Greater Manchester’s historic £6bn health and care devolution agreement is ground breaking on many levels
It’s the biggest act of devolution in England’s NHS since 1948 – and it now means that Greater Manchester will soon make its own decisions around the health and social care needs of its residents.
It’s also testament to the solid history of collaboration in Greater Manchester.
This has paved the way for a new era of working which will see NHS England, 12 clinical commissioning groups, 15 NHS providers and 10 local authorities all work together to agree a framework for health and social care – with plans for joint decision making on integrated care to support physical, mental and social wellbeing.
At the heart of devolution are the concepts of people and place driving public service planning and delivery. That recognition is the power that will fuel a new approach to joining health and social care in the region.
‘At the heart of devolution are the concepts of people and place driving public service planning and delivery’
Looking at Greater Manchester, we know that there are high levels of inequality in life expectancy, accompanied by other socioeconomic factors such as long-term unemployment, which is often linked to mental and physical illness.
What we want to do is focus on more preventative strategies: identifying ill health earlier and looking at and acting on early signs of vulnerability. The balance of our attention, effort and resource needs to change so that it prioritises proactive, pre-emptive care and support.
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This change has to recognise that prevention, healthcare, employment support, education and training to improve skills cannot continue to be directed from multiple different sources in a disjointed fashion. It must be properly sequenced and understood as a blend that works for one person at a time.
Devolution starts to make that blend possible. It repositions organisational priorities towards place and people to allow us to act on shared objectives.
It means a focus not only on integrating health and social care, but integrating all public services in the interests of our residents.
We are already seeing how better links between the police and mental health services can help people in crisis.
We are already seeing how better connections between employment services and healthcare can help people find and keep good work.
‘The real strength in our armour in Greater Manchester is unity of purpose’
And we are already seeing where joined up working between the fire service and ambulance service can provide good early help alongside preventative support in people’s homes.
As we move into this first build up year we will be making sure all the infrastructure is in place to support full devolution of health and social care services by April 2016.
As part of this a Greater Manchester Health and Social Care Devolution Programme Board has just been established and work streams identified.
However, the real strength in our armour in Greater Manchester is unity of purpose.
We all agree that these proposals must bring better outcomes – better health, longer and more productive lives – for our residents.
The process of integration is already underway – and devolution will take that pace further and faster as we make the best use of the money we have.
‘Our response to health and care devolution will make public service partnership routine’
We need to reduce unnecessary admissions to hospital. We want quicker discharges with better care packages.
We want to relieve pressure on accident and emergency departments.
We want to support the thousands of people who aren’t working because physical or mental health problems are preventing them from finding work or returning to their jobs.
Our response to health and care devolution will make public service partnership routine across all parts of Greater Manchester.
And that holistic partnership could not only transform lives, but the future potential or our region. These too, are ground breaking opportunities that we can’t afford to miss.
Sir Howard Bernstein is chief executive of Manchester City Council and co-chair of the Greater Manchester Health and Social Care Devolution Programme Board