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