What is NE12 and how can I get my views to the commissioners. 

In 2014 the 12 North East local authorities identified that something needed to be done about the way they
commissioned placements in residential schools.

These ‘low-volume, high-cost’placements were being commissioned in a variety of ways from a range of Providers. There was inconsistencies in relation to understanding of, and monitoring of the quality of provision and outcomes for Children and Young People.

There was no consistency regarding price and contracting arrangements.

On 15 May 2014 Newcastle City Council convened a meeting of representatives of the 12 North East local authorities and their Clinical Commissioning Groups (CCGs) through the North East Commissioning Service (NECS) The meeting determined that there
was benefit in having a joint approach to the commissioning of these placements. Following a formal commitment to
participate process across the region the NE12+ Collaborative was established

The Journey so far

Following debate between the members of the NE12+ Collaborative (NE12+) the following scope for the commissioning
and procurement exercise was agreed and written into the groups Terms of Reference: “Placements in Department for Education registered, non-maintained and independent special schools and colleges; residential and / or day placements.  All placements in these settings for children and young people aged 0 – 25 years (inclusive).

The NE12+ agreed a number of desired outcomes for this exercise: 
•To ensure good and improving outcomes for children and young people 
•To ensure relationships with all Providers are good and improving; open and transparent  
•To achieve financial transparency in placement costs 
•To achieve fairness of financial contribution from Health, Education and Social Care in those instances where placements are joint funded 
•To ensure a consistency of quality across all Providers 
•To increase financial efficiencies and value for money in all placements 
•To encourage and enable growth in the local market in order to provide a range of choice and suitable placements to
meet the needs of children and young people 
•To establish ‘harmonised’ terms and conditions for Providers and purchasers

The remit was later expanded to include weekly and termly boarder placements.  Although placements in other settings were discussed, including academies, the NE12+ determined that we would take a ‘step approach’ to changing commissioning practice

A number of influencing factors and considerations were identified for this complex exercise and included: 

•Special Education Needs and Disability (SEND) reforms 
•The Personalisation agenda and an increase in families having the ability to commission services directly through individual budget 
•Parental choice is an essential factor in choice of placement under SEND  
•The introduction of Education, Health and Care (EHC) Plans  
•The consideration of services for children and young people both pre and post 16 and through transition being brought together under one arrangement  
•Changes in funding arrangements between local authorities and Education Funding Agency (EFA) 
•The variation in placement type: •Day placements 

•Weekly and termly boarder placements  

•52-week residential placements 

•Services that are joint funded by health, education and social care 
•The current market place: 
•Specialist providers that span the breadth of the sectors 
•Geographical location of current Providers 
•Influence of current ‘market leaders’ 
•Variation in size of Providers within the current market 

Even with all of this the NE12+ were determined to work with Providers to achieve the desired outcomes and effect positive change and work started in earnest in the latter half of 2014

A data collection exercise carried out in 2014 and refresh exercise carried out in March 2015 evidenced that the region spends in excess of £35m on placements that would fall under the scope of Phase One of the NE12+

The market for Phase One was deemed to be ‘immature’ from a procurement perspective and as a result the decision was taken to carry out extensive consultation with relevant Providers and offer a procurement support package to upskill the market place in readiness for tendering.

An initial Provider Engagement Event was held in December 2014 with good attendance from current Providers As a result of advertising the
opportunity through the NEPO Electronic Tendering Portal there was also interest and attendance from Providers who had been, as then
yet, unknown to the NE12+ partners and / or were operating outside of the North East region. Providers were introduced to the NE12+ and participated in group discussion around: 

•Harmonisation – the ‘best bits’ of current arrangements and opportunities for change

•Importance of moving towards a system of greater financial transparency and the challenges this would bring 

 Providers were positive in their reaction to the overarching plans of the NE12+ and welcomed the opportunity to work together with Local Authorities and Health colleagues to bring about positive changes.

A ‘New Entrant’ event and second Provider Engagement Event were held in February 2015 

Providers were introduced to: 
•the changes in European Public Contracts Regulations and the impact these have on the NE12+ 
•An indicative procurement timeline for this activity

Providers were given headline data relating to placements across the NE12+. Initial work was done with
Providers around financial modelling NE12+ gave feedback on how Provider feedback from the first event was influencing the development of the contract; for example, the Link Officer structure for contract monitoring

A third Provider Engagement Event was held in April 2015. As requested at the second event, Providers were given additional data relating to placements across the NE12+ .The NE12+ confirmed our intention to go out to tender for a 12 month Framework Agreement with two six-month options to extend. Further thinking was shared with Providers around quality and contract monitoring.

Further work with Providers around a potential financial model took place. The NE12+ shared initial thinking  around Lotting, categories and bandings.

A fourth Provider Engagement Event was held in May 2015 More work was done with Providers around a potential financial model Additional information was requested from Providers after the event to inform costings . The NE12+ shared further thinking round Lotting informed by the previous event. The NE12+ shared initial thinking around category descriptors and bandings.

A fifth Provider  Engagement Event was held in June 2015 We brought Providers of placements in Children’s Residential Homes up to speed with our thinking and feedback received to date and invited them to join the consultation process. We thought the model could be the basis for future contracting arrangements for Children’s Residential Homes and sought feedback from Providers whether they felt there would be any benefit to a single approach Providers of Children’s Residential Homes felt that there would be benefit of a combined solution.

At each event the NE12+ gave  regular updates to Providers regarding the Procurement timeline. The NE12+ Placing Authorities consulted with Parents and Carers and their Schools Forum.  Newcastle (as Lead Authority) also communicated with:

•National Association of Special Schools,
•Education Funding Agency, 
•Department for Education, 
•National Association of Special Schools, and 
•Association of Special Colleges

Following a competitive tender exercise carried out in late 2015  / early 2016, 13 Providers representing 22  settings were appointed to the NE12+ Framework Agreement. The Framework Agreement constitutes Phase One and commenced on 1 February 2016 for an initial period of 12 months with 2 x 6-month options to extend.

PHASE TWO

Two scoping sessions were held in April 2016 with NE12+ Participating Organisations to consider the potential scope of NE12+ Phase Two
Following these scoping sessions and approval by regional governance arrangements the scope of NE12+ Phase Two will be Services in the current NE12+ Framework Agreement plus

1.Placements in Ofsted registered Independent Children’s Residential Homes for Children and Young People 0 – 18 years and

2.Residential short-break services

The NE12+ Participating Organisations are still considering whether it is appropriate to include palliative short-break services in Phase Two

As we did for Phase One, the NE12+ Collaborative Participating Organisations would like to work closely with Independent Children’s Residential Home Providers to develop:

•a Service Specification 
•a Lotting Structure, and 
•a Financial Model Current commissioning arrangements for placements in Independent Children’s Residential Homes: •NE6 Approved Provider List  •In place since February 2013 

•Due to expire 25 February 2017 

•8 North East councils participating in this collaboration: Gateshead, Newcastle, North Tyneside, Northumberland, South

Tyneside, Sunderland and Durham (opted in during 2016) and Stockton (currently considering),

•This arrangement was Led by NEPO 
•Tees Valley Framework Agreement: 
•In place since 1 April 2016 
•Due to expire 2019 / 2020 
•4 North East councils participating in this collaboration: 
•Darlington, Hartlepool, Middlesbrough and Redcar and Cleveland 
•Led by Darlington  
•Spot purchasing across the North East With different arrangements there is potential for Providers and Local Authorities to get confused: 

•Placements through NE6 and Tees Valley Framework are Social Care driven and for settings registered as Residential Children’s Home 

•Placements through NE12+ Phase One are Education driven and for settings registered as non-maintained and independent special school


The NE12+ Participating 

Organisations acknowledge that there is some crossover in the markets / Providers delivering services across both of these areas and therefore it makes sense to bring these Services together under a single procurement solution. There  may also be crossover between Residential Homes placements and Residential Short Breaks.

•As part of Phase Two the NE12+ Participating Organisations are aiming to further implement the aims from Phase One, and: 

•achieve financial efficiencies

•put in place a procurement solution that will be flexible and appropriate to meet the needs of Children and Young People, Parents and Carers and the Participating Organisations 
•encourage Providers to develop and grow their services across the North East for:
•non-maintained and independent special schools and colleges,

•Ofsted registered children’s residential homes, 

•overnight short breaks, and 

•palliative short break services.

Colleagues in the Tees Valley have recently worked together to establish their Framework Agreement for placements Independent Children’s Residential Homes. The NE6 Local Authorities have been working formally with the same Provider market since 2011.

We are keen not to ‘start from scratch’ and following a review of existing commissioning arrangements we have:

•taken the best bits from these two arrangements,  
•considered any ‘lessons learned’   
•considered external factors, and 
•reviewed data 
• As a result of these things we are proposing the following as a ‘starter for ten’:

Lotting Structure: Currently our solutions have only one Lot (SEMH) with the facility of enhancements. What are your thoughts on
this? Do you feel that we could have a separate Lot for :

1)Sole Placements? 
2)Placements with Educationa; requirements? 
3)PACE (Police and Criminal Evidence) Beds?

As this new solution will cover the requirement for Residential Short Breaks, we wanted to establish if you provide respite care?  If not, would it be something that you would consider offering under this new solution?

Additional Services:

Placements under the new arrangements will be flexible to meet the needs of the individual child / young person. We propose to do this by offering an Additional Service menu which would be used to bespoke placements. The current type of Additional Services currently purchased by the Placing Authorities are as follows:

Social Care Services:

•Support Worker / Residential Care Worker


Education Services:

1:1 Education tuition 
•Education provision (provided other than a residential school) 
•Alternative education 
Educational psychologist 

Health an Wellbeing Services, Mental Health Services:

•CAMHS professionals 
•Counselling 
•Psychotherapy
•Art therapy 
•Drama therapy 
•Cognitive Behaviours therapy (CBT) 
•Play therapy 
•Music therapy

Health an Wellbeing Services, Therapeutic Services:

•Physiotherapy 
•Speech and language therapy 
•Occupational therapy

Health and Wellbeing Services, Primary Care Services:

•Paediatrician 
•Paediatric Nursing Care


Data 

The high-level spend for the Category of Independent Residential Children’s Homes Services for the financial year 2015 – 2016 was circa £24 million. This is with the omission of three councils data for the second half of the financial year.

•Following review of information available from council spend across the region, it shows an average weekly costs for placements varying from less than £2,700 – £3,400+ per week.

  
•Information available from NE12+ Placing Authorities indicate Children and Young People in Independent Children’s Residential Homes have a range of needs including:  ]

•requiring higher levels of support due to SEMH issues, 

•excessive use of legal highs and the subsequent concerns, 

•child sexual exploitation (CSE),

•going missing and other related risky / challenging behaviours,

•exiting from secure

•requirements to place outside of the Local Authority area

•We anticipate that in August 2016, we will be in a position to share a greater
level of data with Providers which will include:

•number of placements broken down by age group, 
•number of placements broken down by gender, 
•number of placements broken down by presenting need, and 
•the geographical distribution of placements by Local Authority and how many are placed within and outside a 20
miles radius of the Local Authority area. 
•Commissioning Officers have been asked to work with their Social Care Teams during July 2016 to obtain the information
above. Is there anything missing from the list above that you require?


Indicative project timeline


•CommissioningPhase
•From July 2016 – February 2017 
•July, August and September 2016 – consultation with Independent Children’s Residential Home Providers 
•September, October and November 2016 – consultation with Residential Short Break Providers 
•November and December 2016 – consultation with non-maintained and Independent Special Schools and Colleges
•January 2017 – consultation with the full market and sign-off of the final commissioning model for NE12+ Phase Two
•Procurement Phase
•Tender Readiness sessions February 2017
•Tender process March – August 2017
•Implementation Phase
•From 1 September 2017
Please note all dates are indicative and can change at any point

Next Steps 

Consultation with Independent Children’s Residential Homes Providers in July
2016:

•gather feedback on our initial thoughts of a Lotting Structure, Additional Service Menu, Financial Model and Service
Specification, 
•share a Financial Model template and ask Providers to complete this (NE6 Providers to provide a ‘refresh’)
 In August 2016 we will consider feedback received from Providers and:
•share our proposed final Lotting Structure for your comment
•share a proposed draft Financial Model utilising the data received from Providers and Local Authorities
•provide high-level data of placement requirements across the region
•begin discussions with Providers around a ‘Core Service Offer’