South London Child Sexual Abuse Therapeutic Service

Description

NHS England - London (hereafter referred to as "the Authority") is seeking to commission a specialist therapeutic service for child victims of sexual abuse, covering the 12 South London Boroughs and two ICB regions (SEL and SWL) to meet the needs of this population in an area that historically has been underserved by such services. Initial development was supported through time-limited grant funding, enabling pathway design, stakeholder engagement and early learning. This service now sets out a refined, evidence-informed model suitable for sustained commissioning. Key features of the service are: • A specialist, trauma-informed service for children and young people (CYP) aged 4 - 24 affected by sexual abuse and rape across South London's 12 boroughs. • The service will support CYP who have experienced sexual trauma and/or safeguarding needs in relation to CSA and will provide appropriate support to non-abusing parents and carers where clinically indicated, alongside sibling support where needed. • The service will deliver specialist assessment, therapeutic interventions, safeguarding support and system navigation, recognising the significant impact of sexual trauma on emotional wellbeing, mental health, relationships and safety across childhood and adolescence. • Safeguarding will be a core and continuous component of service delivery, operating alongside therapeutic clinical interventions rather than as a separate or sequential process. • The service model has been developed in response to identified gaps in local provision, including increased demand for specialist sexual trauma support, pressure on statutory mental health pathways and the need to strengthen coordination between therapeutic care and safeguarding responses. • The service will operate as part of a coordinated system response, working closely with children's social care and safeguarding partnerships, Child and Adolescent Mental Health Services (CAMHS) and wider mental health provision, Sexual Assault Referral Centres (SARCs), education settings, voluntary and community sector organisations and where relevant, criminal justice agencies. To ensure accessibility for the local population, NHS England - London Health and Justice is seeking the service will be based in one of the 12 South London Boroughs and be accessible for all across the region. Lot 1: The notice relates to the South London Child Sexual Abuse Therapeutic Service. The process being followed is a Most Suitable Provider Process under the Provider Selection Regime 2023 under the Most Suitable Provider (MSP) process (The Health Care Services (Provider Selection Regime) Regulations 2023, Regulation 10). The commissioner is seeking to achieve, via this route, a service and provider that is committed to supporting the development of CSA services and pathways, as well as direct service provision for clinically led and trauma‑informed therapeutic interventions for children and young people. The provider must demonstrate a proven track record of five years working in partnership with stakeholders relevant to the service. The provider must be able to demonstrate robust structures to deliver the service specification, as well as the clinical and trauma‑informed expertise to support child victims of sexual abuse. The provider must be able to demonstrate relevant staffing and infrastructure to mobilise imminently. Contract details: - Under this contract, the provider will be expected to deliver the service specification within the financial envelope available. - The contract will be a block contract. - The contract will run for one year, with the possibility of two further one‑year extensions (1+1+1). - Annual contract value: £370,000. Additional information: Referral Pathway: The service will be available to CYP aged 4-24 with interventions tailored to developmental stage. Access will be based on clinical assessment, safeguarding considerations and presenting need, rather than diagnostic thresholds. Access will follow a no wrong door approach, enabling referrals from statutory services, education, health and voluntary sector partners, alongside agreed self-referral or family referral routes. • Accepted referral sources The commissioned service will accept referrals from appropriate statutory and non-statutory safeguarding and support agencies, including social care, education, health services, Sexual Assault Referral Centres (SARCs), and voluntary sector partners, in line with local safeguarding pathways. Self or family referrals may also refer directly. • Consent and parental involvement requirements The service will require providers to operate a developmentally appropriate, trauma-informed consent framework, ensuring that the voice and wishes of the child or young person are central to engagement in the service. Providers will be required to: • obtain informed consent from the child or young person where they are Gillick competent, or provide age-appropriate assent and consent processes where relevant; • implement clear, age-appropriate service agreements that set out confidentiality boundaries, including circumstances in which information must be shared for safeguarding reasons; • include non-abusing parents or safe adults in assessment and therapeutic processes where clinically appropriate to support engagement, recovery and system stability; • identify and involve safe, non-abusive caregivers or significant adults as part of a holistic, systemic approach where this supports therapeutic outcomes; • ensure that family involvement is determined through clinical assessment, safeguarding considerations and the wishes of the child or young person. The service will operate within a systemic, whole-family and contextual approach, recognising the role of family, carers and wider systems (including school and community networks) in supporting recovery and sustained wellbeing. Safeguarding and confidentiality arrangements will be clearly communicated in developmentally appropriate formats and embedded within service agreements, including clarity on when information may need to be shared with other professionals or safeguarding partners. Patient Admission Criteria The commissioned service will operate a structured, multi-factor prioritisation and triage model to ensure timely, safe and clinically appropriate allocation of children and young people referred into the service. This will include a thorough and consistent referral and assessment process, clinical oversight of the service waitlist and throughout service engagement. The service specification will require providers to demonstrate a multi-modal, trauma-informed therapeutic workforce capable of delivering a range of evidence-informed interventions appropriate to the complexity and developmental needs of children and young people affected by sexual abuse and rape. This will include access to appropriately trained practitioners able to deliver: • Evidence-based psychological interventions, including CBT-informed approaches delivered by suitably qualified practitioners (e.g. clinicians with training aligned to Improving Access to Psychological Therapies / cognitive behavioural models where appropriate for CYP contexts); • Specialist mental health nursing input, supporting structured clinical assessment, formulation and intervention where clinically indicated; • Creative and developmentally appropriate therapeutic modalities, including play therapy, arts-based approaches and integrative counselling tailored to children and young people; • Trauma-specific expertise, including practitioners with specialist training in domestic abuse, childhood sexual abuse and complex trauma; • System-focused practice, including safeguarding coordination, multi-agency system navigation, consultation and liaison with partner agencies; • Family-informed and systemic interventions, where clinically appropriate and safe, to support recovery, relational stability and sustained impact of therapeutic work. Providers will be expected to allocate cases according to clinical complexity, modality suitability and practitioner expertise. • Safeguarding weighting within triage The service specification will require providers to embed safeguarding as a central determinant within triage and prioritisation decision-making. This will include: • structured risk assessment at point of referral, incorporating trauma history, safeguarding concerns, current risk presentation and active seeking of further referral information when necessary; • weighting of safeguarding factors within prioritisation decisions to ensure safe allocation of cases; • allocation of higher-risk presentations only where appropriate stabilisation and external safeguarding support is in place; • ongoing monitoring of risk during waiting periods and throughout engagement with the service. The commissioned service will be required to maintain active oversight of children and young people awaiting allocation, including: • clinical risk monitoring during waiting periods, undertaken by appropriately trained practitioners; • regular wellbeing check-ins to maintain engagement, assess changing need and identify emerging risk; • enhanced monitoring for higher-risk presentations, including periodic welfare contact where clinically indicated; • escalation of safeguarding concerns identified during waiting periods to appropriate statutory partners where necessary.