Date: 21 May 2014
REPORT TITLE: Use of resource for emotional wellbeing and mental health from Dedicated Schools Grant via the Schools Forum from April 2015
Report presented by Clare Burrell
Contact details: Telephone: 07748 623993;
1. Purpose of report
1.1To present to Forum for information and further discussion the options as discussed at the SEN subgroup of6th May about the annual usage of the emotional health and wellbeing resource for 3 years from April 2015. This is a followup to the decision of the Schools Forum in February 2014 that £400,000 should be made available to Local Delivery Groups (LDGs) for 2014-15for a further year for early, school and community based, collaborative and partnership intervention and that plans from April 2015 be reconsidered.
2. Recommendation
2.1 To agree further development of Option C and that a paper is brought back to Forum in July 2014 for a review of the current LDG funded provision and for final decision for 2015 onwards.
2.2 To agree sharing this with schools/LDGs and seeking their views on the options.
3.Relevance to Strategic Plans
3.1Improved child and adolescent emotional wellbeing and mental health supportsthe Authority to achieve the corporate outcomes that children in Essex get the best start in life and people have aspirations and achieve their ambitions through education, training and lifelong learning.
4.Background
4.1The funding agreed bySchools Forum is focused on early intervention and follows on from the support which schools themselves provide as part of fulfilling their own responsibility to support and respond to emotional wellbeing needs. (As the government policy says - Mental health is everybody’s business.) In the 3 years to and including 2014-15 the resource was assigned on an annual basis to LDGs who submitted plans for using it to deliver or commission local interventions.
4.2 There is a varying picture across the County, with different interventions provided and many children/young people supported to improve emotional wellbeing and attendance/attainment in some areas especially areas with larger, organised LDGs, with less impact in other areas. Many LDGs have advised that they find the responsibility of providing services and the reporting onerous, especially as some receive quite a small sum. Two LDGs did not have the capacity or will to apply for the resource to enable local activity in 2013-14.
4.3 The report on activity by LDGs in 2013-14 has been provided already and is attached again. A final report on this will be available by September/ October 2014. LDGs were informed of the availability of grants for 2014-15 in April 2014 and applications are due back 23rd May. An overview of plans of all LDGs can be provided by end June 2014.
4.4 The activity funded by the LDG grants is additional to and separate from the CAMHS Services provided by ECC Tier 2 and health Tier 3 services and addresses an earlier level of need. Plans are being developed by ECC and the 5 health Clinical Commissioning Groups (CCGs) in Essex for the recommissioning of CAMHS services. The Service Model for a redesigned Emotional Wellbeing and Mental Health (EWMH) Service has been developed to reflect consultation findings and the Joint Strategic Needs Assessment and there has been feedback on the Model through locality multiagency stakeholder workshops, SurveyMonkey and by email.
4.5 The Model includes a single doorway to access appropriate provision with evidence based interventions provided by locality teams integrated across Tiers 2 and 3. It sets out an expectation that half the Tier 2 level need when there are emerging mental health problems will be met by direct interventions by the integrated EWMH Service; half by other services with advice, support, consultation and training provided by the EWMH Service.
4.6Resource contributions for this integrated EWMH Service are being finalised from the 3 LAs(including Southend and Thurrock) and 7 CCGs for 3 years from April 2015. Indicative figures are:
- £11million - CCGs (health)
- £1.8million – ECC
- £210,000 – Southend Borough (includes from the Schools Forum)
- £202,000 – Thurrock Borough Council (Schools Forum being asked to contribute)
4.7Plans for securing the service will be agreed by end May 2014 and the process will then commence with a view to the procurement process commencing from July 2014 and the new EWMH Service commencing from November 2015.
Options Appraisal for SF Resource.
4.8The SF resourced provision is additional to the integrated EWMH Service and continues to focus on earlier intervention responding to need at a level a little lower than the threshold for the EWMH Service.
4.9The proposal is that all options are applicable for 3 years from April 2015 to March 2018. This will enable continuity and certainty for the provision and means it is necessary to give annual progress reports to the Schools Forum rather than to come back each year to discuss and agree a plan.
4.10The option of allocating all funding to individual schoolswas considered at the February SF meeting and rejected as it provides insufficient resource for many schools to use effectively and there is no guarantee the resource would be used for early intervention for emotional wellbeing and mental health needs.
Option A – Repeat arrangements of last 3 years - LDGs apply for resource via a grants process and provide/commission local delivery
4.11Collaboration with the EWMH Service could be part of the grant requirements and the EWMH Service could be asked to provide advice, support, consultancy and quality assurance to the provider/s.
4.12LDGs have had annual grants for the 3 years from April 2012. The grants process currently takes some 3-4 months. Most LDGs currently renew existing arrangements, hence a 3 month timescale is possible. As the grants and plans are to be for 3 years however, it would be preferable to give a longer timescale of 6 months so LDGs could review and possibly revise existing plans and seek alternative providers. ECC could provide some support and assistance to LDGs who need and want support to help them develop appropriate plans and secure suitable providers.
4.13ECC and partners would then review and approve the grant bids submitted. Commencing the grant application process in September 2014 would enable provision to be in place for April 2015 (or January 2015 for September 2015 start).
Pros
a)Ensures targeted early intervention is available at a very local level.
b)Ensures flexible provision which reflects local schools’ needs.
c)Enables provision to focus on greatest needs across the area rather than equally across schools.
d)Enables larger numbers to be supported as schools often augment resources.
e)Encourages collaboration between schools in LDG/area.
Cons
a)Not all School collaboratives/LDGs want to or have the expertise and capacity to be responsible for commissioning or delivering and monitoring provision.
b)Variable provision, quality and impact across the County – depends on LDG capacity. This could be mitigated by provision of support to those LDGs.
c)Small projects are time consuming to administer and difficult to evidence impact.
d)Some LDGs are reluctant to report and consider monitoring requirements onerous. Reporting has been streamlined in 2014-15.
e)Quality of monitoring returns is inconsistent.
f)Provision in some areas is not open to all schools/cyp in the area but is dependent on whether the school is part of the LDG. This can be mitigated by a grant requirement that provision is open to all.
g)Provision in some areas stands alone and is not integrated with other provision.
h)Requires liasion to ensure joinup with the redesigned EWMH Service and prevent disjointed provision. This could be mitigated by a grant requirement for coordination.
i)Grants process not preferred for 3 years as a contract better enables us to hold providers to account for outcomes and deliverables.
j)Considerable administrative requirements for both ECC and LDGs with so many small grants.
Option B – Separately commission an External Provider/s
4.14A specification for the outcomes and activity to be delivered would be developed together with a number of Forum and LDG reps and Forum could run and oversee its own tender process for the provision of this (supported by ECC).
4.15The specification could be different for each locality and tendered in locality lots. See Appendix for draft. Specific outcome and performance measures would be set and these would be monitored and reported quarterly to the Schools Forum and the LGDs locally possibly via the Local Children’s Partnership Boards where LDGs/schools are represented. There could be local Steering Groups.
4.16Each quadrant would have named staff to deliver interventions employed by the selected provider. It would facilitate coordination if the service took referrals from the EWMH doorway as well as directly from schools. Collaboration with the EWMH Service could be part of the specification and the EWMH Service could be asked to provide some advice, support, consultancy and quality assurance to the provider/s. The process of securing this would take some 6-9 months so would need to start by January 2015 or earlier for a service to commence in September 2015.
Pros
a)Delivery of outcomes focussed, evidence based interventions with consistency across the County which may be tailored to local needs.
b)Equitable across the County
c)Could be quadrant lots – hence locally delivered and based and tailored to respond to local needs and align with new EWMH Service model
d)Provides opportunity for the community and voluntary sector
e)Complements the redesigned service model
f)Outcomes reporting easier as built into contract
g)LDGs could tender, possibly in partnership with voluntary sector organisations
Cons
a)SF does not have capacity or expertise to run this itself – though ECC could do this with/for the SF
b)Some overlap in timing with the tender for the EWMH Service which could be confusing.
c)Possible lack of coordination with the EWMH Service – could be mitigated by clear criteria and requirements for joint working.
Option C – Provision of a locally tailored school-focused early intervention service as a separate, specific but integral element of the overall EWMH Service
4.17 An outline (the specification) for the outcomes and activity to be delivered would be developed with significant input from Forum and LDG reps.The outline of what is to be delivered and the outcomes to be achieved could be different and tailored to each quadrant locality. See Appendix for initial draft
4.18. This would be included as a separate but linked element of the service specification and open competitive process for securing the redesigned EWMH Servic (NB ECC is not bidding to deliver this).
4.19The tender could require collaborative/partnership bids for this schools focused service between the provider and schools and the voluntary sector. The provider/sselected to deliver the EWMH Service would then deliver this as outlined through the tender and dialogue process. Forum reps would be involved with the selection process.
4.20Specific outcome and performance measures would be set and these would be monitored and reported quarterly to the Schools Forum and local LDGs and the Local Children’s Partnership Boards where LDGs/schools are represented. There could be local Steering Groups.
4.21Each quadrant would have named staff employed and line managed by the selected provider/partnership to deliver interventions and liaise with and support schools. Referrals could be via the doorway and/or directly from schools.
4.22The process of securing this would start in July 2014 with assessment of the qualifications of interested organisations; detailed dialogue about this element of the delivery in autumn 2014 and final bids in spring 2015 for a service to commence in November 2015.An outline of this as an option would need to be included within bidding documentation that has to be ready by the end of August 2014.
Pros
a)Ensures targeted early intervention is available at a local level to respond quickly to children and young people’s emerging emotional wellbeing and mental health needs.
b)Ensures flexible provision which works closely with and supports schools and responds to the needs of local schools and LDGs.
c)Ensures quality provision is delivered by trained and qualified staff who are supervised by staff from a qualified organisation.
d)Enables provision to focus on greatest needs across the area rather than equally across schools.
e)Provides opportunities for schools toaugment resources in their area and for locality service outlines to deliver different levels and types of activity.
f)Provides opportunity for smooth transfer to more specialised services when the early intervention is insufficient to address the need as it is part of the overall EWMH Service and delivered by the same organisation/s so no need for further assessment or referral across boundaries of different organisations.
g)Encourages collaboration between schools in LDG/area.
h)Fair – with consistent type and quality of provision across the County with local tailoring
i)Easiest to implement
j)Least input required from LDGs/schools
k)Consistent, easier, more comprehensive and definite provision of outcome monitoring as part of contract management.
l)Less time consuming to administer as one contract.
m)Easiest option long term as best fit with new EWMH Service model
n)Ensures cover for sickness across the team
o)Ensures integrated joined up provision with the EWMH Service as it will be a part of it
p)Line management and clinical supervision provided by the Service for directly employed staff and clinical supervision available for School staff focused on emotional wellbeing making no demands on schools/LDGs for this and ensuring safe services.
q)More efficient procurement as one joint process not 2 separate ones
Cons
a)Less control/influence/responsibility by schools/LDGs themselves (could have a local steering group and local variation in what is delivered)
b)Short time to firm up plans – an outline of this as an option needs to be ready by end August 2014
c)Adding this to the scope of EWMH Service could detract from a focus on the specific outcomes for each project
d)The complexities of working in partnership and securing agreement on one contract with several elements could delay the award of the contract.
SEN Sub Group
4.23The SEN subgroup considered the options and concluded as follows.
Option A
- Enables locally determined and provided provision to respond quickly and easily to children’s needs.
- It encourages collaboration across schools; enables them to direct provision so provision is easy to access and is flexible and responsive to their needs; and is often enhanced by other local and school resource and so enables larger numbers to be reached.
- However it means provision is variableand inconsistent across the County.
- Furthermore many LDGs do not have the capacity or will to continue delivery and more are reluctant to monitor and report on outcomes.
Option B
- Capacity required to run a tendering exercise parallel to but separate from the EWMH Service process is probably greater than for other options.
- Having a separate provider of this could continue the separation and “batting back and forwards” with the EWMH Service – though aimed at different levels of need and if this funded provision accepted referrals from the doorway that would be reduced.
- Could provide benefits of equity and consistency across the County as in Option C.
- Like C, the actual provision may not change much from what is delivered in some areas now –however, who delivers would change.
- The provision would be more consistent across the County with coordination and performance management information undertaken consistently by one process across the County or in quadrants/CCG areas rather than needing to be done locally at LDG level.
Option C
- Enables locally tailored provision by skilled and qualified staff from an organisation/partnership that is specifically focused and competent in delivering emotional wellbeing and mental health provision.
- It enables good relationships with schools, a quick response to children’s needs and a smooth and integrated transfer to more specialist help from within the same organisation when early intervention does not meet the needs.
- It is beneficial and preferable in terms of equity and consistency across the County yet provides local quadrant tailoring.
- It is fair, easy to implement and provides consistency and integration with the wider model.
- It enables schools to steer and oversee local tailoring but does not require them to deliver or oversee delivery or monitor and report outcomes themselves.
- The actual provision may not change much from what is delivered in some areas now –however, who delivers would change.
- The provision would be more consistent across the County with coordination and performance management information undertaken consistently by one process across the County with a requirement for quadrant/CCG level reporting rather than needing to be done locally at LDG level.
5.Financial Implications
5.1The financial implications are embodied within the report.
6.Other Resource Implications
7. Consultation with stakeholders
7.1Following the February School Forum decision, the options were discussed at a meeting of the SEN working group on 6th May 2014and this paper reflects the conclusions of those discussions.
7.2Consideration could be given to sharing this with schools/LDGs and seeking their views on the options.
8.Supporting papers
See
- Report on Outcomes of LDG 2013-14 funding for Emotional Health and Wellbeing (attached)
- The Southend, Essex and Thurrock Emotional Wellbeing and Mental Health Service Model (available on request)
- The Essex Joint Strategic Needs Assessment for Children’s Emotional Wellbeing and Mental Health Mental Health Strategies Summer 2013 See
- The Greater Essex Emotional Wellbeing and Mental Health Strategic Position Statement December 2013 Available on request
APPENDIX INITIAL STARTING DRAFT SERVICE SCHEDULE
Service Specification No.Service / School and community based early intervention support for children and young people with emerging emotional wellbeing and mental health needs in Essex