Katy Calvin Thomas

The UK’s second growth pole Source: Yale University Geocon Project

GM Devolution – Background Greater Manchester Devolution Agreement settled with Government in November 2014. Powers over areas such as transport, planning and housing – and a new elected mayor Ambition for £22 billion to be handed to GM MOU Health and Social Care devolution signed February 2015: NHS England plus the 10 GM councils, 12 Clinical Commissioning Groups and 15 NHS and Foundation Trusts From April 1st - Greater Manchester has taken charge and taken responsibility – in a historic first, devolution has handed the power and responsibility over to the people and the 37 local authorities and NHS organisations, primary care and other partners Local H&SC decision makers take control of estimated budget of £6 billion

Greater Manchester: a snapshot picture Good context slide for what we are trying to tackle and the fact that we need to work across public sector to tackle the wider determinants of health. – we know that if people are in good employment, they enjoy better health. We know that our children with a stronger start in life will progress through our education systems and develop the skills they need in adult life.

Vision To deliver the greatest and fastest possible improvement to the health and wellbeing of the 2.8m people of Greater Manchester

This slides reiterates our vision Then describes the 4 strategic objectives to deliver that vision. The objectives will be delivered through planning and delivery at 4 spatial levels (GM, cluster, locality, neighbourhood), which are all aligned through the 5 transformation themes. Localities and the 5 transformation themes are working to describe how they will deliver the objectives through a range of improvement programmes, but they have also identified that some of their reform cannot be delivered within existing resources or through existing efficiency plans. Each locality and each theme is working to understand what one-off investment or what double-running costs it needs support from the GM transformation Fund to resolve. There is a process around localities and the transformation themes being able to put a proposal into the TF and how the Fund will operate is still being worked through.

Aligning reform in GM - examples of our work We recognise that we will not deliver the transformation we need for our population – close the life expectancy gap and deliver a financially sustainable system by incremental change. Our plan – Taking Charge describes a transformation programme for GM based around 5 transformational themes – above. Since the plan was approved in December, we have been working to describe in more detail what each theme will look to deliver, but when and at what level (i.e. what we will do together at GM and cluster level and what will take place in the localities – the 10 Local Authority footprints across GM)

Principles Still part of the national NHS and social care system Decisions are made in the interest of GM residents - organisations will collaborate to prioritise those interests Commissioning at a GM level where optimum for residents Subsidiarity - decisions made at most appropriate level Transparent decision making underpinned by open sharing of information Shared outcomes to drive changes to organisational form where necessary Transitional risks will be shared with NHSE Skills and resources will transfer with commissioning functions New Burdens principle applies and will still access any new health and social care funding Underpinned by GM Strategic Sustainability Plan - achieving clinical and financial sustainability over 5 years with certain caviats eg investment A radical approach to optimising the use of NHS and social care estates “all decisions about Greater Manchester will be taken with Greater Manchester”

1st April – What is different? GM Governance GM Partnership Team GM Strategic Plan The Money Money flows in usual way through LA's or CCGs Specialist commissioning financial risks remains with NHSE but management of budget is responsibility of Chief Officer Adhere to national "business rules" for CCG but at GM level We are only assessed once We are responsible within GM to stick to control totals, National decisions should be agreed with and communicated through GM £450m Transformation Fund

We constructed a single, shared strategic financial framework to underpin the Plan and CSR submission 1 2 3 4 5 Radical upgrade in population health Transforming care in localities Standardising acute hospital care Standardising back office Enablers This is the GM financial gap 5 Opportunities still return GM to financial balance, with significant contingency e.g. baseline expected to be updated further to reflect 15/16 actual outturn, additional pension pressures announced in 2016 budget, etc. 4 3 2 2 1

Our Governance

Raising awareness and understanding of devolution and our plans

The End Any Questions