Greater Manchester stakes claim to 'lead regulation' of providers

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Greater Manchester has staked a claim to take on responsibility for regulating local providers, under new plans to devolve sweeping powers over health and social care services to the region.

The radical proposal is outlined in a draft memorandum of understanding between NHS England and the conurbation’s local authorities and clinical commissioning groups, obtained by HSJ, which if enacted would see the region taking control of £6bn of health and social care spending.

The draft memorandum - which is dated 20 February - lists a number of goals which NHS England has said it is committed to working with Greater Manchester’s councils and CCGs to achieve.

Greater Manchester ‘should the regulation of its provider community’, the memorandum says

This includes that “[Greater Manchester] should lead the regulation of its provider community, with support from Monitor, the NHS Trust Development Authority and the Care Quality Commission”.

There is no detail in the document about how this would work in practice, but the devolution of any responsibility for regulation to a regional level would represent a radical change to the current regulatory framework.

A spokesman for Monitor said their regulatory role in the region would not be affected.

He said: “NHS England has made us aware of the plans for a health and social partnership in Greater Manchester.

Manchester health devolution plan

“Discussions are at an early stage and we will be working with other health bodies to establish how this can work for people in the area.

“However, this will not affect Monitor’s role as the sector regulator for health in the region.”

A CQC spokesman said it would not be commenting on Greater Manchester’s plans until they are officially announced, which is expected to be on Friday.

Nigel Edwards, chief executive of the Nuffield Trust, told HSJ that while it was difficult to comment on the proposal until more detail was known, regional oversight could have the advantage of avoiding the current situation of “contradictory signals coming from different regulators”.

However, he added that it would bring the risk of a “degree of collusion” between providers and local bodies, and a “lack of challenge”.

“If you don’t have that external challenge of people who could look across a wider canvass, you could run some risks,” he said.