PRJ 2305 - Intercultural Therapeutic Service for Lewisham

Tender description

NHS South East London Integrated Care Board (SEL ICB) intends to award a single contract for the delivery of the Intercultural Therapeutic Service (ITS) in the London Borough of Lewisham. The Intercultural Therapeutic Service (ITS) provides specialist psychological support for Lewisham residents experiencing emotional distress, trauma, isolation and mental health difficulties where cultural, racial, migratory, faith, identity and social experiences are significant factors in presentation and recovery. The service was established to address recognise inequalities in access to and outcomes from mental health services amongst communities who may be underserved by conventional psychological support pathways, including people from Black African, Black Caribbean and other ethnically diverse communities, refugees and asylum seekers, migrants, and individuals with experiences of complex trauma. The service forms part of Lewisham's broader commitment to addressing mental health inequalities and improving culturally responsive support. It complements, rather than duplicates, existing statutory and NHS mental health provision. The Commissioner considers that delivery of the service requires a distinctive combination of intercultural psychotherapy, trauma-informed practice, racially aware therapeutic approaches, specialist supervision arrangements and workforce development functions that are not routinely available through standard counselling or wellbeing services. The Intercultural Therapeutic Service is not a standard counselling service. The model integrates: • intercultural psychotherapy; • racially-aware and anti-oppressive therapeutic practice; • trauma-informed approaches; • culturally adapted therapeutic interventions; • multilingual provision where appropriate; • reflective and relational therapeutic approaches; • academic and clinical expertise through a specialist training environment. A key distinguishing feature of the service is the integration of therapeutic delivery within a specialist academic-clinical model. Therapeutic practitioners are supported through a structured supervision framework involving qualified psychotherapists, experienced clinical supervisors and academic expertise. This enables intensive reflective practice, robust clinical governance and continuous service development. The Commissioner considers this supervision structure to be a distinctive component of the model, combining specialist clinical supervision, academic expertise, reflective practice and workforce development within a single service. The combination of intercultural psychotherapy, racially-aware practice and enhanced clinical supervision is not routinely available through existing mental health pathways and provides a level of specialism that would be difficult to replicate through a generic counselling or wellbeing service. The service therefore represents a specialised offer which contributes innovation within the local mental health system whilst maintaining appropriate standards of clinical governance and quality assurance. Independent evaluation of the service has demonstrated positive service-user outcomes, successful engagement of populations experiencing mental health inequalities, and evidence that the model is reaching individuals whose needs may not be fully met through conventional psychological support pathways. The Commissioner intends that the next phase of the service will build upon this evidence and further evaluate integration, accessibility and scalability. A key objective of the service is to improve access to psychological support for residents who are historically less likely to engage with, benefit from, or remain within traditional mental health services. The contract value is £150,000 for a period of 18-months. The process being followed is a Most Suitable Provider Process under the Provider Selection Regime 2023. Lot 1: NHS South East London Integrated Care Board (SEL ICB) intends to award a single contract for the delivery of the Intercultural Therapeutic Service (ITS) in the London Borough of Lewisham. The service provides a specialist community-based psychological therapy offer designed to address mental health inequalities and improve access to culturally responsive therapeutic support for people who may experience barriers to engaging with, benefiting from, or remaining within mainstream mental health services. The service delivers trauma-informed, intercultural psychotherapy and psychological support to adults experiencing mental health difficulties, emotional distress, trauma, social exclusion and other complex challenges affecting wellbeing. The service is specifically designed to support individuals and communities who may be underserved by traditional mental health pathways, including people from ethnically diverse communities, refugees and asylum seekers, migrants, and individuals whose experiences of culture, identity, discrimination, migration, faith or trauma are significant factors in their mental health and recovery. The service provides structured therapeutic interventions, assessment, formulation and ongoing psychological support delivered through an intercultural and racially aware clinical framework. The approach recognises the impact of social, cultural and structural factors on mental health and seeks to deliver interventions that are culturally appropriate, trauma-informed and responsive to the needs of Lewisham's diverse population. A distinctive feature of the service is its integrated academic-clinical model. Therapeutic interventions are delivered within a specialist clinical training environment supported by qualified psychotherapists, experienced clinical supervisors and academic expertise. The service includes a comprehensive supervision and governance framework that supports safe clinical practice, reflective learning, quality assurance, workforce development and continuous service improvement. This model enables the provision of a specialist therapeutic offer not routinely available through standard counselling, wellbeing or talking therapy services and contributes to the development of a culturally competent future mental health workforce. The provider will receive referrals through agreed referral pathways, undertake assessment and allocation processes, deliver time-limited and longer-term therapeutic interventions where appropriate, maintain robust clinical records and outcome monitoring processes, and ensure effective risk management, safeguarding and clinical governance arrangements are in place throughout the contract period. The provider will work collaboratively with local mental health services, primary care, voluntary and community sector organisations, social care and other relevant partners to ensure integrated pathways of support. The service will maintain effective arrangements for onward referral, step-up and step-down support as required, ensuring that service users receive coordinated and person-centred care. The provider will be responsible for maintaining appropriate clinical leadership, workforce capacity, supervision arrangements, safeguarding procedures, information governance, quality assurance, risk management and business continuity arrangements. The provider will collect and report activity, demographic, outcome and service-user experience data in accordance with commissioner requirements and support ongoing evaluation of the service's contribution to reducing mental health inequalities and improving outcomes. The service aims to improve psychological wellbeing, reduce the impact of trauma and emotional distress, increase engagement with therapeutic support amongst underserved communities, improve service-user experience, reduce inequalities in access to mental health care and contribute to a more culturally responsive and inclusive local mental health system. The contract value is £150,000 for a period of 18-months. The process being followed is a Most Suitable Provider Process under the Provider Selection Regime 2023. Role and Responsibilities of the provider: The service provider's role is to lead and coordinate the service, and they will be responsible for: A. Overall The provider will lead and coordinate the delivery, governance and ongoing development of the Intercultural Therapeutic Service (ITS) across Lewisham, ensuring the service operates as a safe, effective, evidence-based and culturally responsive therapeutic offer that addresses mental health inequalities and improves access to psychological support for underserved communities. The provider will maintain appropriate clinical leadership, workforce capacity, supervision, training and operational management arrangements to ensure the service can safely and effectively deliver the contract requirements. The provider will deliver a specialist ITS model that is: •trauma-informed; •racially aware and anti-oppressive; •culturally responsive; •psychologically informed; •underpinned by robust clinical governance and supervision arrangements; • responsive to the diverse needs of Lewisham residents. The provider will undertake assessment, formulation, therapeutic intervention, risk management, safeguarding and onward referral activities as appropriate to the needs of service users, ensuring interventions are delivered within agreed clinical governance frameworks. The provider will maintain a robust clinical supervision model, including individual and group supervision, reflective practice and professional development arrangements that support safe, effective and high-quality delivery. Particular emphasis will be placed on supporting practitioners working with trauma, racial trauma, migration experiences, exclusion, discrimination and other complex psychosocial factors affecting mental health and wellbeing. The provider will establish and maintain effective referral pathways and collaborative working arrangements with primary care, neighbourhood teams, mental health services, social care, voluntary and community sector organisations and other relevant partners. Supporting Neighbourhood Integration and Pathway Development A core responsibility of the provider will be to support learning, evaluation and system development relating to culturally appropriate and trauma-informed mental health provision within Lewisham. The provider will work with the ICB, Lewisham Council, neighbourhood teams, primary care and mental health partners to test and evaluate how specialist intercultural therapeutic interventions can be effectively integrated within emerging neighbourhood health models and more joined-up models of community mental health support. The provider will contribute to the development of a clearer stepped-care approach for Lewisham residents experiencing trauma, racialised experiences, cultural barriers to accessing support, or other forms of mental health inequality. This will include: •identifying where the service best sits within the wider mental health pathway; •defining referral and escalation pathways between community, primary care, voluntary sector and statutory mental health services; •identifying appropriate thresholds for intervention; •supporting clearer step-up and step-down pathways; •identifying opportunities to reduce fragmentation and improve continuity of care. •identifying unmet need and variation in access between neighbourhoods and population groups and supporting targeted service responses where evidence demonstrates disproportionate levels of trauma, domestic abuse, exclusion or mental health inequalities The provider will work with commissioners and partners to generate learning regarding the effectiveness, scalability and sustainability of intercultural therapeutic approaches, including consideration of how the model may be expanded, adapted or replicated in neighbourhood settings across Lewisham. The provider will support the collection and interpretation of qualitative and quantitative evidence to inform future commissioning decisions and contribute to a wider understanding of what constitutes effective trauma-informed, culturally responsive and racially aware mental health provision. Evaluation, Learning and Continuous Improvement The provider will maintain a culture of continuous improvement and service development, using routine outcome measures, service-user feedback, workforce learning, equality data and evaluation findings to inform improvements to service delivery. The provider will collect and report timely, accurate and complete activity, outcome, equality and experience data. Reporting will include: • demographic and equality information; • referral sources; • access and waiting times; • clinical and wellbeing outcomes; • service-user experience; • engagement of underserved communities; • safeguarding activity; • onward referral activity; • evidence of pathway integration; • learning relating to neighbourhood working; • emerging unmet need and service gaps. Data collection and reporting should support contract management, service evaluation, neighbourhood planning, pathway development and the identification of opportunities to reduce mental health inequalities. The provider will actively contribute intelligence regarding demand, unmet need, barriers to access, emerging population trends and opportunities for service improvement, supporting commissioner understanding of how best to develop a culturally appropriate and trauma-informed mental health offer across Lewisham. The provider will maintain robust safeguarding, information governance, risk management, business continuity and quality assurance arrangements throughout the lifetime of the contract. The provider will ensure that all workforce practices support equality, diversity and inclusion and contribute to the development of a skilled workforce capable of delivering culturally responsive and trauma-informed care. Additional information: B. With patient experience: •The provider will ensure that the service is delivered in a person-centred, trauma-informed, culturally responsive and racially aware manner, taking account of the individual needs, preferences, identities, experiences and circumstances of residents accessing support. •The provider will maintain mechanisms to gather, review and respond to service-user, referrer and stakeholder feedback and will use this information to support continuous service improvement, pathway development and quality assurance. This should include approaches that enable meaningful participation from communities who may traditionally be less likely to engage with statutory mental health services. •The provider will ensure that residents can access support in a way that is appropriate to their needs, including through consideration of barriers relating to language, culture, disability, digital exclusion, migration status, trauma, faith, stigma or previous experiences of services. •The provider will maintain arrangements to routinely gather insight into service-user experience, barriers to access, reasons for disengagement and unmet need. Particular attention should be given to understanding the experiences of communities who experience poorer mental health outcomes or lower engagement with existing services. •The provider will use service-user and community feedback to inform the ongoing development of culturally appropriate and trauma-informed therapeutic provision and to support the identification of opportunities to improve pathways across Lewisham's mental health system. •The provider will work collaboratively with commissioners, neighbourhood teams, Lewisham Talking Therapies and wider partners to identify emerging trends, patterns of need and communities experiencing disproportionate levels of trauma, domestic abuse, social exclusion or mental health inequality. •Where population health intelligence, referral patterns or service-user feedback indicate concentrations of unmet need or elevated levels of trauma, domestic abuse, social exclusion or mental health inequality within particular neighbourhoods, including Bellingham where relevant, the provider will work with commissioners and system partners to identify and implement targeted engagement, pathway development and service improvement activities. •The provider will maintain appropriate processes for managing compliments, concerns and complaints and will ensure that issues affecting patient experience are addressed promptly, proportionately and transparently. •The provider will ensure that all staff, trainees and clinical supervisors understand their responsibilities in relation to confidentiality, safeguarding, information governance and the delivery of a high-quality service-user experience. •The provider will support the participation of people with lived experience in service review and development activities and contribute learning regarding what constitutes effective intercultural, trauma-informed and racially aware therapeutic practice. C. With promotion and publicity: •The provider will actively promote awareness and understanding of the Intercultural Therapeutic Service amongst residents, referring professionals and partner organisations, ensuring that information regarding eligibility, referral criteria and available support is clear, accessible and up to date. •The provider will work collaboratively with Lewisham Talking Therapies, neighbourhood teams, primary care, mental health providers, local authority services, community organisations and the wider voluntary and community sector to strengthen awareness of the service and ensure appropriate utilisation of the therapeutic offer. •The provider will support the ongoing development and refinement of referral pathways and eligibility criteria to ensure that residents are able to access the most appropriate level of support through a coherent and integrated stepped-care model. •The provider will play an active role in supporting the integration of the service within emerging neighbourhood health models and community mental health arrangements, working with partners to identify where intercultural therapeutic interventions provide the greatest value within local pathways. •The provider will work with commissioners and system partners to identify opportunities for spread and scale of effective practice, sharing learning regarding culturally responsive, trauma-informed and racially aware approaches to mental health support. •The provider will undertake targeted engagement and outreach activities where appropriate to increase awareness amongst communities who may face barriers to accessing psychological support, including communities experiencing mental health inequalities, racialised inequalities, migration-related challenges, experiences of trauma and domestic abuse. This is a Provider Selection Regime (PSR) intended approach notice. It is NHS South East London Integrated Care Board's intention to carry out a Most Suitable Provider Process under the Provider Selection Regime 2023 to award a contract for the Intercultural Therapeutic Service (ITS). The Authority will be guided by the five key criteria outlined in the NHS Provider Selection Regime in the process to select a suitable provider the under MSP route. These criteria are: 1. Quality and innovation 2. Value 3. Integration, collaboration and service sustainability 4. Improving access, reducing health inequalities and facilitating choice 5. Social value It is NHS South East London Integrated Care Board's view, taking into account likely providers and all relevant information available at this time, that it is likely to be able to identify the most suitable provider for this service without running a competitive procurement.