0. Six Month Progress Review
Jon Rouse
Chief Officer

1. Taking Charge of Our Health and Social Care in Greater Manchester
In December 2015 we set out three main strategic objectives to be delivered by 2021.
Transform the health and social care system to help more people stay well and take better care of those who are ill.
Align health and social care to wider public services such as education, skills, work and housing.
Create a financially balanced and sustainable system and make sure services are clinically safe.
Our approach is to secure improved outcomes by overseeing system performance, improving quality, securing delivery of our financial plan and driving transformation.
This six month review gives an overview of our progress and the main challenges we currently face.

2. System Performance In our first six months we have:
Established a performance and delivery board
Established a GM outcomes framework
Developed a locality assurance framework
Established an urgent and emergency care taskforce
Created a single performance dashboard to track performance.

3. Performance Review: Cancer
Outcomes: We are slightly below the national average for cancer survival rates. 69.8% of people with cancer survive at least a year against a national average of 70.2% but the gap is closing.

4. Performance Review : Urgent Care
We are currently amongst the lowest performing in the north of England in terms of A&E waiting times and delayed discharges of care.
Our new urgent and emergency care taskforce is working with a number of systems to support the most challenged localities
We used the opportunity of devolution to create a £5m Fund to support all local areas in improving their system resilience as we move into winter.

5. Performance Review : Elective Care -Referral to Treatment
We have consistently performed above national standards. But pressures on waiting lists are starting to increase with some impact on performance levels.
Our task is to use our collective responsibility to ensure that providers are supporting one another when the pressure is on.

6. Performance Review : Mental Health
We have achieved an aggregated average performance of 1.31% access to IAPT services against a national monthly standard of 1.25%
We have achieved the target for 75% of people referred to IAPT to begin treatment within six weeks for the first time since the target was introduced.
We have not achieved the recovery rate of 50% yet with respect to IAPT services.
We have achieved above the national standard of performance for access to Early Intervention in Psychosis services.
We are commissioning a comprehensive, independent review of mental health provision to gain insight into areas of good practice and areas of under-performance.

7. Performance Review : Other Headlines
We continue to reduce the numbers of people in police custody when needing a place of safety during a mental health crisis. At 1% the rate is five times lower than England & Wales.
Our dementia diagnosis rate was 77.2%, well above the national performance.
We are just slightly behind our planned position in terms of moving people with learning disabilities and challenging behaviour out of long stay hospitals and back into the community.

8. Finance In our first six months we have:
Established Transformation Fund access and assessment process and made several awards
Created a fund to support development of Transformation Fund proposals across the transformation portfolio, and made two awards
All ten localities have set out five-year finance and activity plans ‘roll-ups’ to ensure a ‘bottom-up’ financial model for Greater Manchester.
Updated our financial plan based on the most up-to-date information
Made a clear evidence-based case to Government of the need for an increase in access to finance for social care in 2017/18.

9. Financial Performance
The first six months have delivered a financial position which is £3m better than planned, however, due to the phasing of the plan, the financial position at the end of the financial year is currently forecast to be a shortfall of £10m against plan, 0.2% of the overall budget.

10. Next Steps Before the end of March 2017 we aim to:
Coordinate the delivery of the planning round.
Pilot a Greater Manchester system control total
Sign off seven Transformation Fund investment agreements.

11. Quality In our first six months we have:
Reformed the Quality Surveillance Group to create a much more proactive Quality Board focused on improvement
Developed the new nurse associate role to pilot from Jan
Introduced the Learning Disability Mortality Programme.
Introduced a web-based system for reporting controlled drug incidents.
Developed a risk register covering strategic and operational risks.

12. Quality: Next Steps Before the end of March 2017 we aim to:
Develop guidelines for supporting mothers who lose a child in the second term of pregnancy.
Develop a hub where staff train in a new young people’s mental health care model.
Introduce a community service complementing the mother and baby unit at University Hospital South Manchester.
Embed our new liaison mental health standards.
Implement diabetes prevention programmes and test what works.
Work with The Christie to develop a cancer education resource for GPs.
Test and roll out referral systems to prevent non attendance and use text messages to communicate with patients.
Encourage participation in dementia research projects.

13. Transformation In our first six months we have:
Undertaken GM-wide engagement about being in control of their own health, to underpin the development of our population health plan
Agreed and endorsed a primary care strategy with partners, setting out how more effective integrated care will be delivered.
Facilitated development of plans for Local Care Organisations and Integrated Commissioning arrangements in all ten districts
Agreed the next set of projects for acute care standardisation and collaboration, and continued implementation of Healthier Together.
Made early investment in development of Single Hospital Service
Supported stabilisation of Pennine Acute Trust

14. Enabling Programmes Workforce
All 10 localities have drafted their own workforce plans
Negotiated agreement with key partners to develop GM Centre of Excellence for workforce planning and development
Commenced GM recruitment campaign for urgent and emergency care doctors
Information management and technology (IM&T)
Agreed an IM&T strategy that identifies priorities.
Digital maturity assessments completed by all10 localities.
Agreement to create single integrated digital fund and a single Digital Collaborative to set common standards
Salford designated Digital Global Centre of Excellence
Estates
All localities developed estate plans
Agreement reached with all relevant national and local partners on principles for future estate development.
Commissioning and Incentivising Reform
Published our five-year Commissioning for reform strategy and an implementation plan for the first year

15. Cross-cutting Programmes
Mental Health:
In the last six months we’ve developed or are developing:
A mental health strategy, governance and delivery plan.
A single specification for ADHD and eating disorder services.
A suicide prevention strategy.
An enhanced model of street triage.
A single commissioning framework for mental health.
New crisis support pathways.
Dementia:
In the last six months we’ve:
Led development of the Dementia United model. This has four key outputs – a set of Greater Manchester standards, locality profiles that show any variation, a proposed implementation model and financial model.
Made five pledges to make Greater Manchester the best place in the world to live with dementia

16. Cross-cutting Programmes
Learning Disabilities – Transforming Care:
In the last six months we’ve:
Supported more than 50 people to make the move from in-patient facilities to community placements and supported homes.
Started work to calculate the impact of ‘dowries’ paid to those discharged since 1 April 2016 after being in inpatient care for over five years.
Cancer:
Developed a single comprehensive cancer strategy for publication in New Year
Tested new clinical ideas and ways of organising cancer care as part of the National Cancer Vanguard.
Piloted an innovative lung health check service by the Macmillan Cancer Improvement Partnership to detect lung cancer earlier.
Piloted a new regional jaundice pathway delivering one-stop clinics and fast-track pancreatic cancer surgery.

17. Other Work in Progress
New Medicines Strategy Board to co-ordinate all work on medicines management, optimisation and innovation
New Children’s Health and Wellbeing Board to ensure coherent approach to children’s health needs
Memoranda of Understanding with Voluntary and Community Sector & Healthwatch
Development of learning disabilities’ strategy
Development of carers’ strategy
Developing review of out-of-hours GP services

18. To view the full reports visit:
@GM_HSC