Barnsley Council in-sourcing health visitor services

Alicia Marcroft, Head of Public Health, April 2017

The Journey

Barnsley launched an internal and external consultation with stakeholders at the start of 2015 to develop a new service specification for the 0-19 service.  This resulted in a specification that integrated 0-19 services with a  service value reduction of 1.1million.  Despite positive market engagement and we received only one bid from the incumbent provider but unfortunately the costs were significantly in excess of the budget available, therefore the tender process was deemed unsuccessful and we were unable to award a contract.

A Cabinet paper was approved at the end of 2015 to allow us to engage with the incumbent provider to co deliver the service through a partnership agreement (section 75).  Those negotiations continued until March 2016, at which point the incumbent provided requested to exit from the contract.

A Cabinet paper was approved to bring services ‘in house’ in May 2016.  A project team was established with the intention that services would be delivered internally from 1st October 2016. 

Work steams were established along with a project board to handle all transfer activities, including:-

  • HR which dealt with the TUPE transfer
  • Legal which supported the establishment of a number of external SLA’s, contracts, property ownership and data sharing and transfer agreements
  • IT which dealt with system access and procurement and deployment of agile IT
  • Finance who developed the service budgets and supported initiatives to reduce the current spend
  • Estates which supported the transfer of ownership of service estates and accommodation moves
  • Information Governance which supported the transfer of service paper and electronic records as well as staff training
  • Health and Safety who established good H&S management systems
  • Governance which picked up arrangements for accountability structure, CQC registration, prescribing and all other governance systems and processes such as audit and risk but also service stationery, materials and incident reporting
  • Data, Information and reporting which dealt with the establishment of reporting to meet both service and regional and national returns

The Transition Challenges

  • We lost a number of staff as a result of transition, the main reason cited was a desire to remain in NHS employment
  • Identifying commissioning interdependencies and establishment of new arrangements
  • Obtaining service financial information from incumbent provider
  • Transfer of Service paper records
  • Negative media attention


  • Staff are working agile, the specification of the IT software was not intended for agile workers so we have to scope the needs of the service and change our software
  • Not all service equipment transferred with the service including agile IT, we had to purchase this and set up all the equipment
  • The service use the clinical record keeping system (Systmone/TPP), local authorities are not currently able to be Registration Authorities (RA) , Health and Social Care Information Centre/NHS Digital did start a pilot for LAs to become RAs but this has not completed due to capacity. This resulted in us developing an SLA with the previous provider to provide access to Systmone and RA function. We are planning to be contracting direct with TPP from Oct 17 for the provision of Systmone and are currently sourcing a new provider for RA function.


  • HR and Trade Unions were unable to reach agreement about the TUPE transfer, this caused a lot of anxiety amongst the staff in relation to NHS pension
  • It has also been and still is a huge challenge to bring a whole service up to speed with a new organisations corporate processes and procedures.
  • Completion of DBS checks for all staff
  • Transfer of contractual salary sacrifice schemes e.g. car lease


  • Information Governance was a huge barrier, a would advise that an information sharing agreement being established as a priority
  • CQC registration – there was a lack of knowledge of the process for LAs which resulted in us being asked to complete the wrong paperwork initially. We are now registered under the category of Treatment of disease, disorder or injury which I feel is not correct I would have expected a registration under community services.
  • We are in the process of establishing our clinical governance framework, close working with the CCG has been essential to support the Clinical Governance process. The appointment of a Head of Service who is a registered nurse has been significantly beneficial to developing and leading the Clinical Governance agenda.
  • Clinical supervision was and still is provided within the service, as the Head of Service I meet regularly with the CCG Chief Nurse.