Power plan underway to unite 38 organisations within Greater Manchester health and care devolution

• Governance plan is first of its kind in England and builds on historic devo announcement in February
• Due to start in shadow format in October and brings together 37 GM organisations, plus NHS England
• Final details to be agreed and announced in forthcoming weeks
• Will help with targets for 2020 – could see 70,000 people with long-term conditions having care closer to home and out of hospital

Principles around sharing power and making decisions within Greater Manchester health and care devolution have been agreed – and are unprecedented in England as they outline how 38 organisations will work together to improve the region’s health outcomes as quickly as possible.

The proposed structure includes the creation of a strategic partnership board to run in shadow format from October. Wider details for the structure and board arrangements will be finalised early next year, ready for full operation by April 2016.

The governance plans have been developed from February’s historic health and social care devolution announcement – and the Memorandum of Understanding (MoU) between the region’s 10 local authorities, 12 NHS Clinical Commissioning Groups and 15 NHS providers.

February’s MoU was an outline of a start of a process from April 1, which put local people in the driving seat for deciding on health and social care services to suit Greater Manchester. One of the key principles behind the MoU was that there would be no reorganisation of the NHS or its mandate. It also underlined the need for Greater Manchester to establish strong ongoing governance for the work undertaken together.

Now, the strategic partnership board is set to run in shadow format from October and will be responsible for setting out the vision for Greater Manchester’s health and social care economy to achieve the aims of devolution, so that by 2020 we could see:

• 4,000 fewer children with chronic (long-term) conditions;
• 60,000 fewer adults with chronic conditions;
• 6,000 fewer people with cancer;
• 10 per cent fewer visits needed to urgent care;
• 18,000 children better supported by local services to live in stable, caring homes helping them to progress in education;
• Nearly 70,000 people with chronic conditions with community help to manage their conditions in a way that suits them. This could also reduce demand on planned (elective) hospital services by 15% and help these patients to have 20% fewer unplanned hospital admissions;
• 25,000 people with severe and long-term mental illness benefitting from proactive community care to stop their mental health deteriorating and this could reduce their involvement with urgent services by 30%.

Membership of the Strategic Partnership Board will include:

• Greater Manchester Combined Authority
• 10 Greater Manchester local authorities
• 12 NHS Clinical Commissioning Groups
• 15 Greater Manchester NHS Trusts and Foundation Trusts
• NHS England
• Representatives from primary care (GPs, dentists, optometrists, pharmacists), third sector (voluntary and charity groups) and patient groups
• Greater Manchester Fire and Rescue Service
• Greater Manchester Police and Crime Commissioner’s office

The board will be responsible for the financial and clinical sustainability of Greater Manchester health and care, through the delivery of the Strategic Plan. This plan explains what is to be led and agreed on a local level in each of the ten Greater Manchester areas – and what will be led and agreed at a Greater Manchester level. These regional decisions will be taken by the Greater Manchester Joint Commissioning Board — whose core membership is made up of 10 local authorities and 12 CCGs and also NHS England.

Lord Peter Smith, GMCA lead on health, said: “This is a once in a lifetime opportunity to design a system that brings the delivery of health and social care together in Greater Manchester to improve health, give better outcomes for residents and reduce health inequalities in the region.”

Dr Hamish Stedman, chair of the Association of Greater Manchester CCGs, said: “These plans are the start of a formal framework which mean we can carry on working with the same momentum and scale as in the last six months, which is key to driving our devolution ambitions.”

Ann Barnes, chief executive of Stockport NHS Foundation Trust and chair of the Greater Manchester Provider Federation Board, said: “February’s devolution announcement was a landmark event when we said the atmosphere was so charged, that it fizzed like champagne at a wedding reception. Well, if that was the reception, this new agreement is now the marriage and the day-to-day nurturing of our relationship. As NHS Trust providers we look forward to our role in better connected services that bring real benefits for our patients and their loved ones.”