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Social care cuts ‘will gnaw away’ at GM integration plans

Senior figures in Greater Manchester have joined the growing chorus warning that the city’s landmark health reforms could be held back by the uncertain state of social care funding.

Sir Howard Bernstein, the outgoing chief executive of Manchester City Council, told the House of Lords NHS Sustainability Committee hearing that he had already written to health secretary Jeremy Hunt, chancellor Philip Hammond and NHS England chief executive Simon Stevens about the issue.

He said the letter, also signed by Jon Rouse and Lord Peter Smith, the chief officer and chair of the Greater Manchester Health and Social Care (GMHSC) Partnership, “explained the particular challenges we have around social care funding which, unless resolved, will gnaw away at our capability to create the sustainable funding platform we have committed to in the next five years”.

He also called a “settled, stable pact” on social care funding, introduced from next year, was “absolutely pivotal”.

The Health Select Committee also wrote to Hammond last month urging him to direct any extra money towards social care, which faces a deficit of £2.6bn by 202. However, the Autumn Statement contained no mention of the issue.

In an unprecedented devolution milestone, Greater Manchester gained power over health and social care in April this year and is planning to introduce an ambitious programme of integrated care.

PSE reported last week that papers from the GMHSC Partnership show concerns that the social care cuts could “undermine” the transformation programme.

In a Communities and Local Government Committee hearing on Monday, Rouse said that the GMHSC Partnership doesn’t know how to close the social care funding gap.

Steve Wilson, executive lead for finance and investment on the GMHSC Partnership board, who also appeared in the hearing, told the peers that the social care funding gap would reach £176m over the next five years. “There’s a real risk in that, because the transformation we’re going to deliver in the next five years is going to be key to that vision in 15 years’ time when we see social care integrated with mental health and physical health,” he said.

However, Wilson added that if social care was protected, it would “enable a strategy” to close the GMHSC Partnership financial gap.

He said that overall, he expected the Greater Manchester model to be adopted elsewhere because it was a model of “working on a place basis” that was “the only real way” of meeting the challenges in the sector.

Sir Howard agreed that reform had to be “place-based, not organisationally based” and delivered by localities instead of nationally.

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