Decision details

Update on contracting arrangements for 2024/25.

(1)  To endorse the proposal for an interim arrangement for commissioning of the Community Health Contract, Public Health and Community Partners with the Integrated Care Board (ICB) as Coordinating Commissioner and the Council as Co-Commissioner for a one-year period from 1^st April 2024.  Services commissioned are to be delivered within approved policy and budget frameworks subject to approval of the ICB in July 2023.

(2)  To note the intention of the ICB to continue the existing provision of services with HCRG Care Group for a 1-year period from 1^st April 2024 to 31^st March 2025, subject to formal ICB approval in July 2023.

Bath and North East Somerset Council (B&NES) and the Integrated Care Board (ICB) made a decision not to extend the HCRG Care Group contract for the three-year extension term in May 2022 (Non-extension Decision Ref: E3362). The Council completed a detailed options appraisal, and a decision was taken to transfer Adult Social Care (ASC) to B&NES Council (Transfer Decision Ref: E3393). The Council has been working with HCRG Care Group to ensure the safe transfer of adult social care services as of 1st April 2024.  This will involve the transfer of around 281 staff into the Council to deliver Statutory Adult Social Work and Adults with Learning Disabilities and their Families services.

The Integrated Care Board (ICB) is considering how to ensure the safe transfer of adult and children’s community health services and to allow sufficient time to undertake a complete service review and redesign. It is proposed that the ICB secure a series of interim contracts for Community Services with the existing providers: HCRG Care Group (B&NES and Wiltshire); Great Western Hospital; Wiltshire Health and Care; and Oxford Health. This will cover all age Health services across the Bath and North East Somerset, Swindon, and Wiltshire (BSW) areas. These would take effect from 1st April 2024 to 31st March 2025 in the form of a new interim contractual arrangement for 1 year and follows the legal advice provided to the BSW ICB.

The transfer of social care staff will take place at the end of March 2023 as planned, but the change to the ICB procurement timetable has affected B&NES Council’s timing of the procurement of Public Health and Community Partner delivered services (these services are currently delivered or subcontracted by HCRG Care Group on behalf of the Council until 31st March 2024). Aligning with the interim arrangements proposed for a one-year contractual arrangement with HCRG Care Group would allow the Council to retain alignment of interdependent Public Health and ICB Children's and Adult's Health and Care services. This approach would also reduce the risks to Community Partners who have expressed concerns about decisions that have to be made by the end of Summer 2023 to mitigate organisational impacts.

The proposed new interim contractual arrangement upholds the non- extension decision taken on 26th May 2022 by B&NES Cabinet (Ref: E3362), and the Clinical Commissioning Group (CCG) Governing Body (now the ICB) to not exercise the option to extend the Integrated Community Services contract between B&NES Council, the ICB and HCRG Care Group as this contract terminates on 31st March 2024.

Inclusion in the interim arrangement is proposed for Public Health Services and services delivered by Community Partners.

The inclusion of the sub-contracted services, delivered by Community Partners ensures that they are treated equitably and there is no misalignment in the reprovision of sub-contracted services across BSW during this period. Under the interim arrangement the ICB would be the Coordinating Commissioner for sub-contracted services as well as Public Health services, with B&NES as Co-Commissioner.

The interim arrangement would involve B&NES continuing to fund Public Health services and services delivered by Community Partners, along with the continuation of the contributions towards Heath Services to the ICB, with a total annual value of £12.8m.

The transfer of the directly delivered services of Adult Social Care (ASC) is unaffected and continues to be progressed.

Consideration was given to proceeding with B&NES Council’s original timeline for the procurement of Public Health and Community Partner delivered services for 31^st April 2024 as the council has made significant progress towards preferred delivery options for these services.  However, as these have direct interdependencies with the ICB’s community health services (Programme 3) and due to the timescales involved, alignment with the ICB’s interim contractual arrangement is the preferred option.