• Greater Manchester’s A&E performance has continued to deteriorate
  • Comes after formal “intervention” in devolution agreement in February
  • New regional director has stressed importance of four-hour target

Greater Manchester’s performance against the headline accident and emergency standard has continued to deteriorate, despite a formal intervention from regulators earlier this year.

The proportion of patients dealt with within four hours was 84 per cent in the first quarter of 2019-20, compared with 87 per cent in the north of England, and 89 per cent nationwide.

Greater Manchester, which has benefitted from a unique devolution deal which included a £450m transformation fund, has consistently lagged behind these comparators over the last few years.

But the gap in performance has widened over the last 12 months, and the region’s leaders acknowledged performance is “not as good as it should be”.

As reported in February, the region’s A&E problems prompted NHS England and NHS Improvement to formally intervene in the devolution arrangements, and they have since been working with local leaders to assess the situation.

Since then, the NHS England and Improvement north west regional director Bill McCarthy, who line manages the chief officer of the devolution project, has also stressed the importance of meeting the four-hour target.

Stockport Foundation Trust was the region’s worst performer in 2018-19, at 77 per cent, while Tameside and Glossop Integrated Care FT was the best, at 92 per cent.

According to a recent board report for Greater Manchester Health and Social Care, some key factors in Tameside’s success have been the shared leadership and commissioning function across the council and clinical commissioning group, the high level of integration between services, the use of digital technology to support care homes, and urgent community responses with integrated care teams. 

A GMHSCP spokesman said a joint analysis with NHSE/I had prompted a need to better understand community-based demand and capacity, and a “significant programme of work to review demand” has been commissioned. The output of this work was “confidential” and would not be shared publicly, he said.

The spokesman said there have been improvements in a range of other indicators, such as ambulance response times, ambulance-to-hospital handover times, and length of stay. But he added: “Everyone accepts it is not as good as it should be and all parts of the system have committed to working together to improve it.”

Leaders in the region stress the importance of looking at a range of indicators to judge the impact of the devolution project. At least one study is ongoing, which has been funded by the Health Foundation and carried out by Manchester Business School.