Framework Agreement for Live-in Care (All-Ages), Complex Care (All-Ages) and Trusted Assessors for Spot Therapy and Clinical Psychology Provision (SEND) for NHS Devon Integrated Care Board

NHS Devon (the Commissioner) is responsible for the direct contracting of support for those Individuals eligible for health funding to support an assessed health and social care need. This includes support for those Individuals who are in receipt of Continuing Healthcare funding, s.117 aftercare arrangements and a range of other local funding streams to support rehabilitation, specialist support and interventions, intermediate care, step down services and discharge to assess provision.

Commissioners offer of a range of service delivery models to enable Individuals to remain supported, living within their own homes. Therefore, Commissioners needed to contract with Provider to deliver high quality personal care for Individuals receiving Health funding.

The Commissioners wanted to secure personalised, high-quality care and support, delivered when and where the Individual needs it and in a way that works for them. Their Care Plan should be designed with them and be outcome-focused, should enhance what they can do for themselves and should foster independence.

The Commissioners recognise the challenges associated with supplying services to people with varying levels of complexity and intensity of care needs and in a large geographic county that includes hard to reach parts of Devon. We wanted to work with Providers who understand those challenges and are focused on ensuring that future service arrangements address this issue. Moreover, Quality Assurance must underpin all service provision.

The value for Lot 1 - Live-in Care at Home for All-Ages is £2,757,224 for the 4-year period.

1. Adults

NHS Devon ICB commissioning team are responsible for the direct contracting of support for those Individuals eligible for health funding to support an assessed health and social care need. This includes support for those Individuals who are in receipt of Continuing Healthcare funding, S17 MHA leave funding, S117 MHA, aftercare funding, Transition funding and a range of other local funding streams to support rehabilitation, specialist support and interventions, intermediate care, step down services and discharge to assess provision.

As part of the Commissioned Care offer of a range of service delivery models to enable Individuals to remain supported living within their own homes the Commissioner needed to commission Providers to deliver high quality personal care to Individuals with complex health care needs. These Individuals require a registered nurse to undertake a clinical lead role and provide clinical oversight and management of the package of support. This may include the direct provision of registered nursing staff to deliver care, or care delivered by highly competent non-registered health care staff.

The most important consideration for people and carers is to have a core care team or an Individual Personal Assistant who is respectful, kind, honest and treats the person with dignity and respect. The Personal Assistant or core care team work with the person and their families (as appropriate) to enable their choices and maximise their independence as far as able. They also contribute to the person-centred Care Plan to ensure the care plan meets need.

It is key that commissioned care is personalised, high quality care and support, delivered when and where the person needs it and in a way that works for them. Their Care Plan should be designed with the person in mind and be outcome focused. It should enhance what the Individual can do for themselves and should foster independence.

It is recognised that commissioned care has challenges associated with supplying services to people with varying levels of complexity and intensity of care needs, both in a complex health context and in a large geographic county, that includes hard to reach parts of Devon. NHS Devon ICB want to work with providers who understand these challenges and are focused on ensuring that future service arrangements futureproof these ongoing issues. Moreover, quality assurance must underpin all service provision.

2. Children and Young People

The Commissioner is responsible for the direct contracting of support for children and young people (0-18-year-old) eligible for health funding to support assessed health and eligible social care need. This includes support for those individuals who are in receipt of Children's Continuing care funding, s.117 aftercare arrangements, rapid response to EoL care, and a range of other local funding streams to support rehabilitation, specialist support and interventions, intermediate care, and step-down services as well as on an exceptional basis (e.g., recommendations from an NHS health professional where needs cannot be met by universally commissioned service) and are considered on an individual basis.

To enable children and young people to receive person centred care whilst living at home the Commissioner has a need to commission Providers to deliver high quality personal care to support the child, family, and carers.

These children and young people with complex health care needs require a paediatric nurse, or registered nurse with relevant up to date paediatric experience to undertake a clinical lead role and provide clinical oversight and management of the package of support, with the care delivered by highly competent non-registered health care staff but may require the direct provision of registered nursing staff to deliver care.

Caring for children with complex needs in a community setting is an area of specialised work focused on the services and professionals that offer nursing / care support and interventions to children who have very different physiological and psychological needs to adults. Commissioners recognise that community children's services are fundamental to improving urgent care, through minimising unplanned hospital admissions and reducing the number of days that children and young people spend in hospital.

It's important to Children, Young People and Parents/Carers to have consistent care team, who treat them with kindness, dignity, and respect, and who arrive when expected; that they are involved in deciding the nature of their Provider Care Plan, that they know who to talk to if something is going wrong and that any concerns are quickly addressed.

The Commissioners want to secure personalised, high-quality care and support, delivered when and where the child or young person needs it and in a way that works for them. Their Care Plan should be designed with them and be outcome-focused, enhancing what they can do for themselves and should foster independence wherever possible.

The value for Lot 2 - Complex Care for All-Ages is £56,091,840 for the 4-year period.

NHS Devon Integrated Care Board (ICB) has a statutory duty to commission Speech and Language Therapy (SaLT), Occupational Therapy (OT), Physiotherapy (PT) and Clinical Psychology for Children and Young People (CYP) who are eligible, for whom they are responsible.

A "spot purchase" may need to be arranged to ensure statutory assessment and provision is provided to CYP from Devon, Plymouth and Torbay, for whom Devon ICB is the responsible commissioner when attending education settings both in and outside of the county (this may include home visits for those who are home educated).

The aim of the Service is to establish and meet the therapy need(s) and psychological needs of eligible children and young people by delivering timely evidenced-based, needs-led assessment and health interventions.

The objectives of the service are to:

Provide clinical assessment of children and young people's therapy needs and clinical psychology needs to inform the Education, Health & Care Needs Assessment (EHCNA), this may require a review of a previous assessment, and recommendations completed. It is anticipated that any recommendations forming part of an assessment show an appreciation of, and alignment with, local systems and interventions, noting that any intervention separate to assessment, which falls outside of the Devon system's graduated response will need to be separately considered and additionally commissioned.

Information gathered and reported needs to be in a format that can transfer and input to the SEND / Education Health and Care Plan (EHCP) process and required documentation.

Deliver timely therapy provision as detailed within children and young people's EHCPs,

Contribute to the EHCP Annual Review process by providing timely clinical advice and feedback on outcomes from interventions.

Demonstrate progress and outcomes of therapeutic/ psychology interventions which are goal based and time limited.

Support appropriate discharge from provision in line with children and young people's health needs. This might include end of intervention programme or transfer of care to an NHS commissioned provider.

The value for Lot 3 - Trusted Assessors for Spot Therapy and Clinical Psychology Provision (SEND) is £2,448,000 for the 4-year period