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2. Our collective ambition for Greater Manchester GM has a history of ambition and cooperation. Skilled, healthy and independent people are crucial to bring jobs, investment and prosperity to GM. We know that people who have jobs, good housing and are connected to families and community, stay healthier. We need to take action, not just in health and social care but across the whole range of public services, so people can start well, live well and age well. | 1

3. A challenge and an opportunity The challenge is big; less money year on year, but higher demand for services. We need to Start now and do things differently Don’t spend money on services that don’t work Share ideas, buildings, expertise and spending on services that do work; Otherwise in 5 years by 2021, More people will have poor health, Some services won’t exist We will be facing a £2 billion debt for health and social care services. The opportunity is also huge; we have the power and flexibility to make changes happen, but we need everyone to be a part of this. | 2

4. Looking at four big areas and £450 million to fund improvements: Start well, live well, age well – prevent more ill health. Local community NHS, care and support services working better together Hospitals working more closely together Sharing buildings, roles, ideas and ways of working. | 3

5. Why do this? – some Greater Manchester facts More than two thirds of early deaths could be prevented by lifestyle changes. More than a fifth of GM’s 50-64 year olds are out of work and on benefits, many because of ill health. If more of this age group where in jobs their earnings would result in 16,000 fewer GM children living in poverty. Nearly 25 per cent (700,000 people in GM) have a mental health or wellbeing issue which can affect everything from health to employment, parenting and housing. We spend more than £1 billion on long term conditions linked to poor mental health. | 4

6. People with severe mental illness are likely to live at least 8-12 years less than average (10-15 % shorter). On any day there are 2,500 people in a hospital bed who could be treated at home or in the community. Four out of ten children are not ready to start school when they’re five-years-old; and four out of ten leave school with less than five GCSEs. In five years, by 2021 there will be 35,000 people with dementia; more than 10,000 will have severe symptoms and need 24 hour care. | 5 Why do this? – some Greater Manchester facts

7. Potential benefits in five years, by 2021 Aims (more to be developed in the coming months): | 6 16,000 fewer children living in poverty by increasing the number of parents in employment. 1,300 fewer people dying from cancer. 600 fewer people dying from heart disease. 580 fewer people dying form lung and breathing diseases. 270 more babies born a healthy weight – better for long term health. More children reaching a good level of social and emotional growth with 3,250 more children ready for the start of school aged five. Supporting people to stay well and live at home for as long as possible, with 2,750 fewer people suffering serious falls.

8. Find out more: E-mail: gm.devo@nhs.net Website: www.gmhealthandsocialcaredevo.org.uk Twitter: @GMHSC_Devo | 7 To join in the conversation and for your chance to win a set of family bikes please fill in a quick health snapshot www.takingchargetogether.org.uk

9. THE PLAN COVERS PEOPLE OF ALL AGES Getting a Good Start Thriving children who get the health and nourishment they need to develop and excel. Living Well Resilient adults who are willing and able to take care of themselves and their children Ageing Well Older people who can live a fulfilling and independent life 8

10. OUR VISION LOCALLY By 2021 more people will control their own health and wellbeing, managing their long term conditions well and supported to achieve good health and wellbeing across their life Success will mean more people living healthy longer, not just living longer Our priorities  Extending lifestyle and behaviour change programmes – make changes as early as possible  Strengthening community engagements and ownership of health and wellbeing  Targeting and supporting children and adults at risk before problems set in.  Extending local mental health and wellbeing services, with support for individuals and community groups to get stronger  Integrate the commissioning of health, care and wellbeing so that services meet all the needs of the person 9

11. OUR PLEDGE: We will We will : Transform public services, mobilising people, recognising their strengths and abilities and not just their needs Redefine the relationships between local people and professionals based on a partnership of equals. Organise the system around you, creating joined up services across all agencies Put in place a system so local people can control their health and care needs, as well as choice about how they are met Work to reduce health and social care differences in our borough and close the gap with other areas 10

12. WE NEED YOU TO: 11 with each other and your local communities Connect Take steps to stay healthy from birth to old age Take notice of yourself, others and of your surroundings Keep learning throughout life Support And help others Not to misuse or waste public services

13. THRIVING AND COPING Local people will -  Feel more able to connect with others to develop strong social networks  Live, work and play in settings that support health and wellbeing from birth to old age  Access preventive services offered, and we will reach out to those who don’t and ensure that people are aware and act on early signs of problems  Be supported to take as much control of their own lives as possible We will -  Tackle the causes of poor health including poverty, debt, housing, unemployment, environment and crime and reduce negative impacts on health and wellbeing  Extend mental wellbeing and resilience work  Enhance and enable successful volunteering, self- help, self-care and community action  Provide behaviour change programmes to tackle lifestyle priorities, e.g. tobacco, obesity, blood pressure, alcohol; and encourage aspiration and motivation to change 12 Connecting our services with each other and with communities better.

14. COMMUNITY SERVICE HUBS  Buildings will be inviting and encourage people to attend  Hubs will support local peoples’ journeys through the system  Care and support at the right time in the right place.  Identify high risk cases and prioritise the support they need  Determine if support is needed for issues such as mental health, drug or alcohol problems, domestic violence or neglect and refer into ‘Getting help’ locality based teams.  All agencies will work together and share information at all points in the system 13 Four community service hubs will deliver a remodelled health and social care system. Early access and shifting the balance towards preventative care Coordinated support Helping residents access help when they need it. Tracking patients through the system Preventive and proactive intervention with local people of all ages

15. GETTING HELP We want to increase people’s confidence, independence and wellbeing to support them to cope better and live well with their long term health conditions. We will -  Ensure that people with multiple or complex conditions receive coordinated and proactive help  Extend the range of help available for people with ongoing long term conditions, taking a personalised approach to care planning.  Extend the range of care and support for carers  Bring expertise out of intensive services to support people at home where necessary  Develop and implement an early help offer for all ages  Extend the care and support services available to people at, or near, the end of life.  Streamline access to housing advice and support 14

16. GETTING MORE HELP We will -  Enhance community provision of service  Increase the use of assistive technology  Manage patients / local peoples’ disabilities and long term conditions better with an initial focus on Dementia  Commission a more responsive reablement and rehabilitation service  Roll out integrated elective care pathways  Repatriate all existing patients with learning disabilities back to the borough  Provide more flexible and responsive respite services  Deliver a clear ADS pathway 15 We will prevent escalation to ‘Getting specialist help’ by managing and supporting local people within this element to allow step down to ‘Getting help’ and to support the prevention agenda

17. GETTING SPECIALIST HELP We will -  Repatriate local people back to the borough or Greater Manchester from out of area placements and reduce the number of children with complex needs placed out of borough  Commission local provision of specialist / forensic learning disability treatments  Deliver GM Learning Disability Fast Track objectives  Build local foster care and adoption capacity to meet local demand  Ensure synergy with the GM Trauma Network, GM Neuro Rehabilitation services and GM Healthier Together Programme for those who need specialist help and to improve outcomes for people with cancer 16 We will manage local people within this element to help them step down to ‘Getting more help’ where appropriate

18. MENTAL HEALTH We will –  Embed the Five Ways to Wellbeing  Provide assessment closer to home  Shift the balance of current system  Strengthen the ‘Getting help’ offer for Mental Health All Age provision This programme cuts across each of our other Programmes Support for people with mental health conditions will be provided within all offers, whenever possible We will reduce the number of people reaching mental health crisis through rapid access to the right level of support and a managed approach to care 17

19. SYSTEM TRANSFORMATION We will focus on key change programmes. They will be delivered on a borough-wide level to create a new cooperative relationship between local people, business and agencies. Behaviour change Co-design of services Marketing Quality Improvement 18 This programme cuts across each of our other Programmes ‘ Rochdale Change Co-operative’ will drive radical and sustainable change in how health and social care is delivered. We will challenge current norms for public service delivery, identifying new and innovative ways to work by developing local talent

20.  Do our plans make sense?  Is anything missing? NEXT STEPS  We want to work with you and local people further to deliver these plans 19