Decision Maker: Shared Services Joint Committee

Outcome: Recommendations Approved

Is Key Decision?: No

Is Callable In?: No

Date of Decision: July 16, 2025

Purpose:

Content: RESOLVED   That the Shared Services Joint Committee:    i.          Approved the Approved Mental Health Professional Service becoming a permanent countywide Service for adults as an aggregated service with North Northamptonshire Council named as the Lead Authority, with new arrangements coming into effect on or after 1st September 2025.   ii.          Approved the transfer of responsibilities for provision of an Out of Hours Approved Mental Health Professional Service and Out of Hours adults social care response service from Northamptonshire Children’s Trust, creating a permanent Countywide Service for adults as an aggregated service with North Northamptonshire Council named as the Lead Authority.   iii.          Approved the implementation of the EDT Enhanced Call Care service proposal.   iv.          Granted delegated authority to the Monitoring Officers for North Northamptonshire Council and West Northamptonshire Council to amend the relevant provisions within the IAA.   v.          Approved that North Northamptonshire Council and West Northamptonshire Council work together under an MOU that will provide for the agreed new governance procedures, charges and associated joint collaborative working arrangements to ensure service delivery under the new arrangements.    vi.          Noted that North Northamptonshire Council will commence recruitment of additional AMHPs to the service team.   vii.          Agreed all parties to work towards a transfer of services and the creation of a 24/7 AMHP and out of hours social care response service team led by North Northamptonshire Council, supported by an enhanced call care service provided by West Northamptonshire Council from 1st September 2025.    viii.          Agreed that both North Northamptonshire Council and West Northamptonshire Council make provision for an increased service delivery budget through Medium Term financial Planning from 2026/27 onwards.   Reasons for the Recommendations:   1.         It is a requirement of the Mental Health Act 1983 and 2007 that Local Authorities put in place arrangements to provide AMHP services 24 Hours a day, 7 days a week. Out of Hours services, are currently provided through an Emergency Duty Team (EDT) function at NCT, which provides services to both Adults and Children across Northamptonshire. Having considered their own service delivery model and operational pressures, NCT have formally requested that the adults' elements of the EDT service transfer to WNC and NNC to sit directly alongside the substantive Adults Social Care functions during weekday evenings and nights.   2.         Retaining the daytime service delivery under the IAA and amending the IAA to reflect the addition of out of hours services to create a single 24/7 service delivery model, will ensure that there continues to be a formal agreement in place, agreed by NNC and WNC. The 24/7 service model for the AMHP service ensures a continuous effective service delivery within this statutory function. It also considerably reduces the risk of service failures or issues as a result of limited specialist resources and capacity to support the vulnerable end-users, as well as reputational damage.   3.         From a budget perspective, the direct costs to both NNC and WNC will increase as additional AMHP qualified staff will need to be employed to deliver services, and additional team leader and business support roles will be required.   4.         From a workforce perspective, staff at NCT will be redeployed to NNC under TUPE regulations. Consideration has been given to reviewing shift patterns and rotas to focus resource availability to times of greatest demand, and to provide suitable cover at all times to ensure statutory requirements are met.    5.         From an operational delivery perspective, combining AMHP services into a single point of delivery 24/7 model will reduce handover of casework between teams, enable flexibility and harmonisation of services.   6.         From the perspective of people accessing the service, separating service delivery teams focussing on children's and adults' needs will improve efficiency and surety of service. A single point of delivery 24/7 service for adult social care and mental health response will allow staff to reduce handovers of case work and focus on front line service delivery.   7.         To ensure the service has resilience an analysis of points of contact considering source, date and time data has been carried out. This information has been used to establish service team operations (shift patterns, staff rotas etc) to ensure that sufficient resources are available at times of need, with suitable levels of provision being provided to comply with statutory requirements at all times.    Alternative Options Considered:   Disaggregation of the service   The disaggregation of the AMHP service (i.e NNC and WNC operate separate 24/7 AMHP and safeguarding services) would present a high statutory risk to both local authorities, leaving people experiencing mental health crisis at risk and posing a potential danger to themselves or others.   The Approved Mental Health Professional Service and Out of Hours adults social care response service is the statutory responsibility of each Council with safeguarding of the people supported paramount, ensuring that they receive the best outcomes.   Fully disaggregating the service between NNC and WNC would require increasing the size of the team in each council in order to provide a safe service.  There is a national shortage of suitably qualified AMHPs and therefore recruitment to vacant posts is difficult.  Due to the complexity of the role, it takes two years to train staff   Continuing with an out of hours Emergency Duty Team (EDT) provided by NCT   The existing NCT EDT establishment does not have enough AMHP-qualified staff to be able to cover all of the shifts required. Therefore, shifts are either short-staffed or rely on overtime, agency hours and cover from the Senior Management.   Only 2% of AMHP-qualified staff nationally are employed in Children’s Services. This may suggest that an increased risk profile may exist for recruitment, retention or staff training in such operational models. For example, NCT has had open-recruitment for AMHP-qualified Social Workers for 12 months and during this time one AMHP-qualified Principal Social Worker has been recruited.   As well as the additional cost that this expensive method of resourcing carries, service and response times are also adversely affected. It is not currently uncommon for casework originating through an out of hours referral to be handed over to the substantive daytime team for completion.   Outsource service delivery.   There may potentially be options to outsource service delivery to third parties (e.g. neighbouring local authorities) however these have not been considered as it is unlikely that either a) other local authorities have sufficient resources in place to provide such services b) NNC and WNC would still retain statutory responsibility for the services and outsourcing would result in delivery being put at arm's length with less direct control over risk management and c) there are unlikely to be any financial benefits of outsourcing – particularly given the limited national resource availability.  However, partnership working with other health care sector partners is and will continue to be an important factor in AMHPs and out of hours service delivery considerations.