Trust chiefs in Greater Manchester are set to create a ‘federation’ of NHS providers, as they aim to maximise opportunities for sharing services across the region.
The federation would operate a “collective decision making” process, which would effectively limit the ability of individual trusts to veto a decision.
The work involves 15 acute and mental health providers, and is being progressed as part of the region’s devolution plan.
The decision making process would feature a series of “locked gateways”, which once passed through could provide a solid basis for a majority vote in the final stages.
Darren Banks, director of strategy at Central Manchester Hospitals Foundation Trust, told HSJ: “If we as providers are trying to do things which run counter to the [Greater Manchester] strategic plan, then rightly it needs to be challenged.
“We want to get away from an organisation saying ‘no’ when they don’t like the outcome, when you’ve already agreed the need for change, the principles and processes that are to be followed, and the nature of the change.”
He warned that “it’s not going to be easy or straight forward, which is why nobody else has come up with this yet”. However, he added that the Healthier Together decision to reconfigure acute care in the region, which was agreed by every clinical commissioning group in Greater Manchester, has shown that collective decision making can work.
Two areas that could be considered by the federation are recruitment and induction processes, and research and development projects, as there are thought to be potential benefits of working at scale in these areas.
Mr Banks stressed the federation would not determine “where and who should provide a particular clinical service”, as this will remain the duty of commissioners.
Provider chief executives in Greater Manchester have held regular meetings for several years as part of a “nascent federation”, chaired by Stockport FT chief executive Ann Barnes. The new arrangement would formalise the group and enhance its terms of reference.
Mrs Barnes told HSJ there would be a “taper mechanism” for trusts adversely affected by changes, which could ease the financial impact of a decision.
Asked if the federation would be a prelude to a reduction in the number of providers in Greater Manchester, she said: “If that’s going to happen then this is not the first stage.”
Information provided to HSJ
- BOLTON NHS FOUNDATION TRUST
- CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
- EAST CHESHIRE NHS TRUST
- GREATER MANCHESTER WEST MENTAL HEALTH NHS FOUNDATION TRUST
- MANCHESTER HEALTH AND SOCIAL CARE NHS TRUST
- North West
- PENNINE ACUTE HOSPITALS NHS TRUST
- PENNINE CARE NHS FOUNDATION TRUST
- SALFORD ROYAL NHS FOUNDATION TRUST
- Service design
- STOCKPORT NHS FOUNDATION TRUST
- TAMESIDE HOSPITAL NHS FOUNDATION TRUST
- THE CHRISTIE HOSPITAL NHS FOUNDATION TRUST
- UNIVERSITY HOSPITAL OF SOUTH MANCHESTER NHS FOUNDATION TRUST
- WRIGHTINGTON, WIGAN AND LEIGH NHS TRUST