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Single commissioning hub and place-based approach vital to devolution aims, says Sir Howard

Greater Manchester and other devolved regions across England have to move to develop a single integrated commissioning hub for all public services in order to focus on “real priorities” and place-based planning, Sir Howard Bernstein, the CEO of Manchester City Council, said.

Speaking at the opening of the NHS Confederation annual conference yesterday (15 June), Sir Howard said Greater Manchester is pushing to develop single commissioning hubs for all public services – beyond just health and social care – across all its 10 localities.

“[This will] ensure that when we talk about early intervention, when we talk about early help, when we talk about the type and quality of public services that people of this conurbation, and I suspect in other places in this country, require, we are going to be able to deliver the outcomes that are necessary,” he told the audience, which consisted mainly of healthcare leaders but, for the first time ever, included the official attendance and exhibition of the LGA.

The key enabler behind these single hubs is a place-based approach to public service planning and spending, which Sir Howard said has seen “significant progress” across the board in Greater Manchester in the last 12 to 18 months.

“At all levels, people have recognised the requirement for change; people have also recognised the importance of focusing on place; people are giving time and energy and commitment in order to develop 10 locality plans, which are focused around how we introduce single commissioning foci around individual localities – initially based around health and social care spend, yes, but increasingly, over the next 12 to 18 months and beyond, on the wider public services,” he added.

“Myself, as chief executive of Manchester, and my other colleagues as chief executives of the nine other local authorities in Greater Manchester, are not just chief executives of organisations. We see ourselves as exercising a leadership role working across sectors in our own individual localities, driving place-based priorities.

“That’s absolutely essential, because unless you drive place-based priorities, you’re not actually focusing on the people – which is absolutely fundamental. So for us, collaboration across sectors is absolutely key for effecting change, and also is the requirement to rethink what we mean by accountabilities so that we underpin the place-based approach.”

He argued that focusing on this place-based approach was actually what enabled the entire devolution agenda in Greater Manchester, spurring a “real focus” on making places economically competitive and economically productive.

Sir Howard was introduced to stage by NHS Confederation’s chair, Stephen Dorrell, who called the Manchester CEO the “principle architect of DevoManc and an early champion of the important principal that good health policy is local health policy, and that it’s about so much more than service delivery”.

“It should go without saying that there needs to be better links between health and social care, and indeed within the NHS itself – but that’s only half the story,” Dorrell added. “Good local government is about creating sustainable communities in which people lead full and fulfilling lives, and health policy in its wider sense should be at the heart of that sense of civic ambition.”

Dorrell also argued that the requirement to build a place-based approach to health and care policy isn’t unique to Manchester.

Speaking from his perspective as chair of the Birmingham and Solihull Sustainability and Transformation Plan (STP), he said that all 44 STP footprints will now have a chance to re-write the rules that steered the health and care sphere until now.

“Rather than being stuck in sterile debates between primary and secondary care, health care and social care, commissioners and providers, the planning guidance has issued us with a challenge,” added Dorrell.


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