Chief financial officer Paul Baumann confirmed that NHS England is ‘open for devolution business’ as he joined Sir Howard Bernstein, chief executive of Manchester City Council, and Jon Rouse, chief officer for Greater Manchester Health and Social Care Devolution to discuss the progress of the ‘DevoManc’ project at Expo.
Devolution plans are now being developed in areas covering some 55% of England, following the early successes in Greater Manchester, with propositions ranging from more integration of local services to complex new structures, and more interested expected as Sustainability and Transformation Plans begin to be implemented.
However, Baumann was keen to point out that devolution is not an end in itself and would not be a free for all, with Jon Rouse and Sir Howard Bernstein keen to stress that the successful creation of formal partnerships to deliver devolved services in Greater Manchester owes much to a history of collaboration and shared objectives.
As Sir Howard told the audience, Greater Manchester was the first area in the country to understand the importance of a ‘functional economic geography’ – local authorities and other agencies working together towards common strategic goals, and particularly economic development.
The good news for prospective devolvers is that devolution is not about the technical details, Baumann said; with Greater Manchester, there has been no need yet to change the law, with everything delivered so far within existing structures.
Baumann also said that, in its success so far, Greater Manchester was also setting a blueprint for other candidate health economies, as well as a test; future devolution would be most likely where candidates could show that they can emulate Greater Manchester in five key areas:
- Assembling a powerful and comprehensive leadership coalition, which is prepared to make tough decisions and act on them;
- Putting together a credible and comprehensive plan which focusses on long term sustainability – clinically and financially;
- Securing the transformation resources and developing a value-based investment model to get the most bang for the public’s buck;
- Being able to implement transformation programmes at a quick but measured pace, and;
- Demonstrating that they won’t shy away from big issues and challenges, such as acute reconfiguration and getting most value from the NHS estate.
Key to all successful devolution plans, however, will be whether they can deliver real benefits for patients. As Jon Rouse ended his presentation with, in spite of its quick successes over the last year, Greater Manchester devolution will need to be ultimately judged by improvements in patient experience and outcomes – particularly in the key clinical priority areas of cancer, mental health and learning disabilities.
Learn more about NHS England’s approach to health and care devolution.