Exclusive: Burnham proposes new ‘single system’ pilot to government

He has asked local government secretary Robert Jenrick, and health ministers, to consider the proposal, HSJ understands.

The government is under huge pressure to take action after more than 10,000 confirmed covid-19 deaths in care homes, as well as many thousands of excess deaths in homes and among those receiving home care, sparked widespread outcry and criticism. The sector is now also even more financially unstable, and its workforce has been at greater risk of harm from coronavirus.

The Greater Manchester mayor said he had made the offer to national government previously but had raised it again with Mr Jenrick in recent weeks and believed it should now be taken up.

He said: “The eyes of the country have been on social care and people can see how completely broken it is.

“We are putting ourselves forward again as a national pilot for a single system approach.

“History would never forgive us if we went into another pandemic without having fixed this.”

Mr Burnham, a former health secretary, has long been a proponent of much closer integration of social care with the NHS, and the creation of a “national care service”.

Government faces major outstanding questions about how long-term care is paid for, but Mr Burnham said his proposed pilot would focus on service provision. 

“While government does whatever it wants to do around funding, it could set us up as a pilot to go further on the delivery of integration,” he said.

It would look at a joined up workforce, including more common training; a “new deal” of pay and conditions for care staff; funding flows via a combined “year of care” health and care tariff; and further institutional integration.

Mr Burnham highlighted Tameside as a model part of Greater Manchester where there have been benefits from greater integration. The clinical commissioning group and council there are working as one with a joint chief; and an integrated foundation trust has been established.

Other areas, in Greater Manchester and elsewhere, needed to take a bigger leap, Mr Burnham said.

“Sometimes people are tiptoeing around integration. There is evidence in Greater Manchester that the places which have  embraced it more wholeheartedly, such as Tameside, have seen more improvement.

“The health service needs to embrace a lot more its relationship with other public services.”

Mr Burnham said some developments during the outbreak had highlighted opportunities for service reform, such as community hubs set up to provide support in Oldham, and the common identification of shielded groups from data across the NHS and local government. He said the response had highlighted some strengths of GM’s integration so far including a combined health and care record and a system for alerts for pressure in care homes.

Greater Manchester has taken a number of steps towards integration in recent years under its “devolution” arrangement, including oversight of NHS and social care being centralised in a cross-GM agency, and several boroughs and NHS providers developing models of integrated commissioning and delivery. There have been questions about whether the project has improved outcomes, however.

A Department of Health and Social Care spokesman said: ”We have set out a comprehensive action plan to support the adult social care sector throughout the coronavirus outbreak, focused on minimising the spread of the virus and keeping people safe… We know there’s a need for a long-term solution for social care and there are complex questions to address. We will bring forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.”