SUBJECT: Agreement Under Section 75 of National Health Service Act

DECISION OF COUNCILLOR NIGEL ASHTON

LEADER OF NORTH SOMERSET COUNCIL WITH ADVICE FROM THE DIRECTOR OF PEOPLE AND COMMUNITIES DECISION NO: 86 - 2013/2014

SUBJECT: Agreement under section 75 of National Health Service Act 2006 between North Somerset Council and Avon Wiltshire Mental Health Partnership Trust to deliver social care within an integrated service

1. BACKGROUND

1.1 For well over ten years, Avon Wiltshire Mental Health Partnership Trust (AWP) has been managing North Somerset Council social care staff who have been deployed into an integrated mental health and social care service. Although this is an established service, there has never been a clear defined basis on which the council or AWP were operating. This meant that it was difficult for the council to hold AWP to account for delivery of social care or to be included transparently within AWP service developments. The service has been maintained purely through managing the working relationships between both organizations.

1.2 The council has 31.3 fte staff within the integrated service and in addition has 0.4 of a services manager and 1 JM3 to provide professional social care oversight, quality assurance, support and guidance to AWP to ensure adherence to council’s processes, ethos and procedures, including the focus on People and Communities strategic direction. There are also 1.6 Managers who lead the council’s Approved Mental Health Professional service.

1.3 AWP, as commissioned by North Somerset Clinical Commissioning Group (CCG), undertook a redesign three years ago and this was follow up by a further restructure on the appointment of a new chief executive in November 2012. Although the council worked with the CCG on the redesign, it was difficult to influence the restructure, as we did not have a formal relationship with AWP.

1.4 There have been occasions when AWP has not always kept to social care priorities and policies, and, again, it has been difficult to help them understand the importance of this.

1.5 For these reasons the council has been working closely with AWP over the past two years to draw up this agreement, to our mutual benefit. AWP are now clear on what they are required to deliver for the council and what resources are being committed to enable them to do this.

1.6 The agreement sets out the social care activities/services that AWP will ensure are delivered within the integrated service. These include:-

• Information, advice and signposting • Social Care Assessment • Personal Budgets, support plans, packages of care (including placements) • Social work interventions • Reviews • Enablement/re-ablement • Safeguarding

2. RECOMMENDATIONS

2.1 That the Executive Member endorses the agreement with Avon and Wiltshire Partnership Trust for a term of three years beginning on 1 April 2014 and ending on 31 March 2017.

2.2 That the Executive Member instructs officers to complete the agreement in substantially the format attached and that the Director of People and Communities be authorized to agree minor amendments to the format.

3. REASONS

3.1 This will enable North Somerset Council to clearly hold AWP to account for the delivery of social care functions on behalf of the council.

3.2 This will ensure AWP understands what it is required to deliver for the council and what resources are committed to support this.

3.3 This will enable both partners to work with North Somerset Clinical Commissioning Group to further develop this integrated health and social care service to the benefit of the organizations and the residents of North Somerset.

4. OTHER ALTERNATIVES CONSIDERED

4.1 There are principally two other options, to maintain the status quo, or to bring social care staff back to the council and no longer have an integrated mental health service.

4.2 Maintaining the status quo has a number of risks and issues which are indicated in the background section, not least the lack of a clear basis on which the arrangement is made. For this reason this alternative has been discounted.

4.3 It would be possible to bring the social care staff back to the council, however the most significant shortcoming of doing this would be the detriment to mental health services users, who currently have one care coordinator and a joint health and social care plan to meet their needs. An integrated service supports the direction of travel for social care as set out in the documentation for the Better Care Fund and the draft Care Bill currently passing through Parliament. For these reasons this option has been discounted.

5. FINANCIAL IMPLICATIONS

5.1 The agreement, schedule 3 contribution, sets out that the council will pay annually towards management overheads and accommodation £90,851, which is £272,553 over three years. The 31 staff seconded come to the value of £1,164,470 per annum, but their cost stands outside of the financial contributions of each party.

6. IMPLICATIONS FOR FUTURE YEARS

This will provide an assured social care service within the integrated service, and provides consolidation and clarity for three years. The Council will be able to reassess this agreement to decide whether to maintain it for future years, or whether at that time to consider other options.

Signed ...... Leader of the Council and Executive Member for Adult Social

Care Dated ......

Confirmation of Advice Given:

Signed ...... Director of People and Communities Directorate

Dated ………………………..

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