Care Closer, Care Smarter Improving Mental Health Care Across Greater Manchester – A joint programme by Greater Manchester Mental Health NHS Foundation Trust and Pennine Care NHS Foundation Trust

Why change was needed:

In 2023, too many people in Greater Manchester who needed mental health inpatient care were being sent far away from home. At its worst, 180 people were placed in hospitals hundreds of miles away.

Being cared for so far from home meant:

• People were separated from family, friends and their community.
• Continuity of care was disrupted.
• Recovery and return to everyday life became harder.
• Inequalities were widened.

When we added up the total distance travelled by these placements, it was the same as sending people nine times around the world. This was not acceptable — for individuals, families or staff. At the same time, around £70 million a year was being spent on these placements. We knew this money could be better used to strengthen local crisis, community and rehabilitation services, helping people get the right care, in the right place, at the right time.

What has been done?

Greater Manchester Mental Health NHS Foundation Trust, Pennine Care NHS Foundation Trust and the Greater Manchester Integrated Care Board worked together to fundamentally change how mental health care is planned and delivered. They created the Greater Manchester Mental Health Integrated Fund — a shared, system‑wide approach focused on one clear aim: Helping people receive care closer to home whenever it is safe and appropriate.

This was not about cutting costs. It was about:

• Putting people first
• Improving safety, dignity and continuity of care
• Making better use of local services
• Reinvesting savings into prevention, crisis and community support

The Fund aligns money with quality and experience. When inappropriate placements are reduced, the savings are shared and reinvested in services that help prevent crisis and support recovery — particularly where communities are most affected by inequality.

What difference this has made:

The impact has been significant and sustained:

• People placed in inpatient beds reduced from an average of 193 to 101.
• Out‑of‑area placements reduced from 180 people to just 2.
• Many more people now receive care close to home, surrounded by family and familiar services.
• Fewer people are admitted to hospital when safe alternatives are available.
• Decisions about admission are stronger and more consistent, with a focus on least restrictive care.

Care teams now work together daily across Greater Manchester to manage beds, support timely discharge and remove barriers before delays occur.

Investing back into local care

As a result of these changes:

• £23.2 million has been saved in one year.
• £11.6 million is being reinvested in 2026/27 into mental health services.
• Savings are strengthening crisis care, early intervention and community support.
• Around £11 million of national funding has been secured to redesign rehabilitation services.

This means more people can be supported in their communities, with fewer long stays far from home.

What happens next:

Over the next three years, Greater Manchester aims to:

• End avoidable out‑of‑area placements completely.
• Use remaining independent sector care only when it is in a person’s best interests.
• Strengthen 24/7 crisis services.
• Improve discharge support with councils, housing and local partners.

This work will release around £35 million to reinvest in local mental health care, supporting NHS long‑term priorities. The same approach is now being expanded to rehabilitation, long‑term support, urgent care and specialist pathways.

In summary:

This programme shows what can happen when organisations work together with a shared purpose. By focusing on people’s experience, using resources wisely and strengthening care closer to home, Greater Manchester is building a fairer, safer and more compassionate mental health system — one that supports recovery and keeps people connected to the places and people who matter most.

Digitally Transforming Dialysis Care

Improving safety, experience and efficiency at Manchester University NHS Foundation Trust

Manchester University NHS Foundation Trust (MFT) has transformed how dialysis care is delivered by introducing the UK’s largest real‑time digital connection between dialysis machines and patients’ electronic health records. This change is improving safety, saving staff time, and giving patients greater confidence that the right information is available at every treatment.

Why was change needed?

Dialysis is life‑sustaining treatment, usually delivered several times a week. Until recently, much of the information from each session was written down on paper and then typed into computer systems later.

This meant:

• Nurses spent a lot of time on paperwork instead of patient care.
• Important information could be missing or recorded incorrectly.
• Clinicians did not always have a full picture of how a patient was doing.
• Only some dialysis units could share information nationally to improve care.

A review of over 160,000 dialysis sessions showed that a large amount of essential information was missing or inaccurate, which could affect care and decision‑making.

What has been done?

MFT introduced a new digital system that connects dialysis machines directly to the Trust’s electronic patient record, across all nine dialysis units.

This means:

• Prescriptions are sent straight from the patient record to the dialysis machine.
• Treatment information flows back automatically in real time.
• Over 600 pieces of information are safely recorded during each session.
• Staff no longer need to re‑enter information by hand.

The change was designed with nurses, doctors, digital teams and patients, and learning from other hospitals in the UK and Europe. At the same time, dialysis workflows were updated to make care safer and more consistent wherever treatment is delivered.

How this benefits patients

Patients are already seeing clear improvements:

• Safer care – all dialysis information is now complete and accurate, every time.
• Better decisions – clinicians can see trends and changes more quickly.
• Joined‑up care – information follows patients across hospital, satellite and community settings.
• Greater confidence – patients know their care team is working from the same up‑to‑date record.

In a survey of over 230 patients:

• Overall satisfaction scored 4.68 out of 5.
• 91% agreed that real‑time information improves understanding and decision‑making

How this supports staff and the NHS

The changes also help the wider health system:

• Nurses now spend 19 fewer minutes per shift on paperwork
• Over 1,700 hours a year has been freed up for patient care
• Costs per dialysis session have almost halved
• All nine MFT dialysis units now share data with the UK Renal Registry, helping improve care nationally

So far, the system has securely recorded 2.5 million pieces of dialysis information, creating new opportunities to improve care and learn what works best.

What happens next

This way of working is now standard practice at MFT. Next steps include:

• Extending real‑time monitoring to home dialysis patients
• Giving patients digital access to their own dialysis trends and results
• Expanding the approach to other types of dialysis
• Using data to spot early signs of health problems and personalise care

In summary

This programme shows how digital technology, designed around patients and staff, can make dialysis care safer, more personal and more efficient. It is already improving the experience for patients at MFT — and provides a model that could benefit people receiving dialysis across the NHS.

Let’s Talk Boobs, Supporting women with learning disabilities to understand breast health and screening – Pennine Care NHS Foundation Trust, working with Pathways Associates CIC and five other NHS Trusts across Greater Manchester.

Why was change needed?

Women with learning disabilities often face extra barriers when it comes to healthcare. They are less likely to receive clear information about cancer, and many feel anxious or unsure about breast screening. This can lead to lower screening uptake and poorer health outcomes. The Let’s Talk Boobs project was created to help change this by making breast health education clearer, kinder and easier to understand.

What has been done?

We ran 13 friendly, women‑only workshops for women with learning disabilities across Greater Manchester. The sessions were co‑designed and delivered with women who have lived experience of a learning disability, who were paid members of the project team. This ensured the workshops were shaped by real experiences and needs.

The workshops covered:

• What breasts are and how to look after them?
• What breast cancer is
• Signs and changes to look out for
• How to check your breasts
• What breast screening is
• What happens at a mammogram appointment?
• How to get extra support and reasonable adjustments

Sessions used:

• Easy‑to‑understand words.
• Pictures, demonstrations and repetition
• Games and activities like Boobie Bingo
• Group discussions and time for questions.
• Support to access the reasonably adjusted breast screening pathway in Greater Manchester

What difference did it make?

After taking part, women showed much better understanding and confidence.

• 94.6% said they knew what breast cancer is (up from 58.7%)
• 81.3% understood why mammograms are done.
• 97.3% knew what happens during a mammogram.
• 88% said they felt motivated to go for breast screening.
• More women described mammograms as good, helpful and important.

Women also felt more comfortable talking about breasts, asked sensitive questions, and showed less fear about screening. Many said they now knew what changes to look out for and how lifestyle choices can affect breast health.

What we learned

• Safe, women‑only spaces help people feel comfortable asking questions.
• Clear, repeated information helps people remember and feel confident.
• Many women need support from carers or staff to book and attend appointments.
• Reasonable adjustments really matter.

What happens next?

The Let’s Talk Boobs project shows that accessible, co‑produced education can reduce worry, improve knowledge and support informed choices for women with learning disabilities. The learning, resources and delivery model will be shared across Greater Manchester and beyond. The approach can also be adapted for other cancer screening programmes and health topics.

Summary:

Let’s Talk Boobs helped women with learning disabilities feel more confident talking about their bodies, understanding breast cancer and making informed choices about breast screening. By using clear language, fun activities and listening to lived experience, the project reduced fear and confusion around mammograms. The workshops showed that with the right support and reasonable adjustments, women with learning disabilities can feel informed, empowered and better supported to look after their breast health.

Making Support Work for Male Survivors of Sexual Violence
Duncan Craig – Chief Executive, We Are Survivors (Working with Greater Manchester NHS)

Why was change needed?

For a long time, men and boys who experienced sexual violence were often left out of support services. Many did not realise help was available for them, or felt services were not designed with them in mind. This was especially true for men in prison, those with complex trauma, or people who had lost trust in healthcare.

What has been done?

Over more than ten years, Duncan Craig has worked to change how services understand and support male survivors.

He helped create specialist trauma services for men, including support available in all 15 prisons across the North West. This means men can begin to get help while they are still in custody and continue their support when they return to the community, instead of having to start again alone.

Alongside this, Duncan worked with the NHS to develop a Talking Therapies service designed specifically for male survivors. The service recognises the different ways trauma can affect men and adapts therapy to meet those needs. As a result, more men stay in treatment and make progress, even those with long‑term or severe trauma.

Duncan has also helped bring change beyond individual services. He worked with NHS partners, commissioners and national government to make sure men and boys are properly recognised in policies about sexual violence. This helped shift thinking away from “one size fits all” approaches and towards truly inclusive care.

He also made sure that partners and family members could get support too, recognising that trauma affects whole families, not just one person.

Working Together

A key part of this work has been bringing different organisations together. NHS services, charities and criminal justice teams now work more closely, creating clearer pathways so survivors don’t have to repeat their story or fall through gaps.

This joined‑up approach means support follows the person, whether they are in prison, leaving custody, or living in the community.

What difference did it make?

• More men now come forward and stay in therapy.
• Men in prison can start recovery earlier and continue support after release.
• Fewer people reach crisis point after leaving custody.
• Families feel less isolated and better able to understand trauma.
• Staff feel more confident supporting men with complex experiences.
• Services are more aware that men can be victims too, leading to earlier help.

Most importantly, men are no longer treated as the exception in sexual violence services.

NHS Values in Action

This work reflects NHS values by:

• Working together across organisations so care is joined‑up.
• Showing respect and dignity to people who were previously overlooked.
• Designing services with compassion, especially for those who find help hardest to access.
• Improving quality of care through specialist knowledge and lived experience.
• Improving lives, not just for individuals, but for families and communities too

In Summary

Through steady leadership and strong partnerships, Duncan Craig has helped create services that truly work for male survivors. Care is now shaped around people’s needs, not assumptions — making the health system fairer, kinder and more inclusive for everyone.

Liverpool Place Population Health Management: Helping People Earlier, Before Crisis – NHS Cheshire and Merseyside Integrated Care Board

Why was change needed?

In the past, many people in Liverpool only got help when they became very unwell. Support often started after a crisis — for example, when someone went to A&E or was admitted to hospital. Services worked hard, but they were mostly reacting rather than preventing problems. This was stressful for patients, families and staff, and could often be avoided with earlier support.

What has been done?

Liverpool Place decided to do things differently. Instead of waiting for people to become ill, services now identify people earlier who are most at risk of their health getting worse and offer support before that happens.

Using shared health data, teams can spot people in local neighbourhoods who are more likely to need unplanned care — for example people with long‑term conditions like lung disease, kidney disease, frailty or multiple health problems.

Once identified, support is wrapped around the person, which may include:

• Remote health monitoring (Telehealth)
• Community respiratory nurses
• Integrated Care Teams made up of nurses, care coordinators, social care and specialists.
• Review and support from GP practices and hospital teams.

How It Works

Different NHS teams and partners work together through a shared programme agreed across Liverpool. They meet regularly to plan care, avoid duplication and make sure the right people are getting help at the right time. Having access to shared patient information has been a major change. It allows teams to contact and support people directly, without adding extra work for GP practices.

As a result, the Telehealth service grew quickly — from 250 people in early 2024 to 2,000 people by the end of the year, mostly identified through proactive reviews rather than referrals. The Community Respiratory Team introduced planned reviews for people with COPD, with 87% of patients taking part. Support is now expanding to people affected by fuel poverty and frequent A&E visits.

Integrated Care Teams provide whole‑person support, helping with health, care needs and wider issues. A new partnership with a housing association is also helping to improve homes for people whose health is affected by poor living conditions.

What difference has it made?

This approach has changed care across Liverpool, bringing together community services, hospitals, mental health, GP practices and housing.

For people supported through Telehealth, independent analysis showed:

• 28% fewer visits to A&E
• 36% fewer emergency hospital admissions
• 34% fewer GP appointments

People with long‑term lung conditions are getting help earlier, rather than relying on crisis care. Staff say they can now focus on the people who need help most and find proactive working more rewarding. Integrated Care Teams have helped people who were using services very frequently, reducing repeated appointments and helping people manage their health more confidently.

What happens next?

Proactive care is now becoming business as usual in Liverpool neighbourhoods. The approach is expanding to more conditions, including frailty and kidney disease. Liverpool is also sharing what it has learned with other areas across Cheshire and Merseyside, so services don’t have to start from scratch. The aim is simple: help people earlier, keep them well at home for longer, and reduce avoidable crises — improving health, independence and quality of life for patients and communities across Liverpool.

Summary

Liverpool Place has changed how care is provided by identifying people earlier and offering support before they reach crisis. By using shared health data and working closely across NHS services, community teams and housing partners, people with long‑term and complex conditions are now receiving proactive, joined‑up care in their own neighbourhoods. This approach has reduced emergency hospital visits, helped people stay well at home for longer, and made care more coordinated and supportive for patients, families and staff.

Neuro Rehabilitation Online Service (NROL) – East Lancashire Hospitals NHS Trust, Regional Champion

What has been done?

Neuro Rehabilitation Online (NROL) has transformed how people recover after stroke or with neurological conditions across Lancashire and South Cumbria. The service was designed and improved with patients at every step. Their feedback, ideas and lived experience shaped how the service works today.

NROL provides therapy through live online group sessions led by NHS clinicians. These sessions support physical movement, thinking skills and communication. A key part of the service is peer support—patients meet others going through similar experiences, which helps build confidence and motivation.

Patients told us that being able to join sessions from home makes a big difference, especially for people living in rural areas, those with limited transport or those who feel isolated. They value both the clinical expertise and the sense of connection.

We regularly ask for feedback, using surveys every six weeks, and more recently through interviews and focus groups. This has led directly to changes. For example:

• We introduced seated and standing exercise groups so people can join sessions that match their ability.
• We created communication groups for people with aphasia.
• We adapted group options so people with long-term or degenerative conditions feel supported in a way that suits their emotional needs.

Patients also wanted clearer information about what was available. In response, we launched the ‘autonom e’ NROL app in January 2026. This gives patients an easy way to view sessions, follow exercise plans and track their progress at home.

In 2025, we expanded the programme further based on patient feedback. We increased the number of sessions, doubled exercise therapy options and introduced more specialised groups. We also opened access to hospital inpatients, supporting recovery both in hospital and at home.

What difference this has made?

Patients tell us NROL helps them feel supported, connected and more hopeful. Many say they feel “not alone” and are encouraged by seeing others improve.

Since February 2025:

• Over 300 referrals have been received
• More than 240 patients have taken part
• Attendance has stayed steady at around 60%
• Fewer people leave the programme early

In the past year:

• We delivered over 330 sessions
• Provided more than 2,100 therapy contacts
• This equates to around 2,100 extra hours of therapy without the need to travel

Patients are seeing meaningful improvements in their daily lives, including greater independence, confidence and ability to manage at home. Many report improved wellbeing and reduced feelings of isolation.

The new NROL app is also helping patients track their own progress while giving the team valuable information to improve services further.

By offering more choice and easier access, NROL is helping reduce health inequalities and making rehabilitation more flexible and personalised.

What happens next?

We will continue to build NROL around what patients tell us they need. Our focus is on making the service a routine part of rehabilitation across the region.

Next steps include:

• Improving how patients and staff understand the full range of sessions available
• Training more staff to confidently deliver online therapy
• Expanding support for people with complex needs and different stages of recovery
• Increasing access so more patients can benefit (currently around 10–15% of eligible patients use NROL, with plans to double this)

We are also working with Lancaster University to better understand the impact of NROL and guide future improvements. Research findings and ongoing evaluation will help shape a long-term, sustainable service.

Looking ahead, we aim to make NROL a core part of care across hospital, community and primary care settings, ensuring more people can access high-quality rehabilitation close to home.

Summary

Neuro Rehabilitation Online (NROL) is a patient-led service that provides flexible, online therapy and peer support for people recovering from stroke and neurological conditions. Co-designed with patients, it offers more choice, improves access and helps people feel connected and confident. The service has already supported hundreds of patients, increased therapy time and improved wellbeing. By continuing to listen to patients and expand access, NROL is helping shape the future of personalised rehabilitation care.

Touch Activated Phlebotomy (TAP) for People with Learning Disabilities

University Hospitals of Morecambe Bay NHS Foundation Trust

Why was change needed?

Many people with learning disabilities find having blood tests very distressing. Fear of needles is common across the population, but for people with learning disabilities this can lead to extreme anxiety, behavioural distress and avoidance of care altogether. As a result, some people are unable to have routine blood tests, even when these are essential for monitoring long‑term health conditions.

National reviews into avoidable deaths of people with learning disabilities have highlighted poor access to investigations, such as blood tests, as a contributing factor. When people cannot access blood testing, conditions may go undiagnosed, treatment may be delayed, and health inequalities increase.

Under the Equality Act 2010, the NHS has a legal duty to make reasonable adjustments so everyone can access healthcare in a fair and equitable way. Improving access to blood testing is also central to the NHS commitment to reducing health inequalities for people with learning disabilities.

What has been done?

University Hospitals of Morecambe Bay introduced Touch Activated Phlebotomy (TAP) as an alternative to traditional blood tests for people with learning disabilities who struggle with needles. TAP uses a small microneedle device that gently touches the skin and collects a small blood sample. It is virtually painless, causes much less anxiety than standard blood tests, and avoids many of the sensory triggers associated with needles. The process is quick, simple and far less distressing for patients. TAP was introduced as a reasonable adjustment across Morecambe Bay to support personalised, accessible care while meeting the Trust’s legal and ethical responsibilities.

What difference did it make?

Early results show clear improvements in access, experience and outcomes.

Almost half of the people using TAP had not been able to provide a blood sample for over five years, showing how long they had been excluded from routine health checks. TAP removed this barrier.

Feedback from patients showed:

• Less fear and anxiety around blood testing
• Greater willingness to have repeat tests.
• Improved engagement with ongoing health checks

Several patients returned for further testing, showing sustained trust in the service.

Blood results identified previously undiagnosed health issues, including raised blood sugar, cholesterol problems and thyroid conditions, allowing earlier treatment. In one case, previous successful TAP sampling supported continuity of care when a patient later needed urgent hospital treatment for an unrelated issue. Carers reported that TAP was easier, quicker and far less stressful. They valued that the test could be done in familiar settings, including at home, reducing the need for hospital visits. For Learning Disability nurses and staff, TAP reduced reliance on time‑consuming and complex alternatives such as desensitisation programmes, sedation or general anaesthesia. These approaches can delay care, require multiple teams and often add further stress for patients.

What happens next?

Touch Activated Phlebotomy has now been adopted as a reasonable adjustment across Morecambe Bay, with plans to scale across Lancashire.

The method is easy to use, requires minimal training and carries very low risk. Some carers can be trained to collect samples at home, supporting more flexible and person‑centred care. TAP is now being used as part of annual health checks in primary care with no significant additional staffing costs.

While the device costs more per test than traditional blood sampling, this is balanced by avoiding multiple failed appointments, sedation, specialist clinics and emergency care caused by delayed diagnosis. Earlier detection of health conditions helps prevent more serious illness and reduces pressure on NHS services.

This Trust is the first in England to offer TAP as an alternative to routine blood testing for people with learning disabilities. Early evidence suggests it could also benefit other groups who struggle with needles, including autistic people, those with severe anxiety or trauma‑related needle fear.

Summary

Touch Activated Phlebotomy has transformed access to blood testing for people with learning disabilities by offering a kinder, calmer and more accessible alternative. By removing a major barrier to essential health checks, the service is helping people live healthier lives, reducing health inequalities and showing how simple innovation can make a profound difference.

ECO4 Flex Health Referral Pathways – NHS Greater Manchester Integrated Care Board

Why was change needed?

Cold, damp homes can make people ill. In Greater Manchester, around 1 in 7 households struggle with fuel poverty. This can make long‑term health conditions such as asthma, heart disease and limited mobility worse, especially in the most deprived communities.

To tackle this, NHS Greater Manchester worked with the Greater Manchester Combined Authority (GMCA) to connect healthcare with home energy support through the ECO4 Flex scheme.

What has been done?

ECO4 Flex is a government‑funded scheme that helps people on low incomes or with certain health conditions to get free home energy improvements. These can include:

• Better insulation
• Improved ventilation
• New or upgraded heating systems.
• Solar panels

These changes help keep homes warmer, reduce damp and lower energy bills.

People with health conditions made worse by cold homes – such as respiratory disease, heart conditions, weakened immune systems or reduced mobility – can be referred through a health eligibility route.

Originally, referrals were made mainly by GPs, but awareness across the NHS was low and many opportunities were missed.

To improve access, GMCA funded an NHS‑hosted Project Manager to work directly with healthcare services. This role helped embed ECO4 Flex into everyday NHS settings.

Several actions were taken to raise awareness and make referrals simpler, GP practices, hospitals, pharmacies, rehab services and vaccination clinics were engaged directly.

A GP incentive scheme was introduced across 10 Primary Care Networks in areas with high COPD rates and poorly insulated homes.

Posters and leaflets explaining the scheme and the self‑referral route were shared with every pharmacy in Greater Manchester. Information was displayed on GP and hospital waiting room screens, including a short TV advert. GP surgeries were given ready‑made texts, emails, NHS App messages and letter insert to send to patients.

A self‑referral option was also promoted through the GMCA “Feel the Benefit” portal. This allows approved installers to arrange medical sign‑off using locum doctors, removing the need for GP appointments.

What difference has it made?

The partnership has significantly increased access to home improvements for people with long‑term health conditions. Since July 2023, there have been 5,084 NHS referrals 3,501 homes have already received improvements. NHS referrals now account for over 90% of all ECO4 Flex installations in Greater Manchester Households save on average £580 per year on energy bills. Since April 2024, installations have reduced carbon emissions by 9,772 tonnes, similar to the annual energy use of around 3,600 homes.

Why this matters for the NHS

This work supports the NHS Long Term Plan, which focuses on prevention and reducing avoidable demand on health services. It also contributes to the NHS Net Zero goals by cutting carbon emissions. By improving homes, the NHS is helping to prevent illness, not just treat it.

What happens next?

ECO4 Flex is currently funded until March 2026. The next steps include:

• A Health Impact Assessment using NHS data to understand long‑term health benefits and potential cost savings.
• Planning for future schemes, such as those under the Warm Homes Plan
• Better signposting in primary and community care, so clinicians can easily direct patients to housing and energy support.
• Stronger data sharing between the NHS and GMCA to show the value of investing in warm homes.

Summary

The ECO4 Flex Health Referral Pathway shows how joining up healthcare and housing can make a real difference to people’s lives. By helping residents with long‑term health conditions access free home energy improvements, the NHS and GMCA have reduced fuel bills, improved living conditions and supported better health and wellbeing.

The programme has been highly successful, with thousands of homes made warmer and healthier through NHS referrals. Real‑life examples show fewer asthma flare‑ups, improved heart health and reduced reliance on temporary heating.

This work supports NHS priorities around prevention, reducing health inequalities and cutting carbon emissions. Looking ahead, the focus is on evaluating long‑term health and cost benefits and embedding housing support into everyday care. The long‑term ambition is to ensure cold and damp homes are routinely identified and addressed as part of keeping people healthy.

Your Future Your Way, Breaking down barriers to career progression
North Cheshire and Mersey NHS Foundation Trust

Why was change needed?

Warrington and Halton Teaching Hospitals NHS Foundation Trust (WHH) (now North Cheshire and Mersey NHS Foundation Trust) has a diverse workforce that reflects the communities it serves. However, in 2022, this diversity was not reflected in senior roles. There were only 9 senior Allied Health Professionals (AHPs) and 24 nurses and midwives from ethnic minority backgrounds working at Band 7 or 8 level.

Staff surveys and national workforce data showed that colleagues from ethnic minority backgrounds were less likely to access development opportunities or progress in their careers. This mattered not only for fairness, but also because a diverse leadership team helps improve patient care, safety and experience.

To address this, the Trust’s Organisational Development (OD) team created Your Future Your Way (YFYW) – a programme focused on fairness, opportunity and inclusive leadership.

What has been done?

YFYW is a leadership and career development programme that supports staff who are under‑represented in senior roles, while also helping senior leaders become better sponsors and advocates.

The programme has two parts that work together:

Senior leadership development and sponsorship

Senior managers take part in leadership development that helps them understand the barriers faced by colleagues from ethnic minority backgrounds. They commit to becoming active sponsors, using their influence to support and promote fair access to career opportunities.

Leadership development and career progression pathway

Nurses, midwives, AHPs and corporate staff take part in a recognised leadership qualification. They complete a service improvement project in their own area and receive support to build confidence, skills and professional networks.

This approach helps people grow, builds a stronger leadership pipeline and creates a more inclusive organisation. One participant described the programme as “one of the most rewarding experiences of my professional career.”

What difference has it made?

Since October 2022, the programme has had a clear and positive impact:

• 43 senior leaders have acted as sponsors for colleagues.
• 54 staff achieved a Level 3 CMI leadership qualification.
• 26 departments took part in the programme.
• 54 service improvement projects were delivered across the Trust.
• 18 guest speakers and experts supported learning.

Staff experience also improved. Between 2022 and 2024, the Trust’s staff survey response rate increased by 16.6%. Staff from ethnic minority backgrounds reported improvements in career development and access to learning opportunities.

The programme supported 13 staff promotions and increased representation of ethnic minority colleagues at Band 7 and above from 6.5% in 2023 to over 7.5% in 2025.

Many participants led projects focused on patient safety and quality, including:

• Risk assessment improvements – achieving 100% compliance for completing risk assessments within six hours of admission.
• Acute Kidney Injury (AKI) testing – improving staff knowledge and use of point‑of‑care urine testing.

By supporting staff to lead change, the programme has directly contributed to safer care and better outcomes for patients.

What happens next?

Since launching in 2022, Your Future Your Way has been nominated for four awards, including recognition for excellence in organisational development and equality, diversity and inclusion. Learning from the programme has been shared regionally and nationally.

The OD team has now completed three cohorts, with ambitions to expand this approach across integrated organisations so even more staff can benefit.

Summary

Your Future Your Way shows how investing in people can improve fairness, leadership and patient care. By supporting under‑represented staff and helping senior leaders act as sponsors, the Trust has increased career progression, improved staff experience and delivered real improvements in services. The programme is helping build a leadership workforce that better reflects the community it serves – benefiting staff, patients and the wider NHS.

Greater Manchester Urgent Primary Care Alliance (GMUPCA)

Why was change needed?

The Greater Manchester Urgent Primary Care Alliance (GMUPCA) is a partnership of five not‑for‑profit social enterprise providers working together to improve urgent care services across Greater Manchester. It was created in response to national NHS requirements to better integrate urgent and emergency care.

Before this partnership was formed, urgent and emergency care in Greater Manchester was often fragmented. Services were under financial pressure, demand was rising, and patients sometimes experienced delays or were passed between services.

In 2018, GMUPCA became a Community Interest Company, allowing partners to work with a single shared purpose while keeping their independence. The Alliance works closely with the Greater Manchester Integrated Care Board (ICB), NHS Trusts, the North West Ambulance Service (NWAS), and community services to design care around patients’ needs.

Our overall aim is simple, to help people get the right care, first time, as close to home as possible, while protecting frontline NHS services.

What has been done?

1. Greater Manchester Clinical Assessment Service (GM CAS)
   GM CAS provides 24/7 access to senior clinicians who assess patients quickly by phone or digitally. It is now the largest Clinical Assessment Service in the UK.
   By offering early expert advice and direct booking into the right service, GM CAS reduces unnecessary ambulance call‑outs and emergency department (ED) visits, while supporting faster care for those who need it most.
2. Emergency Dental Helpline
   A single urgent dental helpline now operates across Greater Manchester. Patients can access advice and urgent appointments through one consistent service, reducing pressure on GP practices and hospital emergency departments.
3. COVID‑19 Medicine Delivery Unit
   During the pandemic, GMUPCA coordinated assessment and prescribing of antiviral medicines for eligible patients. Electronic prescriptions were sent directly to local pharmacies, ensuring fast and safe access to treatment.
4. Falls Response Service
   Working with NWAS, this service provides a rapid community response after a fall, often within one hour. Many patients receive treatment at home and are supported into local falls prevention services, avoiding unnecessary hospital visits.
5. Digital Integration (Adastra)
   GMUPCA has led digital integration across urgent and emergency care. This allows patient information to be shared safely and quickly between services such as NHS 111, ambulances, urgent treatment centres, hospitals, GPs and community teams. This improves safety, reduces repetition, and speeds up care.

As a nationally recognised Emergency Care Intensive Support Team (ECIST) site, GMUPCA shares learning and best practice with other regions.

What difference has it made?

Faster and safer care

• GM CAS manages over 200,000 patient contacts each year, with senior clinicians making decisions early.
• Around 82% of all “hear and treat” 999 calls in Greater Manchester now go through CAS.
• Over 200 ambulance responses per day are avoided, releasing around 91,000 ambulance hours each year.

Better access and fairness

• The Emergency Dental Helpline handles 300,000 calls a year with a 99.9% appointment fill rate, ensuring fair access to urgent dental care across the region.
• Vulnerable patients received timely COVID‑19 treatments through a coordinated system.

Care closer to home

• The Falls Response Service manages over 75% of patients at home or in the community, helping people stay independent and reducing the risk of harm from long waits on the floor.

Joined‑up digital care

• Over 400,000 digital referrals have been enabled, meaning patients do not need to repeat their story and clinicians have the right information at the right time.

Together, these improvements deliver £9.2 million in annual savings while improving patient experience and protecting NHS capacity.

What happens next?

GMUPCA will continue to develop the Clinical Assessment Service as a fully integrated part of the urgent care system, working seamlessly with NHS 111, ambulances, primary care, hospitals, mental health services and community teams.

Future plans include:

• Expanding digital referrals into more hospital specialties
• Improving care coordination and clinical decision support
• Introducing self check‑in in emergency departments to improve patient flow
• Strengthening shared learning through audits, reviews and a system‑wide performance dashboard

The Alliance will continue to work in partnership to deliver high‑quality, person‑centred urgent care across Greater Manchester.

Summary

The Greater Manchester Urgent Primary Care Alliance shows how strong partnership working can transform urgent care. By joining services together, using digital innovation and focusing on early clinical assessment, GMUPCA has improved access, safety and patient experience—helping thousands of people get faster care, closer to home, while reducing pressure on the NHS today and into the future.