Report of Corporate Director for People
Councillor Woodings, Portfolio Holder for Adult Social Care and Health, introduced the report and, along with Tammy Coles, Public Health Principal, stated the following:
a) the report sought approval to accept and use funding awarded to Nottingham City Council (on behalf of a local partnership facilitated by the Nottingham City Place Based Partnership) following successful applications to the national Changing Futures Programme, for an extension of the existing Changing Futures grant, and to the NHS Nottingham and Nottinghamshire Integrated Care Board Health Inequalities and Innovation Fund, to deliver a programme of work to improve outcomes for people experiencing severe and multiple disadvantage (SMD);
b) Nottingham has the eighth highest prevalence of SMD in England (JSNA 2019);
c) SMD is one of four high-level priorities included within the Joint Health and Wellbeing Strategy 2022-25 to improve the health, and reduce health inequalities, of the population in Nottingham;
d) The approval of the recommendations within the report would allow for the continuation and expansion of an ambitious programme for direct delivery of services and infrastructure to improve how statutory and voluntary sector partners work together to improve the lives of people experiencing SMD and the effective use of system resources during the 2024/25 year
Resolved to approve
(1) receipt of funding to deliver an agreed programme of activity from 01/04/2024 to 31/03/2025 as follows:
(a) up to a total of £993,265 from the Department for Levelling Up, Housing and Communities’ Changing Futures transition fund;
(b) up to a total of £469,375 from The National Lottery Community Fund’s Changing Futures transition fund;
(c) up to a total of £981,853 from the NHS Nottingham and Nottinghamshire Integrated Care Board’s Health Inequalities and Innovation Fund;
(2) spend of £2,444,493 from 01/04/2024 to 31/03/2025 to meet the Changing Futures programme objectives, in line with the indicative spending plan as detailed in appendix 1, with operational oversight delegated to the Changing Futures Programme Delivery Board;
(3) awards of contracts as set out in appendix 1 for transacting the spend to deliver the Changing Futures programme during 2024/25.
Reasons for recommendations
a) Approval to take receipt of the funding detailed in recommendations 1 – 3 (totalling £2,444,493) is sought to allow for the continued delivery and extension of Nottingham’s Changing Futures programme in line with proposals submitted to the Changing Futures national team and the Integrated Care Board.
b) Appendix 1 details the proposed spend of the three sources of funding from 01/04/2024 to 31/03/2025 as described in recommendation 4. This largely replicates the existing model and extends some areas of programme activity in line with opportunities to increase the impact of the programme. These are ring fenced grant monies, subject to the Council’s financial regulations. Oversight of the full budget remains with the Changing Futures Partnership Board, which needs flexibility to resource the programme.
c) Appendix 1 also details the compliant routes to market for the proposed contracts to be approved under recommendation 5. This includes:
i. extending the existing s.75 agreements, so the programme can continue the roles of the Mental Health Practitioner and Programme Director hosted by NHT from 01/04/2024 to 31/03/2025 and the Advanced Analyst at the ICB from 01/07/2024 to 31/03/2025;
ii. expansion of the embedded practitioner model into up to four additional public bodies. Changing Futures currently has embedded practitioners in five partner agencies. This model is proving beneficial and is improving the way they work with people experiencing SMD. The development of new partnerships is currently being explored to confirm scope for delivery and to reach those areas most relied upon by people experiencing SMD. Subsequent approval will be sought for spend and approach to contracting once proposals have been confirmed. It is intended that these arrangements will be in place from 01/04/2024 to 31/03/2025;
iii. the Main Delivery Service contract, currently delivered by Framework, has been confirmed as exempt from Contract Procedure Rules under 18.94. This will allow the current services to continue from 01/04/2024 to 31/03/2025 with some extensions to provision. The services are to meet the needs of people experiencing SMD, this is a particularly complex cohort, which requires specialist knowledge and experience;
iv. the transition to new contracting and funding arrangements in 2024/25 would represent a risk to continuity due to uncertainty in the provider organisation and staff members. This carries a risk of the loss of experienced staff (as occurred during the transition from Opportunity Nottingham). These contracting arrangements will minimise this risk for delivery in 2024/25, with the intention to undertake the more comprehensive recommissioning required for ongoing compliance with procurement regulations prior to the start of the 2025/26 year;
v. by extending the existing contracts for advocacy and the Primary Care Embedded Practitioner, the services will continue uninterrupted from 01/04/2024 to 31/03/2025. This applies equally to the grant agreement with NCVS, which would be extended from 19/06/2024 to 31/03/225.
Other options considered
a) To not accept the funding awarded. This is not recommended on the basis that to not take receipt of the funding would lose the opportunity to realise expected benefits from direct operational delivery and prospects for longer term improvements.
b) Various options were considered in developing the model. The model proposed incorporates all elements of the current model and provides for expansion of the Wraparound Multi-Disciplinary Team and the Embedded Practitioner roles.
c) Reprocuring all services was considered as an option. This is not possible for operational reasons. There would be significant risk to the continuity of services. To minimise the risk around transition, the Programme has recommended options to extend existing agreements where compliant with the Council's financial regulations. This will ensure the continuity of the programme and minimise associated uncertainty amongst services and colleagues over their future involvement in the programme.