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The world has changed since 1948 so health and care services must change too

5 min read

Improving health is not just about the NHS, but housing, work and education. In Greater Manchester, our joined-up approach and focus on early intervention is leading to real progress, writes Lord Smith

This year, our NHS will turn 70. It is one of the most recognised and trusted ‘brands’ in the world and 80% of patients say they would recommend its services to family and friends.

However, our NHS is also under significant pressure. Increased demand from an ageing population, more advanced and costly treatments, and staff shortages, combined with funding shortfall, mean our health service is operating in extremely difficult circumstances.

In Greater Manchester we are taking our own approach to ensuring a healthier population and sustainable health and care service. In February 2015, we signed a devolution agreement and became the first city region in the country to take control of our combined health and social care budgets – a sum of more than £6bn. This is led by a partnership of NHS organisations, local authorities and other partners.

Our vision is to achieve the greatest and fastest improvement to the health, wealth, and wellbeing for our residents. Good health is not just about health services – housing, work, and education also influence health and wellbeing. Devolution allows us to work in a more joined-up way to focus on local need.

As a result of devolution, Greater Manchester was awarded a £450m transformation fund to help pay for large scale changes to health and social care. Most has now been allocated with our 10 boroughs all receiving allocations to integrate care along with region wide investment in hospital services, GP practices, and mental health.

It is a sad fact that, on average, people in Greater Manchester die younger than those in other parts of the country and we face a range of health challenges. We’re working hard to change this.

So far, we have invested £1.5m in improving children’s oral health in priority boroughs, spoken to 6,000 residents about what will help them to live healthier lives, and signed an agreement with Sport England on working together to increase physical activity. We are also working to ensure more children are ‘school ready’ by the age of five, to reduce alcohol consumption and working towards a tobacco-free Greater Manchester.

A healthier population doesn’t just mean physical health. In July, we announced an investment of £134m for mental health – the largest of its kind in the country. It will mean thousands more children receive help when they need it, schools are better equipped to meet the mental health needs of pupils, and anyone in crisis can get the support they need.

We want Greater Manchester to be the best place to live in the UK for dementia care. Dementia United is a long-term transformation and support programme. We’re working with local and national partners to extend opportunities and support for people with dementia. We have also developed resources to support dementia care and encouraged more pharmacies to become ‘dementia friendly.’

Organisations across Greater Manchester have signed up to the Carers Charter, committing to take a joined-up approach to identifying and assessing carers, as well as meeting their health and wellbeing needs.

We also want people in Greater Manchester to have the best chance of avoiding or surviving cancer. Our aim is for everyone to have the best care with access to cancer services that are fit for the future. Our services have performed better than others nationally in recent years, particularly in relation to national NHS waiting time targets. Our Cancer Champions programme encourages local volunteers – over 5000 so far – to support people at risk of developing cancer as well as those who have been recently diagnosed.

We are making real progress in turning around health and care services and boosting the health of our population. Of course, it’s not all plain sailing. We have to contend with similar problems as elsewhere. When it comes to social care, Greater Manchester faces a funding gap of £240m by 2020/21. This shortfall increases pressure on hospitals, where on any given day there can be around 2,500 people in hospital who would be better looked after in the community.

We are working to improve social care across the region by improving care homes, providing more support for carers, and boosting the social care workforce. From the outset, we knew emergency care would be one of our key challenges as a devolved city region.

This winter we faced the same pressures in A&E as others, with many very unwell older patients, workforce shortages and a squeezed social care sector. The difference is that organisations can work more closely together across borough and sector boundaries to tackle the problem. We saw the beginnings of this approach this year with the establishment of an operational hub that receives live hospital data from across the region, helping to predict problems and manage pressures.

There has been much debate over the future of the NHS in recent weeks. The world has changed since 1948 so health and care services must change too. The NHS needs to become more than just an ill-health service and work with local authorities and local communities to deliver better health through early intervention.


Lord Smith of Leigh is a Labour peer, Leader of Wigan Council and chairman of Greater Manchester Combined Authority

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