Devo Manc goes live
The Five Year Forward View has radically changed the health and social care landscape. It reiterates long-held ambitions of breaking down barriers between ‘silos’ in the health service – between GPs and hospitals, health and social care and physical and mental health – and this is to be welcomed, as long as money follows the plan. Devolution will bring radical change. The first model, Devo Manc, went live on April 1. Greater Manchester (GM) makes local rather than national politicians responsible for health as the ten authorities of GM come together to manage a range of services.
Devolution will bring challenges but it gives GM an unprecedented opportunity to improve services. Health and social care in GM is already self-contained due to geography and a history of organisations working together. Examples include the development of Manchester Airport (owned by ten local authorities), the three hyper acute stroke services and the Healthier Together consultation led by the area’s 12 clinical commissioning groups (www.healthiertogethergm.nhs.uk/why-change-needed).
We have the chance to trail-blaze new ways of working – single points of access should improve the service offered to patients
GM faces major variations in health outcomes due to social deprivation, lifestyle choices, mental health problems and gaps in service quality.
Now, local neighbourhood centres serving populations of 30,000-50,000 are being established where services such as GP surgeries, pharmacy, social services and employment offices will offer a single point of access. Unemployment, lone parenting, poor literacy and numeracy skills, offending, homelessness, alcohol and crime affect healthcare outcomes and take up much of a GP’s time.
Wrapping primary care around housing, employment and transport will bring advantages and a drive for commissioners to integrate with local authorities, the third sector, voluntary sector and general practice. GM has the infrastructure to do this. Even with the mechanisms in place it is going to be an uphill struggle, but an exciting one as the model evolves. If anywhere can do it, GM can, with its track record of working together. My prediction is that Devo Manc will blaze a trail down the devolution road.