Issue - meetings

Report CS16003

Report CS16003 considered L B Bromley’s overnight residential short break provision at Hollybank, including outcomes of a service user review undertaken in October 2015.

Forming an integral element of Bromley’s strategy for disabled children and young people, the short break provision provided a preventative service aimed at ensuring disabled children remain within their family home. L B Bromley contributed to joint funding of the provision as a partner with Bromley Clinical Commissioning Group (BCCG), BCCG currently providing the commissioning lead. The current contract value was apportioned 59% BCCG and 41% L B Bromley, with the service at Hollybank being provided by Bromley Healthcare Community Interest Company (BHC).

Approval was sought to extend the existing contract (due to expire on 31st March 2017) for six months prior to a joint re-tendering with BCCG.

The provision was rated ‘good’ by OfSTED in November 2015. To maintain it on a value for money basis, the number of block commissioned bed spaces might need to be reduced with some current service users offered personal budgets or enhanced day time provision. An enhanced fostering service would also provide scope for reduced demand on Hollybank spaces. A funding model based on the Certitude contract with Adult Social care would also mitigate against an increased demand for bed spaces over and above the block commissioned number.

There was also a clear synergy between the Hollybank service and the service provided by the Integrated Children’s Community Nursing Team (ICCNT) commissioned by Bromley CCG within the community contract. Should integrating Hollybank with ICCNT offer BCCG better value for money in terms of overnight support for those with very complex health needs, it might be necessary to analyse how many additional beds spaces this might potentially require. A decision on future tendering was tied into strategic discussions and decisions between L B Bromley and BCCG on (i) the future of the community contract beyond March 2017 and (ii) the future potential for developing integration between L B Bromley and BCCG across children and adult services. The service specification provided for use of an emergency bed which was not being utilised and it was also necessary to consider whether this continues or whether other arrangements can be put into place when the service is retendered.

In discussion it was highlighted that the number of service users amounted to 58 children as at the end of February 2016.

Based on the calculation of cost/nights available, Cllr Fawthrop (Chairman of Executive and Resources PDS Committee) noted a budgeted unit cost per bed per night of £446 (based on nine available beds) whereas the actual cost amounted to £528 (based on eight beds utilised 95% of the time). Benchmarking across other London local authorities and statistical neighbours indicated this unit cost figure to be slightly higher than average. It was confirmed that this would be looked at when re-tendering. The Leader suggested that more income could be created through greater use of the emergency provision, and in supporting the report’s recommendations, the  ...  view the full minutes text for item 373

Report CS16003

The Portfolio Holder presented a report outlining a gateway review undertaken of the Local Authority’s overnight residential short break provision at Hollybank for which the existing contract would end on 31^st March 2017, and seeking approval to extend the existing contract for a period of six months from 1^st April 2017 to 30^th September 2017, after which the contract would be jointly retendered with Bromley Clinical Commissioning Group.

The Hollybank service offered regular planned overnight short breaks with the highest standard of care for children and young people with multiple disabilities and complex health care needs, and worked in partnership with their families and other carers to maintain children and young people within their families.  Bromley Clinical Commissioning Group commissioned nine bed spaces per night at Hollybank, which included one emergency bed available on a 24 hour, seven day a week service.  As at November 2015, 59 children and young people were registered with Hollybank for regular short breaks with an average allocation of two to three nights per month, and the emergency bed was occupied for an average of six nights per month. 

The review of Hollybank had concluded that it was a good quality provision, rated ‘Good’ by Ofsted in every category, and was highly valued by service users and their families.  In order to maintain Hollybank with a context of value for money, the possibility of reducing the number of block commissioned bed spaces had been identified, as had the potential to introduce a funding model to mitigate against an increased demand for bed spaces over and above the block commissioned number.  The synergy between the Hollybank service and the Integrated Children’s Community Nursing Team had been recognised and a ‘task and finish’ project team had been established in February 2016 to explore the integration of these services.  The possibility of extended the remit of the Hollybank provision to meet the short break needs of children and young people with life limiting conditions or as a ‘step down’ from hospital discharge had also been identified and would be considered.

It was proposed to extend the existing contract for a period of six months from 1^st April 2017 to 30^th September 2017, to allow time for strategic discussions between the Local Authority and Bromley Clinical Commissioning Group on the future of the community contract beyond March 2017 and the potential for developing integration of services across both children and adults services to be undertaken after which the contract would be jointly retendered with Bromley Clinical Commissioning Group.

RESOLVED that the Council’s Executive be recommended to:

1)  Agree to extend the contract for overnight residential short break provision for a period of six months from 1^st April 2017 to 30 September 2017; and,

2)  Agree to commencement of the joint procurement procedure for the provision in order for a newly commissioned service to be in place from 1^st October 2017 which would continue to be led by Bromley Clinical Commissioning  ...  view the full minutes text for item 83