Children who are looked after often experience complex emotional and psychological challenges linked to their early adversity and experiences, which can lead to confusion, disconnect and feelings of abandonment. These early life experiences can shape their perceptions of elements such as safety, trust and relationships – influencing mental health outcomes as children but also long into adulthood.   

In addition to these challenges, children who are looked after can also face additional challenges in accessing diagnostic screenings and support due to symptoms being masked or misinterpreted, such as behaviour being viewed as a ‘problem’ or ‘challenge’ instead of as an adaptive response or means of communication.  

Accessing timely and appropriate mental health support through the NHS can be challenging due to long waiting times, high thresholds for specialist services, fragmented pathways and a lack of consistent requirements or approaches to mental health services for children across NHS commissioning which leads to a ‘postcode lottery’ in terms of whether services will be able to meet the needs of vulnerable children when they’re needed.  

As a result of these challenges, the known links and long-term impact poor mental health can have, TACT are committed to ensuring our children and young people can have access to mental health services at the point when they are identified as being needed.  

During late 2023 and early 2024, TACT reviewed their existing Health Service offer and, following internal considerations, opted to move from an in-house service to a commissioning model. Mechelle Holley joined TACT in June 2024 and quickly got to work to establish the needs of the organisation and developed a clear Health Service Strategy. The strategy set out an ambitious and innovative direction to develop a framework contract model which would allow TACT to procure services from fully compliant external suppliers operating in the psychological, mental health and wellbeing sector. This framework contract would ensure that the services and support available were varied, and could meet the unique needs of individual children instead of forcing a ‘one size fits all’ model. A full tender process was developed and launched for applications in August 2025. Following a robust tender evaluation process, the Health Service was officially relaunched as a commissioned model at the end of October 2025.   

The service now has a very broad offer covering psychological, mental health and wellbeing which is broken down into four distinct areas: 

• Assessment: focusing primarily on psychological assessment and formulation, we take a holistic view of a child or young person’s unique journey and experiences and develop a plan with tangible strategies and support pathways which meet their needs in the best possible way. There are other aspects of assessment available including neurodivergence, learning disability and mental health diagnosis if needed.  
• Therapeutic provisions (Regulated): the delivery of clinical, evidence-based therapeutic interventions to support children and young people, either directly or indirectly, through activities such as consultation with foster carers.   
• Wellbeing provisions: everything else which is aimed at supporting a child’s mental health and wellbeing which isn’t categorised as a clinical, regulated therapeutic model. This includes one-to-one and group activities and includes elements such as counselling, self-esteem building, and animal based therapeutic interventions.  
• Second opinion/advocacy: to enable TACT to support our children and young people, for instance by challenging NHS decisions relating to psychological and mental health diagnoses or to support our children and young people to have their voices heard in their health care and treatment planning.  

Whilst the service is still in its infancy, there has been significant interest internally and externally to view how the health service can support the achievement of commissioning principles for children of having ‘the right service, available at the right time and the right cost’. It’s an incredibly unique model to utilise in a fostering organisation, allowing for children’s individual needs to drive the therapeutic or wellbeing approach as opposed to identifying a single preferred model or approach and expecting this to improve outcomes for all children. We are very excited by the direction and the multitude of support options now available to our children, young people and their foster carers.  

The framework has been left open for new suppliers to join during the life of the contract. If you’re a supplier of psychological, mental health or wellbeing services for children and are interested in partnering with TACT please visit our tender page, www.tactfostering.org.uk/health-service-framework-tender, for more information about the specification, terms and conditions and details on how to apply.