1. The Greater Manchester Strategy 2013 - 2020 Greater Manchester Health & Wellbeing Board 17 May 2013

2. Background The Greater Manchester Strategy (GMS) has been updated to: –reflect the economic challenges we’ve faced since 2009 –provide a greater focus on the importance of the public service reform agenda –be stronger on delivery and implementation Repositioned to better reflect the challenges faced in GM

3. Context Recession longer and more severe than expected Economic forecasts repeatedly downgraded Expansion in the global economy driven by emerging markets Business models changing – requiring flexible working space, advanced technology, access to R&D Limited public funding available to support growth - smarter ways of working necessary GM a cost centre for the UK –Requiring £21 billion of public spending –Generating £17 billion in taxes Higher than average levels of worklessness Many vulnerable people and families facing a series of complex, multi-faceted and challenging issues Reductions in public spending mean the costs of dependency are becoming increasingly unaffordable

4. The Challenge To ensure that we create the conditions for growth by repositioning GM within changing global markets as a place in which to invest, do business, live and visit –Addressing market failure –Driving and diversifying business growth –Creating safe, sustainable and healthy places To improve the productivity of our labour market –Aligning the GM skill base with jobs generated through economic growth to increase the productivity of businesses –Increasing self-reliance and reducing demand for public services to help GM residents get back into work and remain in work Strategic priorities developed around the twin pillars of growth and reform

5. Strategic Priorities

6. What does GMS mean for health & wellbeing? GMS seeks to address the multi-faceted social issues that lead to reliance on public sector services Reflects a number of priorities for the Board and the partners that make up its membership: –“a significant proportion of public spending is spent on reactive and unplanned interventions, rather than targeted, planned and preventative interventions” –“Too many people are still in receipt of relatively fragmented services and not receiving best in class outcomes, demand is increasing in part as a consequence of medical advance and the aging population, and the system increasingly appears financially unsustainable” –“The crucial period for child development is between late pregnancy and age 3, by which time a child's brain is 80% functioning. Current early years services… often only identify problems once they become observable and serious (and therefore harder and more costly to address).”

7. The approach The Board will recognise the main actions in the GMS as we have based the Board’s own priorities upon these: –“GM requires a clinically led reconfiguration of acute services that delivers better outcomes, and a whole system leadership commitment to the reduction in unplanned admissions to hospitals and other care institutions.” –Develop a …health strategy for GM focused on stemming onflow of demand for services; and improving health outcomes via prevention and early intervention. –“From 2015 across GM (and with piloting in districts before then) our new delivery model will support all parents to give their child the best possible start in life”

8. What role does the Board play? As an AGMA advisory group the new Board is invited to help lead the strategy –Supporting the lead AGMA portfolio holder (Chair of the Board) –Encouraging partners to work together (recognising CCGs control 68% of the NHS budget), and the Board’s own work in helping to place Healthier Together in the context of the broader health and social care reform context –highlighting key programmes and sharing information (for example, supporting the development of 10 local Integrated Plans) –Reviewing progress (via the Board’s own work programme and performance dashboard)

9. Implementation Actions and interventions that are clear, focused and integrated across strategic priorities Agreed outputs that can clearly be measured Draws on the implementation planning processes underway Lead delivery agencies established and wider partners and their role identified Linked to the budget setting and financial management process to ensure that investment is aligned to agreed deliverables and the achievement of performance objectives

10. Governance Strengthening existing arrangements –Establishment of the GM Health & Well Being Board, Low Carbon Hub, the Police & Crime Commissioner & Police & Crime Panel Lead portfolio holders to oversee development of implementation plans, working with lead Chief Executives, accountable to GM Combined Authority, with third parties brought into accountability arrangements as necessary

11. Next steps 12 week consultation period: 25 March – 17 June –online consultation materials and questions –existing governance structures used to obtain feedback –GMS conference Consultation summary report and revised GMS for consideration and approval by the GMCA: 26 July