Exclusive: Manchester deal criticised for lack of GP involvement

A memorandum of understanding was today signed by 15 NHS providers, 10 local authorities, NHS England, the chancellor and the health secretary to join up health and social care budgets in Greater Manchester, under the authority of a new strategic health and social care partnership board.

The plans received letters of support from Greater Manchester’s acute trusts, foundation trusts and North West Ambulance Service, but it is understood that GPs, outside of the GP led commissioning bodies, were not involved in involved in discussions.

The new arrangements will be overseen by the new Greater Manchester Strategic Health and Social Care Partnership Board, which is expected to involve providers, but there is no indication that it will include GPs.

A health and social care devolution programme board is also due to be set up to “provide overall strategic oversight and direction” before the new arrangements go live in April 2016. It is expected to have representatives from NHS England, the Department of Health, clinical commissioning groups, trusts, and the Association of Greater Manchester Authorities which represents local authorities - but not GPs.

Tracey Vell, chair of the Manchester Local Medical Committee, which represents GPs in the area, told HSJ that “general practice as a provider has not been given a stake so far in the process”.

“Commissioners of services cannot represent the provider at all, and I am disappointed that the Greater Manchester LMC, which has a statutory function of supporting all general practices, [has] not been part of the process so far,” she said.

The memorandum of understanding states that primary care, including the management of GP contracts, would be included in the scope of services devolved to Greater Manchester.

“This is an LMC issue and it would be useful to have a presence in the process which can be extremely helpful and instructive,” Dr Vell added.  

She said the “detail of the agreement” was now “dripping through to general practice”, but “perhaps not the realities of what the principles will mean”. 

“The simple question whether this will actually help patients on the ground is: does pooling of money and wider management of these funds help the funds reach the need or does it cause further constraints?”

“We will only know when we see the details.

“But what we do know is general practice is a huge provider of healthcare and a major advocate for patients and they have not been consulted so far.”