By Richard Johnstone | 27 February 2015
A deal to devolve NHS funding to Greater Manchester’s combined authority has been sealed, with the groundbreaking pact set to devolve all health spending in an effort to improve social care integration.
Under a memorandum singed today by figures including Chancellor George Osborne and NHS England chief executive Simon Stevens, the region’s 12 NHS Clinical Commissioning Groups, 15 NHS providers and 10 local authorities will set up a joint decision-making process for all £6bn of health and social care spending over the next year.
The landmark proposal, which was first revealed on Wednesday, will be intended to integrate care by putting strategies in place to keep people well and as independent as possible. Examples highlighted include moves for people with long-term conditions like asthma or heart conditions to be treated by specialists in the community as much as possible, and only going to hospital when necessary.
This placed-based approach to health spending will not require any reorganisation of the NHS or its principles, according to the statement.
However, it builds on the devolution settlement for the area signed last November, and represents a significant step closer to the area’s ambition of full devolution of public spending.
From April, Greater Manchester will start to develop a roadmap towards devolution, with a target date from implementation of April 2016.
Stevens said the combined authority’s strong and aligned local leadership meant it was now possible for ‘bold moves to deliver the ambitious agenda set out in the NHS Five Year Forward View’.
He added: ‘Today's landmark agreement between NHS England, the local NHS and local government leaders charts a path to the greatest integration and devolution of care funding since the creation of the NHS in 1948.
‘While continuing to deliver on national care standards and the patient rights set out in the NHS Constitution, Greater Manchester now has a unique opportunity for innovation and improvement in health and wellbeing. The eyes of the country will now be on what this new partnership can deliver, and today the work begins.’
Osborne said the proposed devolution was a major step forward in his plans to boost the region’s economy and create a Northern Powerhouse.
‘When I signed the deal with local councils here to devolve more power to Greater Manchester and to create a new elected mayor, I always hoped that a bigger say over healthcare would be part of the package,’ he added.
‘Things have happened even more swiftly than we had all hoped at the time, and now we have a landmark agreement to bring the local NHS and social care much more closely together. 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.’
Combined authority chair Lord Peter Smith said this represented another defining moment in Greater Manchester’s devolution journey.
‘The scope and nature of this unprecedented agreement means we are proudly breaking new ground once more,’ he said.
‘I want to make absolutely clear that this is not, as it has been wrongly portrayed in some quarters, 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. 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.’
Responding to the announcement, Darra Singh, who chaired the Independent Commission on Local Government Finance formed by CIPFA and the Local Government Association, said it was in line with its proposals.
The deal points the way forward for how social care and health should be provided across the rest of England, he said.
‘Our commission has been clear that true devolution is the only way to save public services in an era of reduced public spending and rising demand.
‘If we want vital local services like adult social care to survive, a radical devolution of powers, funding and taxes to local areas across England is urgently needed.’
