Agenda item

Early Years Services Model and Commissioning Plan and Contractual Arrangements for Children's Health Services

(To receive a report which invites the Committee to consider a report on the Early Years' Service Model and Commissioning Plan and Contractual Arrangements for Children's Health Services which is due to be considered by the Executive Councillor responsible for Children's Services on 29 July 2016)


Consideration was given to a report which outlined the early years' service model and commissioning plan and contractual arrangements for Children's Health Services.  It was reported that the Children's Strategic Commissioning Service was reviewing early years and children's health services which were currently outsourced.  The findings of the report to date, and options for future service models had been presented to a variety of Boards and Groups, and a preferred model for new services was provisionally agreed.


Members were advised that further public engagement, via an Equality Impact Assessment (EIA) questionnaire was taking place to understand any positive or negative impacts the preferred model may have and following this, due consideration would be given to any further changes that may be needed.  As well as the final service model, the commissioning route for new services would also need to be agreed.


It was reported that early years and children's health services were currently commissioned separately and the preferred model would continue to uphold this.  Changes to the preferred early years' service model were not significant but the existing contractual arrangements were due to cease on 31 March 2017, with few options to extend.  In order to establish the new early years' service by 1 April 2017 and consequently meet the savings target in 2017/18, a decision was sought from the Executive Councillor responsible for Children's Services to agree the final service model and preferred commissioning route.


Members were advised that four Early Years Locality Leads were in attendance at the meeting, in order to represent parents.  It was noted that they had recently completed peer reviews across the county and worked with parents in their locality so they would be able to give some up to date parent feedback on early years services.  Some of the comments made to the Committee included the following:

·         The paper had been shared with the locality leads fairly recently, and the model fitted with what parents were saying.

·         There was a need for a very strong team ethos, and this model would help to bring this back.

·         There were 28 different contracts for children's centres, and it was suspected that services users would not notice any change.

·         A peer review was recently carried out at the Grantham centre, and some of the comments from parents included – staff were very supportive; there was an opportunity to talk to other parents; children were growing in confidence.

·         It was commented that parents seemed to be very happy with the services being provided, but they valued consistency in terms of members of staff.  This was particularly important with the most vulnerable families.


Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report, and some of the points raised during discussion included the following:

·         Clarification was sought regarding the relationship with the health side of these arrangements, and members were advised that the health aspects of these arrangements would be due for decision in November 2016.  The report presented at this meeting was just looking at the early years services.

·         It was queried whether the breastfeeding service, which had been cut in children's centre the previous year would be reinstated.  Members were advised that this fell under Children's Health and was separate to early years.  Members were assured that there would be a robust pathway around supporting infant feeding and breastfeeding.  It was reported that there would be an enhanced offer, alongside midwifery and health visiting, where there would be more focus on breastfeeding initiation and support, particularly in the early weeks.  The introduction of an ante-natal offer would also be of benefit, to help develop peer networks and relationships before the baby was born.

·         It was queried whether there were alternative models and how the external provider market had been tested.  It was highlighted that an open questionnaire had been carried out along with an event held for existing and new providers.  A working group was also held with a range of representatives from the county council, public health and commissioning, to devise a number of options for the new model.  The model options were then taken through Departmental Management Team (DMT), Corporate Management Board, the Women and Children's Board (commissioner group) and Executive DMT who came up with the preferred model.  This preferred model then went out to further public engagement.  Members were advised that all teams had been engaged in shaping the model, which was within the funding available, as was the best attempt at what the staff and public thought the model should include.

·         It was queried whether there would be any flexibility in the commissioning of PEEP sessions as some vulnerable families may not initially see the benefit of engaging in these sessions but would be in need of that service.  It was reported that if a children's centre was serving a high number of deprived wards, there would be a need for more sessions.  Informal taster sessions would be offered to families to start them on the journey.  It was noted that there was good engagement at children's centres with vulnerable families with clear targets set.

·         It was queried whether there would be sufficient capacity in the health visiting system to cope with any increases in demand.  It was highlighted that the model had been reviewed across early years and health and there was a strong service in place.  It was noted that the health visiting role had good access to families in their homes, but it was felt that there was capacity to deliver more work in children's centres as well.

·         Members were encouraged to visit their local children's centre.

·         One member commented that in their work with the Adoption Panel, in the past, where there was a match, potential adopters were encouraged to engage with their local children's centre, and it was queried whether this practice could be reinstated.  Members were advised that this still took place, and it was suggested that social workers should reflect this in their reports as well.

·         Concerns were raised regarding the low registration of children with disabled parents, pregnant teenagers and teenage parents at children's centres and if the accuracy of these figures was correct.  Members were advised that the figures were a snapshot from June 2015 and would have been correct at that time.  However, officers did not have the current figures and so could not confirm whether they had improved since.  It was highlighted that generally registrations and attendance figures were very good, but there were still some groups that the centres needed to target further.

·         It was requested whether the Committee could be provided with the current figures for children with disabled parents, pregnant teenagers and teenage parents registered at children's centres.

·         It was queried whether the 'Bounty packs' were still given out free to new parents as they contained a lot of useful information as well as free products.  Members were advised that these packs were still available through the midwifery service and were given out when the baby was born.  However, there was currently no universal ante-natal offer and it was hoped that when this was put in place it would help to target vulnerable groups of parents.

·         Members queried where the survey had been carried out and how much had been received so far.  It was reported that it was an online survey, and it was being promoted through Facebook and Twitter to target families and young people.  Letters had also been sent out to the Clinical Commissioning Groups and providers for cascading. Members were informed that 324 responses had been received so far.  It was also noted that 1200 responses had been received to the earlier questionnaire.  Members were advised that an analysis of the responses would be undertaken and an overview of the responses and themes would be published on the Council's website.  It was agreed that the responses would be shared with the Committee.

·         It was noted that the big change would be the way that the services would be commissioned rather than a change in the services provided and it was suggested that the impact on service users would be minimal.




1.    That the Committee supports the recommendations to the Executive Councillor responsible for Children's Services as set out in the report.


2.    That the comments made in response to the report, as detailed above, be passed to the Executive Councillor responsible for Children's Services.

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