This item has been placed on the agenda at the request of the Scrutiny Committee.
Jon Rouse, Chief Officer of the Greater Manchester Health and Social Care Strategic Partnership, has been invited to attend the meeting to discuss the work of the partnership and to answer questions from the Committee.
Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk
Minutes:
Jon Rouse, Chief Officer of the Greater Manchester Health and Social Care Strategic Partnership attended the meeting to update the Scrutiny Committee on the work of the Partnership in overseeing the devolved powers and resources for health in Greater Manchester.
The update focussed on the following broad areas: System Performance, Quality, Finance, Transformation.
System Performance
Overall performance was good, although it was recognised that there were significant challenges in specific areas, such as ED admission targets and delayed discharges. Partners in Stockport were commended for their ongoing efforts to address this latter issue.
Greater Manchester was the only area in England in January 2017 to have met the cancer waiting time standard, and had done so consistently since 2011.
Other highlights included elective care performance and waiting times for mental health services.
Quality
The development of the Cancer plan was highlighted, and ongoing work to implement the Mental Health Strategy.
Finance
It was forecast that spending in Greater Manchester overall would be in balance. Partners in Stockport were again commended for their financial recovery activity.
Transformation
· 6 of the area in Greater Manchester had received funding from the Transformation Fund to support local integration plans.
· Work was also ongoing to implement the Primary Care Strategy and support the expansion of access to GP services.
· The population health plan had also been developed and preparations were being made to deliver the priorities of the Plan.
It was emphasised that the drivers for the Partnership were to deliver real change in health in the conurbation, diverting resources from costly acute provision to more effective preventative activity and to integrate services wherever possible.
The following comments were made/ issues raised:-
· What were the Partnership’s plans to address health inequalities? In response it was stated that reducing inequalities would be the ‘litmus’ test for the success of the Partnership’s work. This involved both population-level work and targeted intervention in the most deprived communities. In particular the importance of early interventions prior to birth and early years and addressing workless by tackling mental health and musculoskeletal conditions was emphasised.
· When the Memorandum of Understanding for the devolution of health funding was signed there was significant emphasise placed on prevention, but was this emphasis maintainable in light of the requirements of NHS England centrally?
· The solutions to the problems in acute and emergency activity were closely linked to the work around integrating health and social care, and it was disappointing that Stockport Together was not progressing more rapidly. In response, it was stated that it was expected that two thirds of the Transformation Fund was likely to be spent on community care programmes, and the Partnership was committed to the vision and delivery of Stockport Together.
· As the activity of the Partnership was expanding, was there a danger that this would draw too many people into this activity to the detriment of activity in localities?
· The early indications from the development of clinical assessment services, working with the North West Ambulance Service had been positive. Concerns were expressed that should Greater Manchester make any changes to the commissioning arrangements for ambulance services that this facility may be lost. In response, it was stated that the value of the clinical assessment services was highly likely to form part of critical and emergency care provision in the future.
· How does the Partnership convince the public, some of whom are wedded to old models of care? In response it was stated that the focus of such debates should be clinical evidence and the significant evidence that the consolidation of specialisms was most effective. This had to be balanced against considerations of access, but ultimately the aim was to ensure people were treated to get better.
· Is transformation the biggest challenge of the work of the Partnership?
· How much latitude was there to ‘test’ innovation in care? In response, the challenge of risk was acknowledge but assurance was given that particularly in relation to public health programmes there was scope to innovate and take risk when the evidence dictated it. Because of the long term dividend from population health investments no savings requirements were attached to the programme.
· How would new professions and jobs types be created in light of so many vested professional interests? In response the challenges posed by professional lobbying was acknowledged, but it was commented that the university and medical schools locally were very progressive and this would assist in local innovation.
· How long was the transformation process likely to take? In response it was stated that this was a long term process that would have a generational impact.