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Greater Manchester NHS devolution deal to start in April

The deal to devolve the entire £6bn NHS budget of Greater Manchester to local control was signed today by the chancellor, George Osborne.

This trailblazing move sees 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.

The Memorandum of Understanding signed today by the chancellor and the health secretary represents a quarter of the region’s public spending budget. It will establish a new strategic health and social care partnership board to coordinate health and care planning across a population of around three million.

It will be responsible for how budgets are allocated for public health, social care, GP services, mental health and acute and community care.

An earlier draft of the memorandum suggested this new organisation would be a statutory body but that wording has not been included in the final version.

The agreement states that the parties will work towards Greater Manchester playing a “clearly defined leadership role in the oversight of its provider community”, in “close partnership” with the regulators.

Osborne said he hopes the deal will “lead to better, much more joined up health care”.

Lord Peter Smith, chair of Greater Manchester Combined Authority, took the time to stress that it was not a “town hall takeover of Greater Manchester’s NHS budget”.

“We will be working together with our NHS colleagues in the region to make joint decisions which reflect local priorities,” he said. “Ultimately this will be via a new strategic health and social care partnership board. This is about decisions about Greater Manchester being taken in Greater Manchester in an integrated way, not being taken away from experts."

NHS England has agreed all plans with the Greater Manchester CCGs, NHS providers and local councils to cement a place-based approach to join up health and social care.

The scope of the Memorandum of Understanding includes the entire health and social care system in Greater Manchester, including adult, primary and social care, mental health and community services and public health.

The second part of the agreement provides a framework for strategies around governance and regulation, resources and finances, the property estate, health education, workforce and information sharing and systems being brought together.

The memorandum is an outline agreement and the full governance arrangements for health and care services in Greater Manchester have not yet been detailed.

From now, Greater Manchester will start making its own decisions and a transitional plan will come into effect from 1 April. This plan will provide the foundations for joined up business and investment proposals, along with a joint Greater Manchester Health and Social Care Strategy – until full devolution of health and care services is in place by April 2016.

Simon Stevens, chief executive of NHS England, said the new deal “charts a path to the greatest integration and devolution of care funding since the creation of the NHS”.

The chancellor added: "I am excited about all this because not only does it mean the people of Greater Manchester having more control over the decisions that affect their lives; I believe it will also lead to better, much more joined up health care. For example, it should mean more people leaving hospital sooner, and others avoiding having to go to hospital altogether. This is just the start of the journey‎."

Hospital chiefs have also weighed in on the deal with Ann Barnes, chief executive of Stockport NHS foundation Trust saying that devolution offers a fantastic opportunity for health and social care services in the area to “grow and develop together”.

She added: "We will have greater opportunities to respond swiftly and effectively to the needs of residents and really transform services for them. They will have a powerful voice in a powerful partnership". 

Cllr Gary Porter, vice chairman of the Local Government Association, said: "With greater control over spending on hospitals, GP surgeries and drop-in centres, local areas can fully integrate their funding for health and social care to help people live independently at home longer into their older years and support people with long-term conditions.

“It is right that local areas should have the powers to make decisions that affect their residents at the most appropriate local level. This is vital to improving care and alleviating the wider pressures on the health service. In all parts of the country people should be able to feel the benefit of important decisions affecting their lives being made closer to where they live.”

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