Provision for Children's and Young People's In-reach and Discharge Support for NHS Devon CCG

Background Information and Service Specification NHS Devon Clinical Commissioning Group (the CCG) is considering their options for commissioning Health Based Mentoring In-reach and Discharge Support for Children and Young People up to the age of 18, who are registered with a GP within the county of Devon and for whom NHS Devon CCG is the Responsible Commissioner. Children and young people up to the age of 18 years, but who would be viewed as 'temporary residents' e.g. overseas students may be also able to access provision dependent on the commissioner's approval and the provider's agreement that the service will make a beneficial impact on a case by case basis. The service offer would cease upon the individual's 18th birthday or the end of the academic year in which they turn 18, whichever is most appropriate and/ or, the individual no longer being Ordinarily Resident in the County of Devon or Devon CCG ceasing to be the individual's Responsible Commissioner. There is potential for the age range of those eligible to increase at a later date, to encompass children and young people up to the age of 25 in line with the CCG's longer term ambitions for children and young people's services. This service is a pilot and therefore will build the evidence to support ongoing service development including the level of demand and capacity needed. At this time it is estimated that 35 children and young people per month would be supported by the service. It is expected that the service will work with and support children whilst on, an acute hospital ward as well as within the community following discharge (and prevention of admission). It will be critical for the service to rapidly build strong relationships with acute care settings, discharge teams and CAMHS teams within the county of Devon, so they are aware of the service's offer and are seen as a trusted partner. Support may be delivered alongside specific evidence based therapeutic intervention delivered by other service providers e.g. CAMHS. It is therefore critical that the service provider has experience of working in partnership with other services and of working with CYP and their families, with EHWB needs. The support being considered within this PIN relates to holistic, person centred support to reduce escalation in needs and behaviours, prepare for discharge and to prevent potential readmission through placement/home breakdown. A detailed service specification for the Health Based Mentoring In-reach and Discharge Support for Children and Young People with Emotional Health and Well Being Needs service will be developed by commissioners. 1.1 Scope Key objectives of a successful service will be to: 1.1.1Support individuals whose behaviour related to underlying emotional health and wellbeing needs is anticipated to/ or has, escalated due to being in an acute health environment, or who do not respond well to receiving care other than for health needs, in an acute health environment. This could include preventing admission/ readmission for CYP known to services. 1.1.2 Where appropriate, initiate/ start planning this support while the individual is still an in-patient to enable relationships to be built. 1.1.3Provide or source the provision of, individual bespoke packages of care which are co-produced with the child or young person and their family or carers, including jointly agreed outcomes. This will include elements that are outside normal working hours across a 7 day week (i.e. to include weekends) but is not anticipated to be a 24/7 offer. An example could be supporting a young person to access a club or an activity at the weekend. 1.1.4To train a cohort of mentors, including young/ peer mentors, that could be embedded in other organisations with appropriate skills and expertise. 1.1.5To enabled individuals/ families to manage provision via personal budgets. 1.1.6Ensure support is grounded in positive and meaningful activities for the individual in relation to their needs and support integration back into the community. 1.1.7To support a withdrawal of the service with appropriate plans and self-management tools and techniques. 1.1.8Ensure meaningful engagement with acute care settings and CAMHS services which identifies appropriate CYP for the service and supports/ compliments mental health needs and care plans. 1.1.9Ensure meaningful engagement with all appropriate partners in identifying the individuals needs and appropriate provision. 1.1.10Ensure that communication is conducted in a timely way and is appropriate to the needs of the recipient. 1.1.11Ensure adherence to relevant statutory and legal requirements. 1.1.12Ensure staff are appropriately trained staff and support children and young people. 1.1.13Ensure that environments provided are both safe and secure. This includes both physical and psychologically security and safety. 1.1.14Ensure that everyone accessing the service, including families or carers, are treated with compassion, respect and dignity, without stigma or judgement. 1.1.15Ensure that all relevant stakeholders and partners understand how and when to access the provision and what the offer is. 1.1.16Embed the principles of THRIVE throughout the pathway of support and care to the child/young person and their family. 1.2 Requirements The provider will: 1.2.1Demonstrate experience of partnership working to support individuals. 1.2.2Demonstrate experience in working with children, young people and their families, who have emotional health and wellbeing needs. 1.2.3Demonstrate experience and the ability to evaluate service delivery against outcomes and benefits realised. 1.2.4Have existing infrastructure to support the delivery of services for CYP with needs relating to emotional health and wellbeing, behaviours that challenge, family breakdown. 1.2.5Have pre-existing relationships with other organisations, and act as an infrastructure organisation to support the brokerage of provision, by other more specialist organisations who have particular skills and experience or are linked to a particular geography/ location, which makes them the right delivery partner. 1.2.6Work with acute care settings and CAMHS teams across Devon in identifying appropriate individuals for inclusion. 1.2.7Develop appropriate mechanisms to agree, manage, deliver and report on, a personal budget offer, including reporting to Commissioners how personal budgets are being used and individual outcomes/ achievement of jointly agreed goals. 1.2.8Work with other organisations to recruit and develop/ train a set of mentors, (including peer mentors), to support delivery of provision. 1.2.9Act as an infrastructure organisation to track and record the work and outcomes of this contract, which is delivered by partners and by the organisations own resources and share these reports with the CCG. This should include using goal based tools as a means of highlighting benefits and outcomes. 1.2.10In agreement with the family/ individual, share details of relevant provision with assigned EHCP co-ordinators. 1.3Site Locations (if applicable) The service should be provided across the county of Devon to enable accessibility for all appropriate CYP. This will include working in the patient's own home, in community locations and with individuals in acute care settings prior to discharge, including: Northern Devon Health Care NHS Trust The Royal Devon and Exeter NHS Foundation Trust Torbay and South Devon NHS Foundation Trust University Hospitals Plymouth NHS Trust 1.4 Outcomes Key outcomes for the service will be: 1.4.1A reduction in the number of CYP experiencing delayed discharge from acute care settings for reasons relating to escalating behaviour. 1.4.2CYP reporting an improved experience of discharge from acute care settings/ transition to community health services. 1.4.3CYP are supported effectively and meaningfully in the community to avoid potentially unnecessary acute admissions and readmissions. 1.4.4Reduced use of additional staffing supporting the person whilst on the acute hospital ward (i.e. security and /or additional (bank) staff). 1.4.5Reduced emotional distress and behaviours that challenge for children and young people on an acute ward awaiting discharge. 1.4.6Increased stability of children and young people in the community i.e. home or placement, including the prevention of placement breakdown due to escalating behaviours. This can be evidenced through a reduction in admissions/ readmissions to acute care settings for reasons other than physical needs, or placement/ home stability breakdown, for CYP known to services. 1.4.7Providing extra support for carers to deliver a successful discharge pathway from an acute setting. 1.5 Contract Term 1.5.1The NHS Terms and Conditions for Services will be used for this non-clinical service. 1.5.2The contract term will be 12 calendar months from the start date of the contract. Acknowledging the potential impact of Covid-19 to delay to mobilization, there is potential to extend the contract for a further 6 months from the end date, with funding remaining within the stated financial envelope. 1.5.3Service evaluation will take place at an agreed point between month 6 and month 9 to inform any contract extension. 1.5.4Contract review will take place at monthly intervals. 1.6 Contract Value - Financial Envelope: £423,000 excluding VAT. This processed is being managed by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioner(s). Additional information: NHS Devon CCG will not be liable for costs incurred by any interested party in participating in this exercise. Based on the market awareness and findings gathered from this process the commissioner may or may not engage in a competitive process. Should it be deemed that there is sufficient interest and capability in the market and subject to commissioner decisions interested parties should be aware that this notice may then be used to trigger as a call for competition and in that scenario no other notices will be placed before the competition is commenced. For the sake of clarity, interested parties should be aware that in that event any subsequent competitive process undertaken will not be advertised. Please ensure to register on our e-Procurement system if you haven't already to view the information provided: https://in-tendhost.co.uk/scwcsu/aspx/Home The deadline for submitting the early engagement questionnaire is the 9th of February at 12 noon. The data will be handled securely and none of the information collected will be published publicly nor shared with other suppliers. The services are healthcare services falling within Schedule 3 to the Public Contracts Regulations 2015 ("the Regulations") which are not subject to the full regime of the Regulations, but is instead governed by the "Light Touch Regime" contained within Chapter 3, Section 7 of the Regulations (Regulations 74 to 77).