Decision

Cabinet:

(1)            approved the proposed commissioning approach for the Healthy Child Programme (0–19), Best Start Service (0-5) and Universal and Targeted Services for Children (0-5) and their Parents, including the preferred delivery model, contract term and contract value as set out in this report;

(2)            agreed to commence a competitive procurement process under the Provider Selection Regime (PSR); and

(3)            delegated authority to the Strategic Directors for Adult Services and Children Services, in consultation with the Portfolio Holders for Health and Adult Social Care and for Children and Young People and the Section 151 Officer, to finalise the procurement documentation, evaluate tenders, and award the contract to the successful provider(s).

Options & Alternatives Considered

In consultation with key system partners, a range of options have been considered in relation to the overall financial allocation and specific discretionary elements of the contracts that fall outside statutory requirements. These options sought to balance affordability with the need to maintain service quality, safeguard outcomes and minimise system risk.

Funding across Lots 1–3 has reduced in real terms, shaping a delivery model that is focused on core statutory requirements. Compared with some similar boroughs, Waltham Forest operates with a more constrained resource base, which limits capacity for service expansion. No additional investment is currently assumed within the medium?term financial plan. In this context, the approach prioritises the continued delivery of mandated Healthy Child Programme and Family Hub services within existing budgets. This enables stability and avoids immediate service disruption; however, it also requires careful management of ongoing pressures, including high caseloads, increasing demand and workforce capacity, which may have implications for service resilience over time.

A detailed review of discretionary elements across the three Lots has been undertaken, and a range of options has been assessed to inform recommendations.

For Universal and Targeted Services for 0–5 year olds (Lot 1), options considered included full withdrawal of discretionary provision, delivery of a reduced model across three hubs generating savings of up to £200k, and retention of the current level of investment. The recommended option is to maintain the existing investment, providing system stability and resilience, particularly in the context of the planned review of community spaces and the increased reliance on integrated neighbourhood delivery.

Waltham Forest will deliver the savings of £60,000 per annum identified through the recommissioning process by reducing investment in the discretionary Healthy Living offer.

The Healthy Living offer delivered through Lot 2 has made a sustained contribution to reducing childhood obesity and is meeting the objectives for which it was originally commissioned. However, as the provision is discretionary rather than a statutory requirement, options were considered to achieve required savings. These included redesigning the model to focus delivery within early years settings or reducing the size of the team to achieve savings of £60,000. Following consideration, the decision has been taken to proceed with the savings option.

The Family Nurse Partnership (FNP), delivered through Lot 3, provides intensive, evidence-based support to vulnerable first-time young parents, delivering strong safeguarding and early childhood outcomes while supporting statutory duties. Consideration was given to discontinuing FNP and replacing it with a reduced cost health visiting model. Continuation of FNP is recommended, reflecting its established effectiveness, strong alignment with prevention and early intervention priorities, and the significant risks to vulnerable families associated with withdrawal.

The recommended options strike a pragmatic balance between financial constraint and risk management, protecting high impact preventative services while sustaining statutory delivery. Maintaining stability across discretionary elements is critical to mitigating system pressures, safeguarding quality and supporting the borough’s wider early help, prevention and safeguarding objectives.