STRUCTURE: The financial challenge facing Greater Manchester will require ‘radical scaling up’ of shared services across the acute sector, according to health leaders.
- Financial outlook means trusts will seek to share back office, diagnostic and clinical support functions
- Local commissioners will aim to reduce spending on specialised services
- Central Manchester and Salford Royal FTs looking to merge immunology services
These include back office, diagnostic and clinical support functions.
Plans have already been agreed to organise the region’s emergency services into four “single services”, but documents submitted as part of the region’s devolution bid prepare the ground for further “bold decisions” to be made.
The Manchester Health and Social Care Locality Plan, which relates to the city population and supports the devolution plan, says the devolution creates the framework in which specialised services can be organised on “a much more efficient and effective basis”.
The plan says there will be a funding gap of £313m in Manchester’s health and social care economy by 2020-21. If current efficiency plans are delivered, the gap is still estimated to be £84m.
It adds: “Furthermore, the opportunities for sharing back office, diagnostic and clinical support services, as well as many clinical services across hospital sites, are going to be large part of the answer to closing the financial gap.”
In the city area, Central Manchester Hospitals Foundation Trust and University Hospital of South Manchester FT will create a “single service” for emergency care as part of the Healthier Together process, although this is subject to a legal challenge.
In a joint statement, the FTs said they are also working together in other areas. They said: “The potential benefits of shared back office functions such as payroll or supplies are fairly clear – we are already working together to develop a joint approach to procurement.
“In principle there could be similar opportunities in diagnostic and clinical support services, which we will be exploring going forward but there are no plans for shared clinical support services at present.”
In relation to specialised services, the locality plan says the populations in south and central Manchester have “significantly higher rates of tertiary activity than areas where the local hospital is not also a tertiary centre”. It adds “variation will be addressed, with clear referral and acceptance criteria”, as most of their income from tertiary activity relates to patients from outside the city.
Meanwhile, the September board papers for Central Manchester Hospitals said it is also exploring partnership working arrangements with Salford Royal FT across radiology and immunology.
A report said: “The immunology project is seeking to bring the immunology services of the two trusts together into the Greater Manchester Immunology Service. Good progress is being made in bringing the laboratory services together, and this is expected to be completed in the autumn.”