The must-read stories and debate in health policy and leadership.

The launch of Greater Manchester’s health devolution project was widely heralded five years ago, with one serious newspaper mentioning it in the same breath as the Magna Carta, and the Manchester Evening News declaring a new “MHS”.

The reality has not matched up to the original fanfare, however.

The region has been largely beholden to national regulators, just as it was before, and has not attempted to diverge from NHS England’s national transformation agenda in any significant way.

This is not to say it has been a failure.

There have been some clear successes (helped by a unique £450m transformation fund) such as improved partnership working with local authorities around issues such as homelessness, and a suite of population health programmes.

But the region also agreed to measure itself against the more traditional NHS standards, against which it failed to excel.

The future of the project is now uncertain, as it is unlikely to get any preferential treatment in terms of transformation funding, while the devolution structures have largely been stood down during covid.

In an interview with HSJ, mayor Andy Burnham says the structures will be reviewed and redesigned, without some of the “unrealistic expectations” of their launch.

He also believes the region’s acute providers have worked better together during the coronavirus pandemic – under a temporary leadership “cell” led by Sir Mike Deegan – and he would support a more streamlined governance structure such as this in the longer term.

Mr Burnham has no formal powers over NHS services, but the former health secretary is clearly among the most influential health figures in the region.

Trust takes a long hard look at itself

Claims of systematic bullying and pay gaps between BAME staff and their white colleagues in a major acute have been revealed in a new report – which the trust hopes will spark more “difficult discussions” about inequalities.

The report by Newcastle FT claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust.

It found that the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers.

In a survey carried out at the trust last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues, been “systematically… bullied and harassed,” or had left departments after being given no chance of progression.

The co-author of the report has praised his trust for publishing it – and said he hopes other trusts produce similar reports to drive change.