National and Devolved Politics


Rouse: Health devolution means taking decisions collectively to avoid tensions

Authorities, care providers and CCGs must work closely with the NHS to make health devolution work, says the chief executive of Greater Manchester Health and Social Care Partnership (GMHSC).

Speaking at the King’s Fund’s annual conference in London yesterday Jon Rouse took health officials through the processes of Greater Manchester’s landmark health and care deal.

The GMHSC brings together all the councils under Greater Manchester Combined Authority (GMCA) as well as 37 NHS organisations, it also works with NHS Improvement (NHSI) and local CCGs.

Rouse said the devolution approach only works because the NHS and local councils are working with the other bodies, “side by side” in a system which forces them to air grievances with each other.

“It means you have a whole system conversation which is about place, but also its impossible to blame anybody else because they’re in the room so if you are going to blame them they’re going to hear it,” he explained.

“Therefore, you resolve issues much more readily, it doesn’t mean we don’t have tensions and disagreements, but it creates a different dynamic.”

The GMHSC leader has previously spoken to PSE about the importance of pooling budgets so that all organisations are responsible for health and care in a localised area.

He pointed to Greater Manchester’s introducing integrated discharge teams, which bring together health, social care, voluntary support, community transport – and even housing in some cases to dealing with health and care transfers.

Partnership with NHSI is also a unique part of Greater Manchester’s deal – although the organisation has to remain statutorily independent. To achieve this, the two bodies share a director of development and improvement, who works collaboratively across both services.

Rouse explained: “When we do assurance, it’s us and NHSI absolutely side by side, and on the other side of the table we’ve got the CCG, local authority and providers together.”

Greater Manchester has recently begun working on a single operational hub which is responsible for overseeing the entire health system from one central base.

The centre would be equipped with several predictive mechanisms aimed at forecasting a potential crisis and allowing escalation of services before a major event hits.

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