How devolution deal has the power to improve health, care and lifestyles for people in Greater Manchester

Last week’s historic health devolution agreement signed in Greater Manchester puts local people in the driving seat for deciding on health and care services. It is also the biggest act of devolution in England’s NHS since 1948 –  and ensures that decisions affecting Greater Manchester are taken in Greater Manchester by our local elected representatives and GP leaders.

The trailblazing move saw NHS England, 12 NHS Clinical Commissioning Groups, 15 NHS providers and 10 local authorities agree a framework for health and social care – with plans for joint decision making on integrated care to support physical, mental and social wellbeing.

This can only be driven at the local level and by local needs. As Sir John Oldham, chair of the Independent Commission on Whole Person Care pointed out, “what makes sense in inner city Birmingham is not likely to make sense in Cornwall”.

Devolution is about ensuring concepts of people and place drive public service planning and delivery. Devolution is about having the responsibilities and powers to shape the future of public services with our own communities. This keeps decision making closer to the ground, it makes political and public service leaders more accountable and allows integrated investment to reform public services. This will then improve the health of our population and generate growth.

Poor health is too prevalent in Greater Manchester and so are other socio-economic factors like long-term unemployment – which is often linked to mental and physical illness.

Currently too many of our public services are based on a crisis response – instead of looking at and acting on early signs of vulnerability. The balance of our attention, effort and resource needs to change. It needs to prioritise proactive, pre-emptive care and support. This change has to recognise that medical interventions, employment support, education and training to improve skills cannot continue to be directed from multiple different sources in a disjointed  fashion.  It must be properly sequenced and understood as a blend which works for one person at a time.

Devolution starts to make that blend possible. It re-positions organisational priorities towards place and people to allow us to confirm and act on shared objectives. It means a focus not only on integrating health and social care, but integrating all public services in the interests of our residents. We are already seeing how better links between the police and mental health services can help people in crisis. We are already seeing how better connections between employment services and health care can help people find and keep good work. And we are already seeing where joined up working between the fire service and ambulance service can provide good early help alongside preventative support in people’s  homes.

Our response to this devolution opportunity will make public service partnership routine across all parts of Greater Manchester. We plan now to pursue a holistic transformation of health care and wider public services to improve both the health and life opportunities of our residents.

Warren Heppolette
Strategic Director – Health & Social Care Reform Greater Manchester

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  1. This is all pure delusion, the government holds the purse strings and are talking about cuts in the region of £30 billion should they get back into office.

    New Labour are talking about zero growth in the public sector, that means cuts.

    The Neo-Liberal agenda rolls on and these mad cap schemes dreamed up on the back of cigarette packets just don’t work.

    For obvious reasons DEVO MANC is just kicking the can down the road and further erosion of a National Health Service.

    We need people that really understand what the real agenda is here, not mickey mouse schemes designed to break up the NHS.

    Just as an aside, our local county council had £75 million taken out of their budget this year, how much do you think they will take out of the Manchester Budget next year?

  2. George Nieman says:

    Again this proves that we can only trust the Labour Party with such important aspects of our needs. Both the Conservative and Liberal parties have proved they are incapable

  3. Martin Rathfelder says:

    There may well continue to be budget cuts. Devolution will not, as far as we can see, make any difference to that. But more local autonomy may enable services to be run more efficiently

  4. tony beddow says:

    Can those who think they understand this proposal enought to write in support of it answer the following?

    1. Will the devolved level have any say in deciding what is provided rather than merely how it is to be provided? If the former, how does this square with a NATIONAL NHS?

    2. Who is to be responsble, year on year, for deciding what services are to cease / be reduced to meet financial targets – elected politicians or clinically informed bodies reporting to the NHS nationally?.

    3. How is the role of “GP commissioning” to fit into the new model? I can just see the GPs loving the idea of having to turn up at Council meetings to argue about service cuts.

    4. is the new Mayor going to be an elected Health Commissioner – Tory policy in Wales by the way?

    5. I’ve looked at the MOU; interesting that NHS providers seem to be locked in. What about the private social services providers – residential and domiciliary )and may be day care)? What about private health care insurers and providers?

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