Greater Manchester and NHS England have today (Friday 27 February) announced groundbreaking plans around the future of health and social care with a signed memorandum agreeing to bring together health and social care budgets – a combined sum of £6bn.
This trailblazing move sees NHS England, 12 NHS Clinical Commissioning Groups, 15 NHS providers and 10 local authorities agree a framework for health and social care – with plans for joint decision-making on integrated care to support physical, mental and social wellbeing. The Chancellor has placed his Northern Powerhouse strategy at the heart of the nation’s growth plans and this has created the platform for today’s announcement.
Today’s Memorandum of Understanding, approved and countersigned by the Chancellor and the Health Secretary, puts local people in the driving seat for deciding on health and care services that suit Greater Manchester. It will also help in the long-term to ease pressure on hospitals – while focusing on services in community that bring health and social care closer to home.
Integrated care in Greater Manchester will focus more on preventative work in the community – putting strategies in place to keep people well and as independent as possible. For example, people with long-term conditions like asthma or heart conditions will be treated by specialists in the community as much as possible – only going to hospital when necessary.
NHS England has agreed all plans with the Greater Manchester Clinical Commissioning Groups (CCGs), NHS providers and local councils to cement a place-based approach to join up health and social care. This approach helps to realise the vision set out in the NHS’s Five Year Forward View.
This historic agreement does not require any reorganisation of the NHS or its principles. It also builds on the work of Greater Manchester Combined Authority (GMCA) and the innovative devolution settlement with Government on November 3 (2014) – and is a significant step closer to the area’s ambition of full devolution of public spending. The Chancellor identified governance and devolution as a key component of his Northern Powerhouse strategy that has paved the way for today’s further devolution.
The scope of the Memorandum of Understanding includes the entire health and social care system in Greater Manchester, including adult, primary and social care, mental health and community services and public health. The second part of the agreement provides a framework for strategies around governance and regulation, resources and finances, the property estate, health education, workforce and information sharing and systems being brought together.
The memorandum is an outline agreement and more details will follow in due course.
From now, Greater Manchester will start making its own decisions and a transitional plan – or roadmap – will come into effect from April 1. This roadmap will provide the foundations for joined up business and investment proposals, along with a joint Greater Manchester Health and Social Care Strategy – until full devolution of health and care services is in place by April 2016.
Simon Stevens, Chief Executive of NHS England, said: “Strong and aligned local leadership in Greater Manchester means that now is the time for courage and for bold moves to deliver the ambitious agenda set out in the NHS Five Year Forward View. Today’s landmark agreement between NHS England, the local NHS and local government leaders charts a path to the greatest integration and devolution of care funding since the creation of the NHS in 1948. While continuing to deliver on national care standards and the patient rights set out in the NHS Constitution, Greater Manchester now has a unique opportunity for innovation and improvement in health and wellbeing. The eyes of the country will now be on what this new partnership can deliver, and today the work begins.”
Dr Hamish Stedman, chair of Salford Clinical Commissioning Group, said: “GPs want better health outcomes for all patients and this agreement is the start of a road map to a healthier Greater Manchester.”
Chancellor of the Exchequer George Osborne said: “Today’s agreement with the council leaders of Greater Manchester and NHS England is a major step forward in our plans to build a Northern Powerhouse. When I signed the deal with local councils here to devolve more power to Greater Manchester and to create a new elected mayor, I always hoped that a bigger say over healthcare would be part of the package. Things have happened even more swiftly than we had all hoped at the time, and now we have a landmark agreement to bring the local NHS and social care much more closely together. I am excited about all this because not only does it mean the people of Greater Manchester having more control over the decisions that affect their lives; I believe it will also lead to better, much more joined up health care. For example, it should mean more people leaving hospital sooner, and others avoiding having to go to hospital altogether. This is just the start of the journey.”
Lord Peter Smith, chair of Greater Manchester Combined Authority, said: “This is another defining moment in Greater Manchester’s devolution journey. The scope and nature of this unprecedented agreement means we are proudly breaking new ground once more.
“I want to make absolutely clear that this is not, as it has been wrongly portrayed in some quarters, a town hall takeover of Greater Manchester’s NHS budget. We will be working together with our NHS colleagues in the region to make joint decisions which reflect local priorities. Ultimately this will be via a new strategic health and social care partnership board. This is about decisions about Greater Manchester being taken in Greater Manchester in an integrated way, not being taken away from experts.”
Councillor Cliff Morris, GMCA lead on health, said: “This is an absolutely central element of what we are trying to achieve through our ambitious public service reform programme. The key principle is improving people’s lives, in this case moving from being one of the places where people have the worst health outcomes to becoming one of the best.
“By fully integrating health and social care we can focus on preventing illness and promoting well-being across all age groups.
“This is about people more than pounds. But in doing so it will reduce the cost to the public purse over time as a healthier population reduces pressure on health and social care services.”
Ann Barnes, Chief Executive of Stockport NHS foundation Trust said: “This is an important and exciting development for Greater Manchester. It is not about increasing power, but about increasing the health and prosperity of local people.
“Devolution offers a fantastic opportunity to grow and develop together, not least in respect of health and social care. We’re starting from a strong place as a number of excellent processes for working collaboratively across the area are already in place.
“We will have greater opportunities to respond swiftly and effectively to the needs of residents and really transform services for them. They will have a powerful voice in a powerful partnership”.