Health and Care Voluntary Sector Strategic Partners 27 th January 2016

The Strategic Plan reflects the boldness of our leadership and the scale of our collaboration The Greater Manchester (GM) ambition is to be a financially self-sustaining city region, sitting at the heart of the Northern Powerhouse, with the size, assets, skilled population and political and economic influence to rival any global city. The integration of health and social care provision across Greater Manchester is a fundamental component of that growth and reform strategy. Reform is not only essential to ensure that the Greater Manchester health and social care system can support Greater Manchester’s priority of reducing unemployment, supporting people back into employment and providing growth through innovation. It is a pre-requisite to addressing the fundamental challenge of ensuring that the health and social care system becomes financially sustainable over time. Vision Case for change Poor health outcomes and significant inequalities £2bn funding gap estimated by 2020/21 Complex landscape of commissioners, providers, local authorities, third sector and voluntary organisations Transformation It is widely accepted that Greater Manchester will not meet the challenges it faces over the next five years through incremental change. Therefore Greater Manchester partners have agreed a need to take a more radical, transformational approach based on exploiting the opportunities arising from devolution. Engagement with the system, alongside best practice from national and international experts has identified five key areas for transformational change, as indicated in the diagram on the next page. These are consistent with 5YFV and Lord Carter work.

December A Unique Context 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 Greater Manchester is taking charge and taking responsibility – in a historic first, devolution is handing the power and responsibility over to the people and the 37 local authorities and NHS organisations here Local H&SC decision makers take control of estimated budget of £6 billion from April 2016 We have developed the GM Strategic Plan & Ten Locality Plans We have already secured our CSR settlement & Transformation Fund We are operating the new GM Governance

STANDARDISING ACUTE HOSPITAL CARE The creation of “single shared services” for acute hospital services and specialist services to deliver improvements in patient outcomes and productivity through the establishment of consistent and best practice specifications that decrease variation in care and enabled by the standardisation of information management and technology TRANSFORMING COMMUNITY BASED CARE & SUPPORT A new model of care closer to home that includes scalable evidence based models for integrated primary, acute, community, mental health and social care. Key features will be targeted case management of the population most in need delivered by upskilled multi- disciplinary teams, together with streamlined discharge planning in order to reduce the demand placed on acute hospitals. RADICAL UPGRADE IN POPULATION HEALTH PREVENTION A shift in focus to population health that supports GM residents to self-manage, innovates the model for prescribers and pharmacies, and tackles the future burden of cardiovascular disease and diabetes. STANDARDISING CLINICAL SUPPORT AND BACK OFFICE SERVICES The transformational delivery of clinical support and back office services at scale across GM, including the establishment of coordination centres to help navigate GM residents through our complex system to the right services. 4 5 ENABLING BETTER CARE The creation of innovative organisation forms, new ways of commissioning, contracting and payment design and standardised information management and technology to incentivise ways of working across GM, so that our ambitious aims can be realised. It describes the application of a radical new landscape of commissioning and provision towards a common purpose to maximise health benefit

Localities (~ ,000 people) Pan-Greater Manchester (3+ million people) x 1 Greater Manchester Clusters(0.5 – 1mpeople) x e.g. NW cluster x e.g. Salford x 50 e.g. Eccles Neighbourhoods (~50,000 people) Focuses on the delivery of integrated health, mental health and social care services through local neighbourhood teams. Staff and patients are empowered to make changes. Innovation is cultured here and spread across Greater Manchester. Provides the majority of acute IP NEL and IP surgical care across a defined number of clusters. This will include the right level of service consolidation that maximises value for money Commissions and provides a range of services that occur on a pan-Greater Manchester basis. This function also is responsible for the design of evidenced based interventions and supports with the adoption of innovation Single place based commissioning across CCGs and local authorities. Provides integrated health and social care services through Local Care Organisations (LCOs) A radically different commissioning and provider landscape in Greater Manchester can be layered into neighbourhoods, localities, clusters, and pan- Greater Manchester

5 GM Health & Social Care Transformation PLACE BASED COMMISSIONING Placed based commissioning in localities and a consistent approach to GM population health PRIMARY CARE AT SCALE The deployment of primary care at scale, acting as the foundation of integrated care in localities, organised with other Local Care Organisations ACUTE & SPECIALIST Single shared acute services coming together under Acute Care Collaborations. MENTAL HEALTH Implementation of our GM mental health strategy HEALTH INNOVATION Confirmation of priority programmes within the HInM pipeline ENABLERS Pricing and contract approach that aligns incentives; common approach to information to enable standardisation at scale.. A single Estate Plan SHARED SERVICES A unified and evidence based approach to Lord Carter’s findings POPULATION HEALTH & PREVENTION High impact approaches and programmes to lift life expectancy FROM APRIL 2016 WE WILL BEGIN TO IMPLEMENT:-

Ten Locality Plans Plans are being finalised locally… …within a GM wide framework. These will include Financial plan Governance Enable implementation of locality plans Assure delivery of health and social care Commissioning Sponsor transformational projects Population involvement GM wide performance GM wide risk Working with regulators Public and political engagement Locality Implementation Plans by 1 st April 2016

| 7 Taking charge Conversations about opportunities and barriers to people and communities taking charge of their own health and wellbeing Taking charge Conversations about opportunities and barriers to people and communities taking charge of their own health and wellbeing ENDORSEMENT of Locality Plans and Strategic Plan led by GM organisations, with media and PR support COMMUNITY & VOLUNTARY SECTOR AND HEALTHWATCH: reaching different groups including those who don’t normally engage COMMUNITY ROADSHOWS and social media support by media partners – reaching general public CROWDSOURCING online conversation to generate ideas, insight and solutions – significant potential reach across GM OUTCOME Increased public understanding of the impact and benefit of devolution, and begin to harness the ideas, energy and collective intelligence of the people and communities of GM around the opportunities and challenges to taking charge and responsibility Public and staff awareness/endorse ment of the plans How will we engage with staff and the public?

Key messages Greater Manchester’s leadership has confirmed its clear support for this direction of travel over recent weeks The transformations build upon and are consistent with the ambitions outlined in Locality Plans The transformation is not achievable purely as a public sector exercise – sustainability confirms the need for Wanless’ fully engaged scenario. These organisations must set a movement for change which will encompass the activity of hundreds of other organisations who can positively impact on the health and wellbeing of the population, through developing a different deal with the GM public to help residents take more control of their lives and improve their health We must explore a new relationship across the statutory and voluntary sector – defined by common purpose and principles of mutuality. The development of that agreement could be supported through the new VCSE Reference Group and the VCS Assembly, connecting to relevant public sector partners.