Agenda item

    To receive a report from the Chief Executive.

Cllr Richard Clewer, Leader of the Council, presented a report regarding the Integrated Care Board’s intended retender for a single, system wide community healthcare services contract from April 2025, and its impact on Wiltshire Council social care services and Better Care Fund administration.

The Leader noted his role as Chair of the Integrated Care Partnership (ICP), distinct from the role of the Integrated Care Board (ICB). He noted the proposed contract would apply for Wiltshire, Swindon, and Bath and North East Somerset council areas. He stated funds needed to deliver value for money, and that he would emphasise the importance of performance metrics, and that within any contract money from Wiltshire would need to have a positive impact for Wiltshire residents.

Cllr Johnny Kidney, Chairman of the Health Select Committee, stated the committee had received an informal briefing on the proposals and then a presentation at their most recent meeting, and had focused upon the engagement with residents on services. They had requested details of a roadmap for delivery of any contract at a future meeting.

Cllr Ian Thorn raised concerns around ICB decisions relating to Calne. The Leader suggested this could be raised through his role on the ICP. Cllr Thorn also sought details of how Wiltshire would be involved moving forward. The Leader noted the role of the ICP overseeing strategy, as well as other bodies such as the Health and Wellbeing Board. The proposal included that a final decision to award a contract would require a further Cabinet decision.

Cllr Gordon King welcomed the proposed approach in the report. Cllr Pip Ridout stated the Health Select Committee would look further at the financial scrutiny of the proposals.

Cllr Clare Cape stated an inquiry day was held in the summer about healthcare and community care, and she hoped the outcomes from that day had been considered. The Leader noted the contract was led by the ICB, who could be asked if that was the case.

At the conclusion of discussion, it was then,

Resolved:

That Cabinet

1)    Noted the past and ongoing work between the ICB and Wiltshire Council regarding the tender of a BSW-wide Community Health Services contract.?

2)    Gave ‘in principle’ agreement to commit Better Care Funding to the ICB Community Health Contract from 2025 to 2032 (with potential for a further 2 years to 2034). Formal commitment is dependent on a revised and agreed S.75 Agreement (Health and Social Care Act 2012) that covers the period of the contract, along with a signed Collaborative Commissioning agreement. Formal agreement will be sought in early 2024 before the contract is awarded.?

3)    Identify any material issues that prevent a decision to proceed as a funding partner with the procurement process, noting the requirement to further develop key elements of the contractual agreement through the negotiated process with providers.?

4)    Approved the revised S.75 agreement that will cover the period of the Community Health Services contract.?

5)    Approved delegated authority to the Corporate Director People (DCS) to authorise activities related to the procurement up and until award (when the award decision will return to Cabinet). 

Reasons for Decision

The ICB will be tendering a BSW-Wide Community Services Health contract, to start from 1 April 2025 with a proposed length of 7 plus 2 years. The Integrated Care Board’s (ICB) community health contract re-tender will have cost and service implications for Wiltshire Council Social Care and management of the Better Care Fund (BCF).

The Wiltshire BCF currently provides £10,453,157 per annum to the £60,802,388 Wiltshire Health and Care run Community services contract for Wiltshire, plus £1,073,054 for the Access to Care service (Medvivo). The total amount is £11,526,211. The NHS commissioned contracts end in March 2025.

Agreement to £10,453,157 has been agreed for 23/24 to support the ICB direct award to Wiltshire Health and Care for 12 months whilst they undertake the procurement activity for a future system wide contract.

The proposals in this report aim to highlight the impacts, so far as they are known and request an ‘in principle’ commitment of £11,526,211 of BCF funding, subject to appropriate S.75 and Collaborative Commissioning agreements.

Cabinet will need to be assured that the procurement process is robust and ensures that Wiltshire’s contribution from the BCF is spent on Wiltshire residents. Cabinet has a responsibility to ensure the Wiltshire £ is spent on Wiltshire residents.