Agenda item

The Board considered a report of the Strategic Director – Children and Young People’s Directorate, and the Operational Director – Halton and St. Helens Primary Care Trust (PCT), seeking agreement on the next steps in the integration of services in Halton for children and young people through new working arrangements between Halton and St. Helens PCT and the Children and Young People’s Directorate of Halton Council. Agreement was also sought to place those new arrangements and their governance within the context of Halton’s Children’s Trust Arrangements (Alliance Board).

 

The report outlined how the proposals were intended to improve outcomes for children and young people, seeking to build on the integration of Education and Children’s Social Care Services that formed the Children and Young People’s Directorate in 2006. The proposals focused on the way the Children and Young People’s Directorate and its partners would do business together in future. An integrated approach would enhance the Council and its partner’s ability to deliver the key objectives of the Community Strategy under the umbrella  of the Local Strategic Partnership. All the services within that Partnership would continue to be directly accountable to their parent body for the quality and effectiveness of their services. However, the proposals enhanced the Council’s ability to fully discharge its new statutory duties to children and young people in the Borough.

 

The Health Services referred to were outlined for the Board’s consideration and it was advised that health services for children were focused on three on three principal groupings:

 

• The Sick Child – children who required specific medical interventions due to illness or injury;
• The Vulnerable child – children who had a particular set of circumstances that made their health vulnerable, for example hearing loss, a chronic condition, or their welfare or safety; and
• The Well Child – routine health matters that all children needed.

 

Integration of those services would be complemented by the further alignment of other health-related services and a dialogue would be established with General Practitioners in the Borough on the “best fit” with General Practice. It was advised that Dentistry Services were not part of this arrangement.

 

Members noted that the PCT was moving towards being a commissioning organisation and, in light of this, the PCT would explore a relevant NHS provider to deliver services to the “sick” child, whilst entering into this management arrangement with the Council for health services for the “well” and “vulnerable” child.

 

The proposed structure for the joint new arrangements were attached at Appendix 1 of the report. It was advised that NHS staff would not be subject to TUPE or seconded to the Council and so there would be no change to the terms of employment or conditions of any NHS employee affected by these arrangements. Lines of accountability were outlined for consideration and it was advised that the PCT would identify a named individual (Assistant Director, Children and Family Health, Halton) to become part of the Children and Young People Directorate’s Senior Management Team. This post would have direct line management responsibility for all PCT staff in the new working arrangements. The post would report directly to the Council’s Strategic Director of Children’s Services for day to day management of services and would also report to the Operational Director, Children, Families and Maternity Services for NHS accountability purposes.

 

The Alliance Board (Children’s Trust Arrangement) would act as the Governance Body for the PCT and Council, cementing the Children’s Trust arrangements that had to be in place by April 2008. A formal agreement was to be developed over the next three months which would be presented to both the Executive Board of the Council and the Primary Care Trust Board. The proposals were initially for one year and then to be reviewed. Information on how arrangements would be dovetailed with services for adults was outlined for the Board’s information, together with options on how the geographic footprint could be used for the future deployment of children’s services.

 

Reason(s) for Decision

 

• To bring together a full range of services (Education, Health and Social Care) for Children and Young People within one directorate under the auspices of Halton’s Children’s Trust arrangements;
• The further integration of services would enable the Council and its partners to provide better tailored and co-ordinated services, particularly for vulnerable groups of young people.
• They would provide, over time, the opportunity to create a series of “Teams Around the Child” delivering services in a much more effective and efficient way and one that was much more accessible and understandable to the public.

 

Alternative Options Considered and Rejected

 

Alternative options regarding the development of integrated services with the NHS and the proposals on Children’s Trusts arrangements included:

 

• No change, that is, current management arrangements and strategic oversight would remain the same. The principal reason for this option being rejected was that the Council would miss an ideal opportunity to bring together the principal services for Children and Young People under one operational umbrella. It was a requirement that the Council-led Children’s Trust arrangements and that this should be fully in place no later than April 2008. It was therefore a requirement that Children’s Trust arrangements were cemented within the Borough.

 

Implementation Date

 

The Children’s Trust arrangements would become effective by 30^th April 2008. The new arrangements for aligning NHS services would come into effect at the same time. During 2008/09, work would be undertaken on the development of new structural arrangements at the front line in close consultation with operational staff. Also during 2008/09, a formal agreement would be developed. The new arrangements would be reviewed in April 2009.

 

RESOLVED: That

 

(1)       the development of new working arrangements for PCT staff working with the “well” and “vulnerable” child within the Council’s Children and Young People’s Directorate be agreed;

 

(2)    it be noted that Health Services for the “sick” child remains the exclusive responsibility of the PCT and thus outside these arrangements;

 

(3)    it be agreed that work be undertaken to use the Alliance Board (Halton’s Children’s Trust arrangement) as the Governance Body for the new partnership arrangements with the PCT;

 

(4)    all Council services within the new working arrangements continue to be accountable to the Executive Board;

 

(5)    it be noted that the geographic footprint that would be used for the future deployment of Children’s Services would need to be agreed from the following options depending on the nature of the service:

 

a)         Boroughwide delivery;

b)         Runcorn or Widnes based delivery;

c)         Locality based delivery, perhaps building on the area networks or other recognised locality; and

 

(6)            Appendix 2 be approved as the structure for the Children’s Trust arrangements.