Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1. A decision is required by the Executive Member(s) to allow Hampshire DAAT to re-tender the Hampshire young people's substance misuse treatment service. The current contract is due to expire on the 30th June 2009.

1.2. The contract for this service was awarded on 1^st July 2005 for three years and it has been extended for one year from 1^st July 2008 until 30^th June 2009. The Council's contract procurement rules do not allow for a further extension.

2) Issues Covered in Report:

2.1 The Young People's Substance Misuse Treatment Service

2.2 Financial implications

2.3 Legal implications

2.4 Value for Money

2.5 Delivery drivers

3) Recommendations:

2.1. For Hampshire DAAT to proceed to open tendering of the Hampshire young people's substance misuse treatment service

2.2. For the tender process to start in Quarter 3 (October - December 2008) for commencement of a new contract in April 2009.

MAIN REPORT

1) Purpose of the Report:

1.1. A decision is required by the Executive Member(s) to allow Hampshire DAAT to re-tender the Hampshire young people's substance misuse treatment service, as the current contract is due to expire on the 30th June 2009. The contract lifetime value (over 2 years) is approximately £1,100,000.

1.2. To seek Executive Member approval for the tender process to commence in Quarter 3 (October - December 2008) for commencement of a new contract in April 2009. The new contract will be for two years with an option to extend up to a further three years (2 + 1+1+1), subject to satisfactory performance and availability of funding.

1.3. To seek Executive Member approval that the service be funded from the investment to support local areas to prevent and reduce substance misuse related harm for children and young people 2008-09 to 2010-11 (confirmed in the recent national drugs strategy) as follows:

Department of Health contribution through PCTs for substance misuse treatment for young people under the age of 18 yrs

Home Office contribution to YOTs in England through the Youth Justice Board

2) Contextual Information:

2.1. The Government's new Drug Strategy 2008-2018, "Protecting Families and Communities" and the Youth Alcohol Action Plan (2008) support the ambition set out in PSA 14, to "Increase the number of children and young people on the path to success" through a shared aim to reduce the numbers of young people frequently using drugs, alcohol and volatile substances (glue, gas and solvents).

2.2. Whilst young people should have their needs met in universal or targeted services whenever possible, specialist substance misuse treatment services should also be offered to all young people whose functioning is significantly impaired by substance misuse, and who have been assessed as requiring it to improve their functioning.

2.3. Cross government departments recognise that it will be only a small proportion of young people requiring specialist substance misuse treatment, nevertheless these young people will not achieve the five Every Child Matters outcomes without it.

2.4. The Government's vision is that every young person in England should have access to specialist substance misuse treatment when they need it. This specialist treatment provision should be of high quality, aim to address the young person's needs and be integrated into the broader Children's Services provision, particularly targeted support for vulnerable young people.

2.5. Hampshire Drug & Alcohol Action Team (DAAT) is a multi agency partnership, established in 2001 and responsible for the local implementation of the Government's 10 Year Drug Strategy: "Protecting Families and Communities". An important factor in this delivery is the effective commissioning of a system of treatment to serve the needs of the local population that complies with the requirements of the national Service Frameworks `Models of Care for Drug Misusers' and `Models of Care for Alcohol Misusers'.

2.6. The DAAT is provided with funds to achieve this function from the Department of Health contribution through PCTs for substance misuse treatment for young people under the age of 18 yrs and the Home Office contribution to YOTs in England through the Youth Justice Board.

2.7. The current young people's substance misuse treatment contract with Cranstoun Drug Services is due to end on 30^th June 2009. This contract was awarded on 1^st July 2005 for three years and it has been extended for one year from 1^st July 2008 until 30^th June 2009. The Council's contract procurement rules do not allow for a further extension.

2.8. It is anticipated that the re-tender process will take in the region of 6 months to complete, hence the request for a decision at this date.

3 Key Issues:

3.1 The Young People's Substance Misuse Treatment Service (Tier3)

3.1.1 The service is a specialist substance¹ misuse treatment service for children, young people (under the age of 19) and where appropriate their parents and carers and other family members. It will offer comprehensive assessment, individualised packages of care, intervention and treatment based on the needs of children and young people.

3.1.2 Substance misuse treatment will be defined as follows:

Young people's specialist substance misuse treatment is a care planned medical, psychosocial or specialist harm reduction intervention aimed at alleviating current harm caused by a young person's substance misuse (NTA, Commissioning Young People's Specialist Substance Misuse Treatment Services, Draft, 26 Sept 2007).

3.1.3 In line with the National Treatment Agency (NTA) guidance the new service will provide a range of interventions that reduce harm caused to children and young people through substance misuse as follows:

· Pharmacological

These interventions include prescribing for detoxification, stabilisation and symptomatic relief of substance misuse as well as prescribing of medications to prevent relapse. 

· Psychosocial

These interventions use psychological, psychotherapeutic, counselling and counselling based techniques to encourage behavioural and emotional change; the support of lifestyle adjustments and the enhancement of coping skills. They include motivational interviewing, relapse prevention and interventions designed to reduce or stop substance misuse, as well as interventions which address the negative impact of substance misuse on offending and attendance at education, employment or training.

· Family

Interventions using psychosocial methods to support parents, carers and other family members to manage the impact of a young person's substance misuse, and enable them to better support the young person in their family. This includes work with siblings, grandparents, foster carers, etc. and can be provided even if the young person misusing substances is not currently accessing specialist substance treatment.

· Assertive outreach for those who do not engage

For some young people engaging with substance misuse services can be a problem and/or some young people will present with low levels of motivation despite the high risks related to their substance misuse. Assertive outreach is a way of working with an identified client group who do not effectively engage with services and the approach is characterised by work with clients in their own environment, wherever that may be.

· Criminal Justice

These are interventions which address both a young person's substance misuse and related criminal behaviour. Interventions to reduce criminal activity should be delivered within the context of interventions to reduce substance use and its related risks.

· Specialist harm reduction

Specialist harm reduction interventions should include services to manage:

a.     Injecting - young people need to be able to access young people's specific injecting services, as adult services for injectors are too low threshold and will put young people in contact with adult drug service users, both of which may put them at further risk of harm. These services could include needle exchange, advice and information on injecting practice, access to appropriate testing and treatment for blood borne viruses and participation in full assessment and other specialist substance misuse treatment services.

b.     Overdose - advice and information to prevent overdose, especially overdose associated with poly-substance use, which requires specialist knowledge about substances and their interactions. This could include protocols with accident and emergency services to ensure that measures to identify and prevent future overdose are in place.

c. Accidental injury - protocols with accident and emergency services to ensure that measures to identify and prevent future substance misuse related accidental injuries are in place.

· Support with access to residential treatment for substance misuse

There should be systems and resources in place to provide access for young people to any specialist substance misuse intervention (as defined in 1-4 above) which is provided in a residential setting where the young person will be placed, away from their normal home.

3.1.4 The service will be required to submit core data set information relating to young people to the National Drug Treatment Monitoring System (NDTMS).

3.1.5 The service will also be routinely monitored by the Hampshire DAAT in respect of a range of treatment quality measures set by the National Treatment Agency.

3.1 Financial implications

3.2.1 The cost for the new service is anticipated to be in the region of £550,000 per year or £1.1 million over the course of the 2 year contract period.

3.2.2 National levels of specific investment to support local areas to prevent and reduce substance misuse related harm for children and young people 2008-09 to 2010-11 in England were confirmed in the recent drugs strategy.

3.2.3 The cost for the service will be met from the following funding streams (based on 2008 - 09 costs):

Funding Stream	Approximate Annual Budget (£)
DH Substance Misuse Treatment for under 18s 2008-09*	£442,300
HO YOT substance misuse worker through Youth Justice Board per year for 2008-09 - 2010-11:	£100,439
TOTAL ANNUAL VALUE	£542,739

* funding levels are indicative for this funding stream for 2009/10 and 2010/11

3.2.4 Within the terms and conditions of the service agreement there will be a clause allowing for a variation of the service delivery and contract price, should this be required in future years.

3.2 Legal implications

3.3.1 The existing contract will end on 30 June 2009 following a 12 months extension of the Agreement period.

3.3.2 The new contract will be for a period of two years with an option to extend up to a further three years (2 +1+1+1), subject to satisfactory performance and availability of funding.

3.3.3 As the contract is for a class B activity the full requirements of the EU Public procurement Rules (OJEU) will not apply to this contract

3.3.4 There will be TUPE implications for the existing provider if another contractor is awarded the contract. This will be dealt with as part of the tender procedure.

3.3 Value for Money

3.4.1 It is the intention of the DAAT to ensure that an appropriate testing of the market is conducted before the existing contract comes to an end in order to ensure that Best Value is achieved.

3.4.2 Value for Money will be a key driver in the proposed tendering process. The evaluation of tenders will be based on the most economically advantageous tender, capturing both cost and qualitative aspects.

3.4.3 The criteria and weightings will be included in the invitation to tender and will be on the basis of 40% for Quality and Service Delivery, 40% for Cost and 20% for Performance. An evaluation panel comprising appropriately qualified members, according to Contract Procedure Rules will be established to evaluate tenders against the pre-set criteria.

3.4.4 A Report will be presented to Members in April 2009 recommending the award of contract to the successful organisation.

3.4 Delivery drivers

3.5.1 This service will be supported by the following main delivery levers:

a. the effective treatment indicator in PSA 25 (NI 40), which also applies to those aged 16 and 17;

b. reduce the proportion of young people frequently using illicit drugs, alcohol or volatile substances indicator in PSA 14 (NI 115)

c. performance management of local areas by Government Offices against designated targets within Local Area Agreements; and

d. performance management of Primary Care Trusts by Strategic Health Authorities against indicators in local PCT delivery plans;

e. supported by assurance of local drug partnership plans via a process of annual agreements and quarterly reviews by the NTA. The publication of monthly performance management information through the National Drug Treatment Monitoring System, the provision of dedicated resources via a joint Department of Health and Ministry of Justice pooled treatment budget and independent assessment and review by the Healthcare Commission, Commission for Social Care Inspection, and the Audit Commission.

4) Outline of Options:

a. Option 1:

i. Do nothing.

b. Option 2:

i. Hampshire County Council provide this service `in house'

c. Option 3:

i. Proceed to open tender for this service

5) Option Analysis / Comparison:

a. Should the service not be tendered the existing contract would end thus putting service provision at risk

b. Hampshire DAAT is looking to encourage specialist organisations that work with drug and alcohol misusing young people at a Tier 3 level to tender for the contract. Services currently provided `in house' by Hampshire County Council are universal (Tier1) and targeted (Tier 2). These services do not have the capacity to deliver the specialist (Tier 3) interventions which are outlined under section 3.1 of this report.

c. This tendering exercise would ensure that the Children's Services department is fully meeting its' obligations under the County Council's Standing Orders on Contracts. This is the recommended option.

6) Conclusions:

6.1. Young people should have their needs met by universal or targeted services wherever possible. Universal services (tier 1) have a vital role in educating and helping to prevent and reduce substance misuse. Targeted services (tier 2) play an important role in helping those identified as vulnerable to avert or address substance misuse. Specialist substance misuse treatment services (tier 3) should be offered to all young people whose functioning is significantly impaired by substance misuse, and who have been assessed as requiring it to improve their functioning.

6.2 Hampshire County Council currently provides services that meet the needs of young people through universal services (e.g. schools and youth provision) and/or targeted services (e.g. Services for Young People and the PRISM Network). However these services do not have the capacity and specialisms to deliver the modalities that make up a specialist treatment service which are in summary: care planned medical, psychosocial or specialist harm reduction interventions.

6.3 The current young people's substance misuse treatment contract with Cranstoun Drug Services will end on 30^th June 2009. Hampshire DAAT would like to ensure that an appropriate testing of the market is conducted before the existing contract comes to an end.

7) Summary Recommendations:

a. The option recommended by officers is for Hampshire DAAT to proceed to open tendering of the Hampshire young people's substance misuse treatment service

b. Recommendation that the tender process starts in Quarter 3 (October - December 2008) for commencement of a new contract in April 2009.

CORPORATE OR LEGAL INFORMATION: