Decision ref
0028 2025/26
Decision date
13/08/2025
Portfolio
Adult Social Care and Health
Wards
All wards
Title
Approval to direct award the Arts on Prescription contract to Creative Alternatives
Summary
Creative Alternatives have delivered an Arts on Prescription mental health and wellbeing programme for 10 years to residents of St Helens and consistently surpass agreed KPI targets and expectations. The NHS Provider Selection Regime Regulations came into force in January 2024, allowing flexibility around traditional commissioning processes. As a result of these regulations, Creative Alternatives are eligible for a direct contract award, ensuring service stability.
Purpose
The purpose of this report is to seek approval to award the Arts on Prescription contract directly to the existing provider, Creative Alternatives, via the Direct Award Process C
Background
Creative Alternatives have delivered an Arts on Prescription mental health and wellbeing programme for 10 years to residents of St Helens. The project is designed to deliver an evidence-based programme of arts and creative activity to improve the mental health and wellbeing of residents with mild-moderate mental health conditions. The current contract of the Arts on Prescription service, that is held by Creative Alternatives, is due to end on 30th September 2025 and is jointly funded through St Helens Council Public Health and Arts Service.
From January 2024, the NHS Provider Selection Regime (PSR) Regulations came into force. These are a new set of rules for arranging healthcare services and replace current procurement obligations for commissioners in relation to awarding contracts for healthcare. This means the process for re-commissioning the Arts on Prescription service in St Helens will now be subject to the new regulations.
The PSR introduces new flexibility in decision making for procuring healthcare, including the potential for direct award in certain defined circumstances. There are also new processes for provider selection where changes to the contract are to be made, and where there is a provider market likely to be interested in delivering these.
Five process options for provider selection are accommodated within the new regulations, with clear criteria for when each may be used. These are Direct Award Process A, B, C, Most Suitable Provider Process and Competitive Process.
Given that the current provider comfortably complies with Direct Award Process C (the existing provider is satisfying its existing contract and will likely satisfy the new contract to a sufficient standard and the proposed contracting arrangements are not changing considerably), the proposal is that the current service provider Creative Alternatives, are directly awarded a three year Arts on Prescription contract, with the option to extend by two further years. This contract length will give the provider further stability and room to continue to flourish and further establish themselves as a key part of the St Helens service provision.
The contract length details are broken down as per below:
· The total contract length to be five years (three initial years from 1st October 2025 – 30th September 2028 with the option to extend by two additional plus one years, taking the full length of the contract to an end date of 30th September 2030).
· The total value of the five-year contract would equate to a value of £245,000. The total commitment for five years would require £222,025 from Public Health (£211,025 for service delivery and £11,000 for room hire) and a further £22,975 from the Arts Service.
· The initial three-year contract would equate to £147,000 and would require a commitment of £133,215 (£42,205 per annum for service delivery and £2,200 per annum for room hire costs) from Public Health and £13,785 (£4595 per annum) from the Arts Service.
· There should also be an agreement to review and explore opportunities to uplift staffing costs of approximately 3% after the initial three-year contract.
Nationally, an estimated 1 in 4 people will experience a mental health problem of some kind each year in England with 1 in 6 adults experiencing a ‘common mental disorder’ such as depression or anxiety in any given week.
4.2 Within St Helens, a rate of 15.9 people per 100,000 are sadly dying by suicide. This is statistically significantly higher than the England average of 10.7 per 100,000 and places St Helens as the borough with the highest rates of suicide across the nine local authorities across the Cheshire and Merseyside footprint.
Creative Alternatives have successfully delivered the Arts on Prescription programme to St Helens residents for ten years. The service has consistently demonstrated an improvement in mental health and wellbeing from participants who have completed the programme are identifiable through key performance indicators which include a mix of qualitative and quantitative data. Measuring outcome tools are used and have consistently shown significant improvements in the mental wellbeing of the participants upon completion of the programme, with the most recent quarterly report showing a 4.8% average SWEMWBS score improvement and therefore comfortably surpassing the 3.5% average target agreed by commissioners. The programme impacts are further confirmed through case study examples which the service present as part of their performance reporting.
Additionally, Creative Alternatives are a key part of the St Helens Mental Health and Suicide Prevention partnership, consistently attending Communities of Practice forums, ensuring visibility at relevant events to promote their service and actively undertaking any training to upskill their suicide prevention knowledge, skills and confidence. It is felt that the provision of a three-year contract, with the option to extend by two further years, will provide stability for the third sector provider and support their further integration into the wider health and social care system as a key mental health and wellbeing service provider in St Helens
The new Healthcare Services (PSR) Regulations 2023 now govern procurement of healthcare services in England from January 2024. They have been introduced as part of legislative changes following the Health and Care Act 2022.
PSR legislation removes the procurement of healthcare services from the scope of the Public Contracts Regulations (PCR) 2015 and revokes NHS (Procurement, Patient Choice and Competition) (No.2) Regs 2013. PSR has been designed to introduce a flexible and proportionate process for selecting providers of health care services (so that all decisions can be made with a view
PSR legislation removes the procurement of healthcare services from the scope of the Public Contracts Regulations (PCR) 2015 and revokes NHS (Procurement, Patient Choice and Competition) (No.2) Regs 2013. PSR has been designed to introduce a flexible and proportionate process for selecting providers of health care services (so that all decisions can be made with a view to securing the needs of the people who use the services, improving quality of the service, and improving the efficiency in the provision of the services). This legislation means that preventative Public Health services are in the scope of the regulations if the intervention is provided to an individual, which the programme delivered by Creative Alternatives is.
From January 2024, PSR now applies to the procurement of healthcare services by relevant authorities, including NHS England and Local Authorities.
Conclusion
In conclusion, after careful consideration of the alternatives, the most suitable cost-effective option is contracting to continue the effective Arts on Prescription service and directly award the contract to the incumbent provider Creative Alternatives. It is proposed that the contract will be for a period of three years with the option to extend by two years in total.
Risk Implications
Risk 1 - There is a risk that a potential provider may challenge the local authority's decision to direct award instead of going down a competitive process route.
Risk 2 - There may be a risk that the current provider refuses the terms of the direct award or states they are unable to deliver the full specification.
Risk 3 - Risk that contract remain unsigned and/or responses to contractual communications are slow.
Measures to Redress Risk
Mitigations to risk 1 - This risk is considered low. However, clear records will be kept and maintained detailing the rationale for decisions. This will support transparency in response and help to demonstrate compliance in applying the PSR regulations. In the event of a challenge, the representation would be reviewed by an independent panel.
Mitigations to risk 2 - This risk is low due to established positive working relationships. However, it will be made clear to the current provider that a competitive process option may need to be pursued in mitigation if the contractual terms cannot be agreed.
Mitigations to risk 3 - This risk is low due to established positive working relationships. However, mitigating actions could include consideration of retention clause
Declarations Of Interest
None
Equality Impact Assessment
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More information
Please contact Matthew Thompson on 01744 671057
