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    This document is from the Greater Manchester Combined Authority and outlines their intentions. The Greater Manchester Devolution Agreement was settled with Government in November 2014, building on Greater Manchester Strategy development.  It includes powers over areas such as transport, planning and housing – and a new elected mayor. Ambition for £22 billion handed to Greater Manchester . The Memorandum of Understanding on Health and Social Care devolution was signed in February 2015 by NHS England plus the 10 Greater Manchester councils, 12 Clinical Commissioning Groups and NHS and Foundation Trusts It covers acute care, primary care, community services, mental health services, social care […]
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    The granting of power to health and social care agencies in Greater Manchester offers the chance to make a significant improvement to the life expectancy of the population of the conurbation. One of the aims of DevoManc is “To close the health inequalities gap within GM and between GM and the rest of the UK faster”. Life expectancy at birth is a summary measure of the health status of a population. Comparing life expectancies across districts indicates the extent of health inequalities. Across English local authorities there is a difference of 8.7 years in the life expectancy of men and […]
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    The supper club at Whalley Range cricket club last night was good. There were about 30 people there from Clinical Commissioning groups, NHS Trusts, patient organisations, academia, trade unions etc. It was a good opportunity to network. The project manager for DevoManc, Warren Heppolette, was there and gave a 10 minute outline of the background to the announcement to the policy, which had gone on for sometime with Treasury officials before the announcement of the policy in February. It gave an insight in terms of how Westminster works. Warren outlined the ambition of DevoManc as a rare opportunity to address […]
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    An MPU-Unite Statement SUMMARY What follows is an analysis of why we feel ‘DevoManc’ is the wrong solution to the correct question – how can we integrate health and social care locally under a national framework which would preserve the ‘risk-sharing’ that is essential in a national service? It is apparent that this agreement was made in a hurry that by-passed any wider democratic input or consideration.  There are also unanswered questions:  What happens to Manchester’s services if the budget proves inadequate?  Who funds any gaps and what is the mechanism for further funding?  Does an agreement such as this […]
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    The £6 billion NHS DevoManc deal has been hailed by NHS England CEO, Simon Stevens, as having ‘the potential to be the greatest act of devolution there has ever been in the history of the NHS’. The proposal builds on the 2014 devolution concordat between the Chancellor and the Greater Manchester (GM) councils to devolve the following powers on the understanding these would be exercised by a directly elected mayor: responsibility for a devolved transport budget responsibility for a franchised bus service powers over strategic planning control of a new £300 million housing investment fund assuming the role currently covered by the […]
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    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 […]
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    Devolution has been coming to Greater Manchester (GM) for some time. The recent announcement that the total health and social care budget for GM  – £6bn – is to be included as part of the devolution settlement has galvanised interest across NHS organisations, the social care sector and the academic community. So what is coming? The Memorandum of Understanding signed on 27 February sets out the principles for GM health and social care devolution, but the details remain to be finalised. There will be an over-arching Strategic Health and Care Strategy Partnership, consisting of the ten GM local authorities and […]
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    I know nothing about writing blogs – but I know what I don’t want for the NHS in Manchester; 1.  I do not want the NHS to be “devolved” to a bunch of Council Leaders with no clinical knowledge whatsoever of healthcare, treating patients and saving lives. 2.  I do not want accountability and responsibility for the “National” Health Service to be “devolved” from the Health Secretary to a cabal of “unelected”  Quangos like Monitor and NHS England (and its 9,”Commissioning Support Units”?) stuffed full of their “free-market” acolytes, “privateers”, “McKinseyites,” Accountants, and Management Consultants – hell bent on using the NHS as a “cash-cow” […]
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    This week’s big news in Manchester is that the devolution of direct responsibility for significant areas public spending to the city-region will now be augmented by the devolution of the entire NHS budget for the city region with a view to integrating this with social care. You can now see more of the detail about the deal (interesting term that) on the AGMA website. I have already written, separately, in the last weeks on both the DevoManc model and on the integration of health and social care. The first piece, for Steady State Manchester argued that the model is flawed […]
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    At what scale are things best organised? That is at the heart of so many of our big debates today – Scottish independence, UK independence, devolution. And yet the debate rarely takes place with a deep look at scale and what should be done at different levels. That is not to say that there is not informed debate, even if some of that is rooted in an emotional sense of the desire to regain control in a complex world, and the perennial promises and illusions of nationalism and regionalism. But scale is something, ever since Leopold Kohr argued for the breakup […]
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    There must be an election coming.  After five years of making savage cuts to council budgets, and five years of fragmenting and privatising, George Osborne has waited until five weeks before this Parliament ends to endorse Labour’s plan to integrate the NHS and social care. We can all speculate about the reasons for his Road to Damascus-style conversion and have every right to be suspicious of the real reasons behind the rushed timetable unveiled this week. But the great thing about our political leaders in Greater Manchester is that they are always more interested in getting the best deal for […]
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    It’s a wow moment in NHS history.  It’s the latest ‘this is the end of the NHS’ moment.  Headline grabbing proposals for Manchester (somewhere up North) are either a brave experiment or a pending disaster. An unholy alliance of Tory Central and Labour Local government has not only dared to suggest that some decisions about health services could be taken locally by those we elect; they have actually set out to try this dangerous idea out for real. The loathing between local authorities and health service is as old as the NHS.  The battle to stop any kind of democratic […]
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