Five-year vision for better health and social care in Greater Manchester

The future of health and social care in Greater Manchester has received a double boost – with the backing of its five-year vision and news of £450m transformation funding.

Plans around the ambitions for health and social care in Greater Manchester over the next five years have today (December 18) been endorsed on behalf of all 37 organisations involved in the devolution partnership, the Department for Health and NHS England.

This has been further bolstered by the announcement of £450m transformation funding from NHS England to help towards creating a sustainable and successful health and social care system in Greater Manchester by 2021.

The strategic plan, Taking charge of health and social care in Greater Manchester, is in preparation for the region taking full responsibility for its devolved £6bn health and social care budget from April 1 next year.

It has been built on the content being developed out of ten locality – or area – plans submitted jointly by councils and the NHS in each of the Greater Manchester boroughs. It also forms the backdrop to ongoing discussions with the Government and NHS England for resources to support health and social care in Greater Manchester.

As a vision it represents the culmination of years of work between the people of Greater Manchester and the organisations which run public services to improve health, wealth and wellbeing. It has also been based on new conversations and partnerships with Government and other national bodies through the landmark devolution deal.

Today’s endorsement via the Greater Manchester Health and Social Care Partnership Board now marks the start of a three-month period from January, when people across all of Greater Manchester will be able to find out more, as well as giving their own views on health and wellbeing – before a final version is published for April. During this time each borough will also be talking to people about their own locality plan and how it fits into the Greater Manchester picture.

The plan also looks at how the region can work towards closing the predicted £2bn shortfall in health and social care funding by 2021, if we carry on spending in the same way. In addition, it illustrates the devolution goal of bringing the biggest, fastest improvement to the health, wealth and wellbeing of the £2.8 million people in the towns and cities of Greater Manchester.

Lord Peter Smith, lead on health and social care for the Greater Manchester Combined Authority, said: “Both the challenge and the opportunity are significant over the next five years. If we don’t use the £6bn budget funding in a radically different way around our health and social care system, we will be facing a major deficit of £2bn by 2021.

“We have been in productive discussions with NHS England and the government about our strategic plan and the necessary transformation funding to enable us to achieve a sustainable health and care system by 2021.

“We are very pleased to have a transformation fund of £450m so that we can start this implementation immediately.

“All the partner organisations are committed to working with NHS England on the detailed operation of the Fund and the wider settlement. Social care – another key part of the Transformation Programme – will need to be the subject of further discussions locally over the coming weeks as we understand the full impacts of the Local Government settlement in Greater Manchester.”

Key health goals have also been identified within the strategic plan, with more to follow in forthcoming months. Initial outcomes and measures are based on prevention and early intervention work to get better results in the following areas:

• Children: We want more children to get off to the right start so that they are classed as school-ready by the time they go into reception. Improving levels of school readiness to projected England rates would mean that 3250 more children in Greater Manchester will have a good level of development by 2021.
• Babies: We want to reduce the risk of low birth-weight babies. Reducing the number of low birth weight babies in Greater Manchester, to projected England rates, will result in an 270 fewer very small babies (under 2500g, or 5.5lbs) by 2021.
• Reducing effects of poverty: We want family incomes to increase across Greater Manchester. Increasing the number of parents in employment with good terms, to projected England rates, will result in 16,000 fewer children in Greater Manchester living in poverty by 2021.
• Heart Disease: We want fewer people to die early from cardio-vascular disease (CVD). Improving premature death rates from CVD, to the projected England average, will result in 600 fewer deaths by 2021.
• Cancer: We want fewer people will die early from cancer. Improving premature death rates from cancer, to projected England average, will result in 1300 fewer deaths by 2021.
• Respiratory disease: Fewer people will die early from respiratory disease. Improving premature death rates from respiratory disease, to the projected England average, will result in 580 fewer deaths by 2021.
• Older people: We want more people to be supported to stay well and live at home for as long as possible. Reducing the number of people over 65 admitted to hospital due to falls, to the projected England average, will result in 2,750 fewer serious falls.

Dr Hamish Stedman, chair of the Association of Greater Manchester Clinical Commissioning Groups, said: “For too long the people of Greater Manchester have suffered more illness than they should. They have died younger and become ill at an earlier stage.

“For instance in Greater Manchester, arguably England’s second major city, women have the worst life expectancy in England. Our levels of heart and respiratory illnesses mean that people become ill younger than in other parts of the country and our growing number of older people often has many long-term health issues to manage.

“These are all issues that we need to prioritise by doing more work to prevent illness, helping people to stay in work, and by reducing poverty.

“As a whole city we can now look at focussing on the key health needs for our area so that we can make a real difference to long-term outcomes.”

Key strands in the Greater Manchester strategic plan include:

• Society and community role. This involves a fundamental change in how people and communities look after their health. More emphasis will be placed on prevention to stop people becoming ill and helping people to take more control over their own health and wellbeing.
• Local Care Organisations. The creation of local care organisations would see GPs, hospital doctors, nurses and other health professionals come together with social care teams, the voluntary sector and managers to plan and deliver care. This means that when people do need support from public services it will be mainly in their community, with hospitals only needed for specialist care.
• Hospital collaboration. More collaboration between hospitals across Greater Manchester, to make sure that expertise, experience and efficiencies can be shared across the whole area in a consistent way.
• Consistently high standards. Other changes to ensure that standards are consistent and high across Greater Manchester, as well as saving money, include exploring sharing some clinical and non-clinical support functions; investing in workforce development across Greater Manchester; sharing and consolidating public sector buildings; investing in new technology, research and development, innovation and ideas.

Dr Tracey Vell, chair of Greater Manchester’s Local Medical Committees, said: “Our GPs are very aware of the key role primary care has at the heart of these developments, keeping people well and out of hospital as much as possible. Thousands of people are treated in hospital, when their needs could sometimes be met in the community, so that they have more control over their illnesses and have treatment closer to home.”

Ann Barnes, chief executive of Stockport NHS Foundation Trust and chair of the Greater Manchester Provider Trusts, said: “We have a huge amount of expertise and skill within our hospitals and communities and for those occasions when hospital care is the right option for patients. We want to work to remove any fragmentation in care and build on our strong history of collaboration by sharing best practice across all our hospital sites.

“Where care is best provided out of hospital – the majority in the future – we want to work with local health and social care partners to provide best in class care.”

Alex Whinnom, director of Greater Manchester Centre for Voluntary Organisation, said: “The voluntary sector has a crucial role in enabling people and communities to do their part towards effective health and social care. Voluntary action is often the bridge that keeps people involved in society – and the more people are involved, the more connected they are to services and the wider community.”

The plan endorsed today is a final draft and a critical part of the work between January and March 2016 will be to continue to engage with people across Greater Manchester and staff working in the health and care system on the plan themes and working together.

A final plan will be produced in April. There are currently very few detailed changes proposed at the moment. Implementation plans will now being developed over the next few months which will contain more details and will be made available to the public. If there are any future changes which may affect how services are provided, there will be formal consultations with staff and the public.

Jack Firth, chair of Healthwatch Bolton, said: “Patients look forward to reviewing the plans and having a strong voice on what can be done to improve health and care across the whole of Greater Manchester.”

Dr Ranjit Gill, chair of the GM Strategic Planning Group, said: “For too long, Greater Manchester has been the sick man of England. This is a unique opportunity to bring together health and social care systems, building from a new model of primary care, at the pace of change needed to make wholesale improvements to the region’s health and wellbeing."