OUTSOURCING CHILDREN’S SOCIAL WORK – THE DEVON EXPERIENCE AN UPDATE ON THE 2013 EXTERNALISATION OF AN INTEGRATED HEALTH & SOCIAL CARE SERVICE Brenda Bartlett Jon Richards Virgin CareDevon County Council

The background Transforming Community Services set out a national requirement for Primary Care trusts to separate their provision from their commissioning function by 1 st April 2011 As a result of this arrangements were put in place with Devon County Council to manage Integrated Children’s Services on behalf of NHS Devon for up to 2 years, to allow time to determine long term arrangements The outcome of the process would be the out-sourcing of health and social care services

Integrated Children’s Services Mental health and wellbeing Primary Mental Health Service Child & Adolescent Mental Health specialist service Joint Agency Child Abuse Team Service around the Child (Children in care) Physical, Sensory & Learning Disability Joint agency multi- disciplinary teams for children with disabilities, including children’s community nursing Specialist Child Assessment Centres Community Equipment Service Speech & Language Therapy Service Family support services, including short breaks units Public Health Nursing Health Visiting School Nursing Immunisation Service Newborn hearing screening service Health service for children in care

Programme objectives  To develop and implement a sustainable solution for the long term provision of Integrated Children’s Services from 31 st March 2013  To explore opportunities for extending the scope of the services to be re-commissioned  To optimise the opportunities for transformation  To improve outcomes for children and young people

Mapping Gather views Market Co- produce the model Dialogue Tenders Evaluation Procure the service Staff Contracts Finance Do due diligence and mobilise new contractor Ongoing engagement Apr 11Sep 11 Jul 12 Mar 13 Mapping Gather views Market Co- produce the model Dialogue Tenders Evaluation Procure the service Staff Contracts Finance Do due diligence and mobilise new contractor

Hiccough No.1 – Judicial Review  Not part of the plan!  Brought on Public Sector Equality Duty grounds but seemingly politically driven  Defended robustly but at considerable cost and effort  Caused capacity challenges in next phases  The result? We lost… but also won!

Hiccough No.2 – Social Work transfer  December 2011 – January 2013: assessment of duties and functions that could be transferred  October 2012 – January 2013: ‘Border protocols’ were in preparation to govern interface between ICS and mainstream children’s Social Work teams  January 2013: DfE consultation re Social Work Practice pilots begged questions about our proposals  January 2013: Leading Counsel’s opinion – no go!  February 2013: Re-negotiate with Virgin Care

So what happened on transfer day?  All NHS staff transferred to Virgin Care  More than half the Social Care staff transferred to Virgin Care – the Family Support, Enabling, and Respite Unit staff  Remaining Social Care staff remained in DCC with dual management arrangements within Virgin Care  However, only small proportion of Social Care budget transferred  Phase 2 transfer for remaining staff was planned for April 2014

Preparing for Phase 2 transfer  ‘Border protocols’ had to be completed, promoted and tested  Interim management arrangements had to be implemented and supported  Responses to DfE consultation had to be agreed  Consideration and interpretation of legislative change and guidance had to be undertaken

Ofsted’s involvement  Safeguarding inspection  April 2013 – DCC found ‘Inadequate’ across the board  Limited scrutiny of ICS but positive feedback  Improvement Plan agreed in September 2013  Single Assessment Framework launched November 2013  Registration process  Virgin Care prepared Ofsted application  Were Ofsted ready for new Social Care providers?

Ofsted’s impact  Decision made to postpone Social Work transfer until April 2015 – ie until Improvement Plan had been completed  Registration therefore also postponed  Further period of interim management required, with a different format  Dip in Social Care staff morale

Could we have gone ahead?  Yes we could  legislation would have enabled the original plan to go ahead (though detailed guidance was limited)  ‘Border protocols’ had been thoroughly tested  Staff were ready to move  Placement purchasing responsibilities were agreed  No we couldn’t  Ofsted impact

Reflections on the wider service one year on  Positives –  Legacy issues can be resolved – Accom, HR, ICT, etc  Much greater flexibility – finance/practice/structures  Much less bureaucracy, and increased development opportunities within a major national organisation  Productivity, consistency and integration within ICS all progressing  Challenges -  External pressures are always with us – CAMHS etc  External scrutiny is much greater!  Contractual relationship – mature approach is required where contractual changes become necessary  Rome wasn’t (re-)built in a day!

Should you be doing this kind of transfer?  Why do you want to do it, what are the issues you want to solve?  What support are you going to give it, now and throughout the contract?  How stable are your organisations and leads?  How stable is the external context?

ANY QUESTIONS?