Wednesday 6th February 2019 #VCSEEngage GM VCSE Assembly: VCSE sector and Taking Charge: The next 5 years, our chance to influence the GM plan for the next phase of devolution. Wednesday 6th February 2019 #VCSEEngage

Welcome, Housekeeping & Setting the Scene Alex Whinnom, Chief Executive GMCVO & GM VCSE Reference Group Member

The GM Health & Care Prospectus & NHS Long Term Plan VCSE Assembly – 6th February

Taking Stock A long-held ambition: Greater Manchester taking greater control of its own destiny Almost 3 years in; most plans in place. Devolution is unlocking fresh thinking and breaking down the silos between public services Our new Prospectus will bring our story up to date and set out our ambitions for the next phase of our work It will do so now because we want to contribute to respond and/or contribute to: The new NHS long-term plan The Social Care Green paper The Government Spending Review in 2019 Wider GM strategies

Wider GM Strategies The GM Independent Prosperity Review. Guided by an independent panel of economic experts this review is updating GM’s evidence base and is expected to provide the analytical underpinnings for discussions with Government generally and the local industrial strategy specifically over the coming years. The GM Local Industrial Strategy. This will be a jointly agreed strategy with Government, setting out how GM will maximise its contribution to UK productivity and earnings growth. It is due to be agreed by the end of March 2019. The Transport Delivery Plan 2020-2025. This sets out our plans for the next five years to deliver the Transport 2040 future vision for “world class connections that support long-term sustainable economic growth and access to opportunities for all” The White Paper on the GM Public Services Model. This will set out how we will deliver the 6 features of the GM public service model and is expected to be published in Spring 2019.

NHS Long Term Plan The NHS Long Term Plan was published on 7th January 2019. The Plan lays out the path for the NHS over the next decade; Many of the initiatives in the Plan mirror those underway here – including on population health, integration and digitally-enabled care; Whilst increases in NHS funding are welcome, it is vital that sustainable financial settlements are agreed for both Social Care and Public Health. Health and Care integration is undermined without long-term financing of Social Care and Public Health; Although lots on personalised care – there could be more on the role of community groups and organisations – and how they can support people in a non-medical model; Some mentions of the VCSE in the document – but could have gone further Prospectus gives us opportunity to go beyond the LT Plan in GM.

The GM Prospectus We want to go beyond other integrated care systems to create a comprehensive population health system based on the capabilities and hopes of our residents; We want to offer a compelling picture of how the intentions of the NHS Long Term Plan are already being delivered, and can be built upon, in the context of Greater Manchester as a place with a vision which connects the whole of public service, the VCSE, the business sector, academia and civic leadership; The Prospectus explicitly states: The VCSE sector should be part of the fabric of public services and public services should be delivered with local citizens, businesses and communities. This also means a radical change in the way we commission and partner with communities and the VCSE sector, we work as one across public services and we work as one with communities; The infrastructure we have in place also provides us with the opportunity to enact a public-service wide response to the ambitions in the Plan. For example, on poor air quality.

If we refresh the picture today we can see how our starting position can be shown to have shifted. Where are we now? Financial Management Hospital Bed Days Mental Health Access We have generated system surpluses over last 2 years, and on track to at least balance again this year We have met the 19/20 CYP access target a year ahead of schedule rising from 11.1% baseline to 33.3% in June ‘18 Emergency bed days in GM have been held broadly stable in GM in early days of devo with signs of a more recent downturn A&E Attendance Cancer Survival Percentage of children achieving a good level of development We have tracked below the national growth level since devolution We have improved cancer survival rates to almost national average We have narrowed the gap to England year on year since the 2014 Devolution Agreement from 4.8% to 3.5% Delayed Transfers of Care Smoking Reduction Reducing Worklessness We are reducing smoking rates currently by 4x rate of average for country Over 3,200 long-term unemployed people have found work through Working Well, with the full programme already having paid for itself We have reduced delayed beds by 1.7% since devolution, compared to a growth seen nationally

The VCSE Contribution The VCSE has made a vital contribution to shifting some of these dials. This includes: On mental health On school readiness Helping people get home from hospital Improving quality and access in primary care LCO development The MOU has been vital in this – but still early days and more to do. In the long term, the system needs to be rebalanced towards prevention/recovery/early warning and the VCSE is fundamental to this. We, together, are the system.

Some Devo Differences to date More children ‘school ready’ 3% reduction in smoking rates Over 3200 long term employed helped back to work GP extended access to national standards everywhere Over 96% GP practices outstanding or good Better access to mental health care for children Improved quality of early years settings A&E attendances below national growth

Some devo differences to date Helping people get home from hospital quicker – delayed discharges down a third. Stable numbers of emergency bed days Improving standards in care homes and domiciliary care Meeting national MH standards and added new services including eating disorders, perinatal MH, schools, university students and crisis care. Transforming Care programme on trajectory Cancer one year survival rate gap closed. Acute stroke care – best in country.

Working Together – An Example In 2018, with the support of a number of partners including across the voluntary sector, community and social enterprise sector, we rolled out a pilot with over 30 of our schools in Greater Manchester to help children and young people look after their emotional health and wellbeing and provide specialist support where needed Each school will have a lead for mental health and they will be trained to understand and spot the signs of mental health issues in children and young people such as anxiety and stress. Teachers will be supported to work more effectively with children and young people experiencing mental health problems, In addition, they will have support and consultation directly with a specialist mental health team who will provide advice, information and support schools to access appropriate services if needed, in a timely way. We are working on plans to extend this to 10% of Greater Manchester schools over the coming two years and then meet an ambition for support in all Greater Manchester schools

Some Big Challenges Remain We have struggled to meet NHS Constitutional Standards in some areas – particularly on urgent care; Although GM has closed the gap in a number of areas – we still are still below the average across a range of health outcomes; There are still significant workforce gaps and financial pressures – for example on adult social care; Health inequalities still run deep – between GM and the rest of the country and within GM itself

Ready to face the future Looking ahead to the next decade we are building on five key values/ characteristics Putting people at the centre Health creation through prevention True parity of esteem The power of innovation An empowered workforce

Creating a population health system Policies/programmes to target prevention in wider determinants of health Every area of public service has health as one of its objectives Economic growth also recognised for its health potential Flexible use of resources across sectors Integrated services across neighbourhoods – including VCSE Marmot city region Together we are creating a new model of public service delivery

Building a sustainable system Further Partnership Development Future of Commissioning Creating a unified commissioning system through: Locality-based public service reform; Standardised approach to commissioning across GM; Economies of scale through greater collaboration Role of the VCSE in commissioning needs to be enhanced System Oversight and Improvement Deepen and formalise our relationship with NHSE/I in the context of their integration Includes joint oversight board and improvement collaborative Financial Management Be early adopters of opportunities in long term plan.

Attracting and keeping the right workforce The 2017 Greater Manchester health and social care workforce strategy focuses on four priorities: grow our own employment brand and offer difficult to fill positions carers and the voluntary workforce Examples of programmes so far include employment guarantee for GM student nurses, collective commitment to Workforce Race Equality Scheme, registered managers training, apprenticeships. We need to think about workforce in the broadest terms – including unpaid family carers, volunteers, etc. .

Unlocking Economic Potential Established Health Innovation Manchester - single organisation that brings together all research and development work under one roof Unique strengths in health informatics, advanced materials and as a global centre for clinical trials. Innovation needs to be spread across the system – including social innovation Social Enterprise Strategy can play a major role in this – and VCSE is a significant contributor to well-being and economic growth Can harness the potential of the health and care system to contribute to innovation and productivity across 2.8m conurbation We need to do more on the role of the health and care system as anchor institutions. The NHS and local authorities in GM are huge employers and we can have a more positive impact on local economies- through approaches to local employment, supply chains, etc. Programme of work is starting with Health Foundation. We seek Government backing for Greater Manchester, as part of the UK and Local Industrial Strategy, to become a global leader for innovation in digital and life sciences.

Moving Forward Prospectus will reaffirm our commitment to implement Taking Charge fully and seek to realise the ambitions of the devolution agreement Our ambition extends to the creation of a comprehensive population health system in GM – that currently goes beyond the scope of other Integrated Care Systems in terms of breadth of single public service model Prospectus is starting point for discussions with partners on realising this aim and will form basis of our five year plan, 2020-25. We want to work together with you to stretch our ambition further .

Group discussion In your groups, please discuss your immediate reactions to Paul’s presentation What excited you?, What has been missed? What have they got right? Please come up with a maximum of 3 questions you would like to ask Paul and his team and record them on the flipchart paper on your table and puck on person to feedback.

Our Response By Stewart Lucas

The VCSE response The VCSE is an integral part of all the Strategies Paul mentioned The Reference Group leading on creation of VCSE strategy / manifesto / BOB that will sit alongside Need you feed in

The Expectation The GM Independent Prosperity Review. The GM Local Industrial Strategy. The Transport Delivery Plan 2020-2025. The White Paper on the GM Public Services Model. The Health and Social Care Partnership Prospectus The VCSE manifesto

The Exercise Having heard from Paul please discuss on your tables what should be in our prospectus and what role you believe the sector can play in supporting the Greater Manchester Health and Social Care Partnership and the wider system in achieving its vision.

Ground rules This is about POSTIVETISM and OPTIMISM Lets draw a line under the past, we are part of the system and we are part of the partnership. So what can we? What should we pledge? What do they need?

Lets Hear from you GO

Local Care Organisation Development Voluntary Sector Engagement and Participation

Who took part? All 10 Local Care Organisation (LCO) locality contacts identified and/or delegated a key person to be interviewed on behalf of the locality. 8 out of 10 locality Voluntary Sector (VCSE) local infrastructure organisations support (or similar) were interviewed. 2 totally amazing and sensational VCSE providers also took part.

Q1. Local relationships.

Q2. Nurturing relationships.

Q3. Connection points.

Q4. Experience of working together.

Q5. Valuable learning.

Q6. Planned investment. Q7. …anything else!

Getting the roles right Understanding the strengths on both sides. Valuing the roles and not underestimating the cost. Equity in positioning and leadership. How’s a VCSE provider different from a public sector one? Connecting to and from the VCSE and enabling that.

Questions (20 minutes) What can you do to enable a strong and equitable relationship for the voluntary, community and social enterprise (VCSE) sector and your Local Care Organisation (LCO)? How do we support the VCSE of all shapes and sizes to better engage in strategy, co-design and commissioning (tactical and strategic)?

Thank you for coming Please remember to complete and return your evaluation forms and name badges on your way out