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Cornwall Council is the lead agency for protecting and improving the health and welfare of children and young people living in Cornwall.

The Council has direct control and governance of Education, Early Years, Early Help and Children’s Social Care services. It commissions a range of children’s community health services through its Public Health duties. These include:

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  • health visiting
  • school nursing and
  • specialist health visitors

It also commissions clinical child psychology and other specialist health services. This is to meet the needs of:

  • children in its care
  • care leavers and
  • children with special educational needs and disabilities

Other community health services are commissioned by NHS Kernow. This is the Clinical Commissioning Group for Cornwall and Isles of Scilly. Services commissioned by NHS Kernow include:

  • Child and Adolescent Mental Health Services and
  • therapy services

Under current arrangements the Council does not have direct control of the full range of children’s services. It also does not have the authority to make integration happen. This is despite Cornwall Council being the primary commissioner. The Council also carrys a disproportionate responsibility for the effectiveness of all children’s services. This is through its Joint Targeted Area Reviews and Inspections, 

The Council and its partners are committed to integrating:

  • children’s education
  • community health
  • social care services

This is under the Cornwall Devolution Deal and One Vision. (One Vision is the children and families element of the Sustainability and Transformation Plan for Cornwall and the Isles of Scilly).

Residents and service users say they want to receive integrated services. Feedback from staff indicates that the majority believe that integrated services can achieve better outcomes for all children. This is especially the case for vulnerable children who are at risk of poor outcomes due to adverse childhood experiences.

All agencies accept that the current arrangements for providing services to children, young people and their families are under considerable pressure. This is due to the double whammy of rising demand/need and reduced resources. There are also increased statutory duties and raised inspection standards. Despite significant efforts and some notable success, the development of integrated approaches and services has been piecemeal. It is a widely held view that only whole-system integration has any chance of meeting the challenges ahead. This offers the best chance of further improving children’s outcomes.

In March 2017, the Council's Cabinet and its partners agreed the ‘One Vision’ Partnership Plan for services to children, young people and their families. Chapter five of the plan sets out a commitment by the partners to move from collaboration to integration. It also planned to undertake an Options Appraisal to explore an alternative model of service delivery. It looked for a model most likely to achieve the goal of improved quality and effectiveness of universal, early help and specialist services at lower cost.

In line with the ambitions set out in ‘One Vision’ a successful bid was made to the Department for Education’s Social Care Innovation Programme (SCIP). This secured a grant of £1.9m to support the Council to explore the potential of an alternative delivery model to achieve its strategic goal for integration and its ambition to become one of the top children’s services in the country.

An Options Appraisal was the first step in considering the potential of an alternative delivery model. You can view our Options Appraisal reports to the Children and Families Overview and Scrutiny Committee and Cabinet's unanimous approval on 15 November 2017 for the development of a full business case.

In line with realising the strategic goal of integrating education, early years, children’s community health, early help and social care services, Cabinet agreed unanimously on 2 May 2018 to bring Public Health Nursing (health visiting and school nursing) into Cornwall Council from 1 April 2019.

As part of the Business Case approval process, an independent review was commissioned.  This identified that more work was required on an in-house option; a view which was shared by the Chief Executive Officer and Lead Member. Work was then undertaken to explore what benefits an in-house integrated children’s services directorate could deliver. Both the Business Case and the alternative Integrated Children’s Services Directorate option were presented to Cabinet for a decision in November 2018 . Cabinet made the decision to proceed with an Integrated Children’s Services Directorate.