Purpose

Delegate to the Director of Adult Social Care,
in consultation with the Lead Member for Adult Services, the
Integrated Care Board decision to award a contract for delivery of
BSW Integrated Services as of April 2025.

Decision

(1) 
To delegate to the Director of Adult Social Care, in consultation
with the Lead Member for Adult Services, the decision to contract
for the delivery of Integrated Community Based Care for Children,
Young People and Adults services as from April 2025 in accordance
with the outcome of the tender exercise currently being
co-commissioned with
the Integrated Care Board and other Bath and North East Somerset,
Swindon and Wiltshire Local Authorities as detailed in the
report.
 
(2) 
Subject to (1) to
agree ‘in principle’ to commit B&NES and Better
Care Funding of £5,062,923 (2025/26) to the Integrated Care
Board Integrated Community Based Care for Children, Young People,
and Adults contract from 2025-2032 (with a potential for a further
2 years to 2034). The total funding commitment over the initial
7-year contract term from B&NES is £35,440,461. The
overall contract is a fixed envelope. Within this there will be
annualised uplifts by the cost uplift
factor for the NHS and BCF element in line with National operating
guidance as published. So, any Local Authority funding is not
subject to an automatic uplift.
 
(3) 
Subject to (1) to appoint the Director of Adult Social Care to be
the Council’s representative on the Collaborative Oversight
Forum as required in the Collaborative Commissioning Agreement
(Principle 2.1.3 and clause 5) and delegate to the Director the
power to appoint other B&NES officers to sub groups of that
body to ensure appropriate governance arrangements are put in place
to support shared leadership and accountability for the
Collaborative, and to build a strong working relationship and
culture of trust between the Collaborative.

Reasons for the decision

Integrated Care Board – The Case
for Change
 
The purpose of an Integrated Care System is to bring
partner organisations together
to:
 
• 
Improve outcomes in
population health and healthcare
• 
Tackle inequalities in
outcomes, experience and access
• 
Enhance productivity
and value for money
• 
Help the NHS support
broader social and economic development
 
The Integrated Care Board (ICB) developed a detailed
Memorandum of Information (MOI) which set out the main ambitions
for delivery of a new model of care in support of these objectives
with a Case for Change which demonstrated that current provision of
services is unsustainable and unequitable.
 
The Integrated Community Based Care programme is seeking to maximise the opportunity for transformational
change in the way that services are designed and delivered across
the three communities of (Bath and North East Somerset) B&NES,
Swindon and Wiltshire. It presents a significant opportunity and is
a key part of delivering the agreed Integrated Care Partnership
strategy.
 
The programme is therefore a contract for much
more than traditional NHS Community Services contract. The focus is
upon prevention, addressing health inequalities and enabling the
left shift away from
hospital-based care into the community. By commissioning Integrated
Community Based Care for Children, Young People, and Adults across
all life stages; Starting Well, Living/Ageing Well and Dying Well,
BSW ICB and its Local Authority partners wishes to ensure provision
of health and care services that work seamlessly and harmoniously
with primary care, secondary care, mental health services, local
authorities (in particular Public Health and Social Care) and third
sector organisations. The intention is
to support local people to stay healthy, well and independent in
the community.
 
The ICB and BSW Local Authorities are looking for a lead
community partner to deliver this new vision for community care.
The way in which they deliver these services will have a key role
in transforming the out of hospital care setting in a way that
delivers proactive care and person centred outcomes.
 
One of the transformative changes in the contract is to
focus on outcomes for the population as opposed to specifications
for the delivery of individual services. There is an outcomes
framework jointly agreed by Local Authority colleagues and ICB
colleagues, to support this to ensure we deliver across Children
and Adults integrated community based care.
 
Scope of Services
To date the ICB and Local Authorities have jointly reviewed
the services, both in scope and potentially in scope (on reserve
list) over the lifetime of the contract and have provided detail
for the ambitions for transformation of services.
 
The proposed core services are aligned across BSW and must
be delivered within the contract. These will cover key elements of
community-based health services for adults and children, plus any
additional services that the ICB and Local Authorities decide to
include in the contracts from 1st April 2025. For services
identified within the core list there is a requirement that these
will be harmonised across BSW, ensuring
equity of access across all local authority areas, with only
warranted variation
 
Integrated Care Board Procurement
Process
 
There have been several stages to the procurement process.
The first stage was a selection qualification process in line with
traditional procurement. Invitation to Negotiate (ITN1) required a
bidders’ submission before entering the dialogue phase and
ITN2 which was launched in July is the final stage and will
conclude with a traditional evaluation process during August.
Evaluators include ICB and Local Authority representatives and the
lived experience voice.
 
The dialogue phase was a very successful step in process
and ensured bidders really understood the requirements.
 
All steps have been robust and followed
procurement and legal requirements and approved by the Integrated
Community Based Care Programme Board (joint membership of ICB and
Local Authority
officers). Assurance has been through the Integrated Care Board
Finance and Investment Committee (including Local Authority
representation) on behalf of the ICB.
 
The ICB Board will consider any recommendation for contract
award in late September 2024. After any decision there will be the
required 10 day stand still period before the contract award. There
is a necessary six-month mobilisation
period for a contract of this nature and scale, this period would
then take us up to the contract starting on 1st April
2025.
 
Public announcement and briefings will follow the stand
still period. A full Equality Quality Impact Assessment (EQIA) has
been undertaken throughout and is updated iteratively. The EQIA
will be shared as part of those briefings.
 
Public engagement ad co-production on the delivery of
transformation priorities will be led by the provider with ICB and
Local Authority engagement earlier public engagement, having been
deferred due to the announcement of the general election. This does
however allow meaningful collaborative engagement when the known
bidder is in place.
 
Contract Arrangements
The Integrated Community Based Care contract arrangements
will be covered by a Collaborative Commissioning Agreement (CAA)
between the Integrated Commissioning Board and Local Authorities as
co- commissioners. This will refer to Section 75 arrangements in
the BSW localities and will set out the governance to ensure
oversight of the ICB commissioned contract.

Alternative options considered

All feasible options have been considered by
the Integrated Care Board and reviewed at the Integrated Community
Based Care Programme Board for approval of the strategic outline
case for the delivery of integrated community services across Bath
and North East Somerset, Swindon and Wiltshire as of April
2025.