract period of 12 months;

3          Agreed to authorise the Director of Adult Services, in the event that  sufficient qualified bidders respond to the Council’s PIN notice, to undertake a full tender exercise, after consultation with the Directors of Finance, HR & OD and Legal and to proceed with the selection and award of a new Reablement service contract to the winning bidder in compliance with the CPRs;

4          Approved the Director of Adult Services, after consultation with the Director of Legal and Governance to finalise arrangements to negotiate the early termination of the current contract with Family Mosaic, in accordance with the terms and conditions of the contract, should the Reablement service contract be awarded to NELFT or another contractor.