Adult Social Care Sub Committee
Agenda Item 21
Subject: Re-commissioning of the Carers Hub for Brighton and Hove
Date of meeting: 12 September 2023
Report of: Executive Director of Health and Adult Social Care
Contact Officer: Name: Gemma Scambler, Commissioning Manager, Health and Adult Social Care
Tel: 07917273629
Email: gemma.scambler@brighton-hove.gov.uk
Ward(s) affected: All
1.1 This report seeks approval for the recommissioning of the Carers Hub, which will continue to be a jointly funded (BHCC/NHS Sussex) single point of contact for all family and friend unpaid carers in the city. The Carers Hub was initially commissioned in 2017, to both galvanise the range of services within the city for unpaid carers, and to ensure that BHCC/NHS had a robust response for the statutory duties towards unpaid carers, via a partnership of providers.
1.2 The Carers Hub contract was awarded to the Carers Centre for Brighton & Hove, as the lead provider within the partnership, from the 1st October 2017, for a period of 5 years, plus the option for a further 2 years, and is due to end on the 30th September 2024, annual value £531,069 per year, with an estimated annual budget for the new commission of between £578 - £590,000 (due to uplift and increased provision). This funding will be allocated within the current BCF carers allocation.
1.3 Supporting unpaid carers is a priority across the statutory services, with duties under the Care Act 2014; Children and Families Act 2014; and the Health and Care Act 2022, as well as recognising the strategic importance of identifying and supporting family and friend unpaid carers.
2.1 That Committee agrees to the re-commissioning of the Carers Hub for Brighton and Hove.
2.2 That Committee grants delegated authority for the award of a new contract to the Executive Director for Health and Adult Social Care to procure and award a new contract to provide a Carers Hub
3.1 Supporting unpaid carers is a key priority for the local authority and the NHS. The Census 2021 data identified that within the Brighton & Hove population, 8% (20,804) provide unpaid care, with more than a third (7,489) providing more than 35 hours of unpaid care per week; and a quarter (5,430) providing more than 50 hours per week. Data shows that the wards with the overall highest percentage of residents who are carers are Woodingdean (11.8%), and Hangleton and Knoll (11.6%).
3.2 Research by Carers UK in 2023, using the data from the Census, has identified that the estimated economic contribution of unpaid carers nationally is £162 billion per year, nearly the annual cost of the NHS (£164 billion). The resulting estimated economic contribution of Brighton and Hove carers per year is £618 million.
3.3 The Carers Strategy for Brighton and Hove, is currently being refreshed, however there is agreement across the Carers Strategy Group that we retain the ‘THINK CARER – Building a Carer Friendly City’, which focuses on 4 key building blocks: Carer Friendly Education; Employment; Social Care; and Health, through the development of ‘blueprints’ by local carers, and national research and policy.
3.4 The Carers Hub was initially commissioned in October 2017, following a period of engagement with local family and friend unpaid carers, and the membership of the Carers Strategy Group (led by Health & Adult Social Care (HASC), with representatives from across local statutory and non-statutory services), who additionally commissioned from Public Health, a Carers Rapid Needs Assessment in 2016, to assist with the commissioning process.
3.5 The Carers Hub bought together a number of providers, under a shared identity, to enable greater promotion and access to the range of services available. It provides a single point of contact (SPOC) to enable unpaid carers to access a wide range support, through a 3 Tier system, - Tiers 1 & 2 form the current contract, with the Carers Centre; Alzheimer’s Society; Crossroads Care; and Changes Ahead providing information, advice, assessment, support and 7 dedicated services – Peer Support; Young Carers Project; Dementia Carers Support; Mental Health Carers Support; Carers Reablement; End of Life Carers Support; and homebased alternative care to enable carers to attend health related appointments. Finally, Tier 3 is made up of the Carers Assessment Workers within HASC Assessment Services, who complete Carers Assessment, or Joint assessments, and can provide Carers Personal Budgets, or arrange services for the cared for person.
3.6 The current contract has an annual value of £531,096, and is funded via the Better Care Fund (BCF), as supporting unpaid carers is one of the defined priorities within the BCF Plan. The discussions regarding the recommissioning of this service, have included the governance arrangements for both NHS Sussex (Integrated Care System); the Better Care Fund Steering Group; Carers Strategy; and HASC.
3.7 It is anticipated that the redesign of the specification of the recommissioning of the Carers Hub, will include greater integration with the NHS. Additionally, NHS Sussex are funding time limited pilot projects for carers via the Core20Plus5 Health Inequalities Program, which has carers and young carers as priority groups facing significant health inequalities.
3.8 The current Carers Hub is a well established, high performing contract, and is strategically significant regarding BHCC’s duties under the Care Act 2014 for supporting unpaid carers in the city, as well as for Young Carers (children providing care) under the Children and Families Act 2014, and the need to support carers regarding hospital discharge processes under the Health and Care Act 2022.
5.1 Through the decision-making process for the recommissioning of the Carers Hub, the Carers Strategy Group has been involved, as well as key BHCC/NHS representative meetings. Additionally, the outcomes of the Adult Social Care Carers Survey (2022) and the Carers Hub consultations, echoed the need to continue with a single point of contact for carers. During the process of developing the service specification, Carers Voice (local carers who have volunteered) will be involved in both the development of the specifications, and the refresh of the Carers Strategy.
6.1 Supporting unpaid carers is a key priority locally and nationally: in recent years the evidence of the disproportionate negative impact of caring, and the inequalities of health provision for carers, has reinforced the need to ‘Think Carer’. The ‘burden of caring’ and ‘toxic combination’ of the impact mentally, physically and financially on carers is well presented. Many carers chose to care for those they love, and benefit greatly for the relationship, however all carers benefit from support for their needs, not just the needs of those they care for. The Carers Hub has proven to be a very successful service, and has become integrated into both key statutory and non-statutory services, providing a clear pathway for the identification and support of all family and friend carers. It is essential that we build on the success of the Carers Hub, which will continue to be central to our Carers Strategy.
7.1 The Carers Hub contract is funded within the Better Care Fund, which is a section 75 pooled budget with the Integrated Care Board which totals £39.267m for 2023/24 and £42.213m for 2024/25. Any spend variance at outturn is subject to a risk share as per the section 75 agreement. For 2023/24, the ICB contribution to the Carers Hub contract is £0.349m and the Council contribution is £0.182m. Any increase to the contract value in future year’s will need to be within the resources available and agreed by the Integrated Care Board and the Council.
Name of finance officer consulted: Sophie Warburton Date consulted: 15/08/2023
8.1 The Council must comply with the Public Contracts Regulations 2015 in relation to the procurement and award of contracts above the relevant financial threshold. The services outlined in this report fall within Schedule 3 of the Public Contracts Regulations 2015 and exceed the relevant financial threshold for light touch regime services (£663,540 inclusive of VAT). The procurement process for the light touch regime is not unduly prescribed but must accord with the fundamental principles of transparency and equal treatment of economic operators. Legal Services will work closely with officers to ensure that the process followed is compliant with the Regulations.
8.2 The Council must also comply with its Contract Standing Orders (CSOs) which apply to Social Care & Public Health services as set out in Section B of the CSOs.
Name of lawyer consulted: Eleanor Richards Date consulted (31/08/23):
As part of both the recommissioning of the Carers Hub, and the refresh of the Carers Strategy an Equalities Impact Assessment (EIA) is in development, which will ensure that areas of potential discrimination are identified and addressed. The EIA will be completed with the local Carers Voice, a group of carers who have volunteered to be involved in the Carers Strategy and related work, with the support of the Carers Hub
The recommissioning of the Carers Hub will include sustainability and climate impact within the procurement process, including the need for applicants to evidence their sustainability policy and commitment in line with Council policy.
Social Value and procurement implications
The recommissioning of the Carers Hub will include Social Value as a key element of the procurement process.
Crime & disorder implications:
Public health implications:
Public Health are a key member of the Carers Strategy Group, and will be part of the procurement process.