1. Taking Charge
Lord Peter Smith, Leader of Wigan Council

2. Healthy Life Expectancy
England
Manchester
Surrey
Male
63.4
56.1
67.4
Female
64.0
54.4
68.9

3. Greater Manchester: a snapshot picture
Good context slide for what we are trying to tackle and the fact that we need to work across public sector to tackle the wider determinants of health. – we know that if people are in good employment, they enjoy better health. We know that our children with a stronger start in life will progress through our education systems and develop the skills they need in adult life.

4. Benefits of GM Partnership
Integration of care at all levels
ICOs
Keeping people out of hospital and getting them out as soon as possible
Prevention

5. A comprehensive framework for transformation underpins GM’s Strategic Plan
STANDARDISING ACUTE HOSPITAL CARE 3 1
RADICAL UPGRADE IN POPULATION HEALTH PREVENTION
STANDARDISING CLINICAL SUPPORT AND BACK OFFICE SERVICES
TRANSFORMING COMMUNITY BASED CARE & SUPPORT 4 2 5
ENABLING BETTER CARE

6. Population Health Transformation
Creating dementia-friendly pharmacies
Sport England MOU

7. Health as a social movement
Connecting and catalysing a social movement for cancer prevention – what we are doing…
Recommendation – the golden thread through the six principles for new care models

8. Transformation Fund £450m To make sustainable improvements to care
Agreed for Tameside, Manchester, Salford and Stockport
Wigan and others in Pipeline

9. Funding Issues £6bn overall health budget Gaps up to £2bn
Savings from workstreams

10. Standardising Acute & Specialised Care
There are 15 NHS trusts and foundation trusts providing acute, mental health and community care across GM.
Their dedicated staff deliver high quality care to the population of the region in the face of growing
demand and tight budgets.
The present system is, however, not financially sustainable and it does not deliver the consistently high standards our population deserve. The total forecast deficit for these provider organisations is forecast to be £1.4 billion by 2020/21 before taking account of cost improvements. NHS trusts in GM must change and evolve to meet today’s demands and the changing demands of the future.
Plans for our acute services will be developed with the public, patients and carers. They will be generated through the GM governance arrangements and by the Provider Trust Federation Board to enable greater collaboration between trusts.
The focus of work for trusts will cover:
● Improving the safety and quality of services
● Improving productivity: hospitals are drawing up plans to achieve
efficiency savings of 2.5 per cent in 2016/17, and 2 per cent per
annum in subsequent years
● Improving delivery: hospitals are working to introduce new care
models to avoid emergency admissions and cut very long lengths
of acute hospital stays. Trusts are working to deliver the four
priority clinical standards for seven day working as part of the first
phase of implementation by 2017
● Increasing collaboration: trusts have agreed to a programme of
collaborative efficiency and to joint working to achieve significant
savings targets
Whilst a large part of the improvement in GM will come from
investment in and expansion of prevention and integrated primary
and community services, we want to improve the quality, consistency
and efficiency of services across the region and make sure there are
adequate specialist staff present at the time of high risk procedures.
Providers in GM are already working together to a greater extent, in
order to spread good clinical practice. This focuses on maintaining
local access to clinical services which might otherwise not be
sustainable due to workforce shortages as well as achieving
economies of scale through sharing services across GM. This
ensures that the vast majority of acute care remains accessible in
local hospitals whilst only the more complex treatments are provided
in specialist centres.

11. Enabling Better Public Services

12. Our Governance

13. Making it Real Cancer Mental health Disabilities
A great example of how working together across GM can create improved services is the work we are doing on cancer. Our goal is to push GM’s outcomes and survival rates to at least the national average and to ensure, through prevention, that fewer people have cancer.
GM has some of the very best cancer services and clinical outcomes in the country. One year survival rates have increased faster than elsewhere over the last 15 years and have now surpassed the average for England. But it also has some of the worst rates of premature death from cancer because of lifestyle factors for example smoking and delays in patients seeking help.
More than a quarter (28 per cent) of cases of cancer are diagnosed in A&E, when it is often too late for treatment to be effective. We also know that how people access services varies across different places.
As part of a GM Cancer Strategy by 2021, our vision is that we will have:
● a single GM cancer commissioning organisation to manage and monitor cancer services
across GM
● a system leader that will be accountable for integrating all elements of cancer prevention and
care
● a strategy for partner engagement to drive improvement
● innovative models of care such as delivering services closer to home
Mental health
A ‘transformational commitment’ is being made to improve mental health services in Greater Manchester, with a new approach to prevention expected to tackle the root causes of mental illness at an earlier stage.
Greater Manchester currently suffers from some of the poorest levels of mental health in the country despite spending £600million on delivering mental health services every year. However, with mental health and wellbeing being such an important factor across all forms of ill health, it is estimated that the wider economic cost of mental health to Greater Manchester is approximately £3.5bn.
We have agreed a comprehensive mental health strategy for GM which will benefit patients needing treatment and support for a whole range of mental health requirements.
This includes tackling priority areas such as: first response/street triage, suicide prevention, children’s mental health needs and dementia.
Learning Disabilities
Greater Manchester is committed to significantly re-shaping services for people with Learning Disabilities and/or autism. The re-shaping that will take place will ensure that more services are provided in community based setting and closer to home, with a shift away from long-term hospital care.
Greater Manchester’s ambition for Learning Disabilities and Autism services is predicated on four key objectives.
Where do we want to be?
60%+ reduction in non-secure beds –
40%+ Reduction in the number of secure commissioned beds –
Improving in / out reach intensive support – this will ensure greater support within a community based setting (including more crisis support options) and enable the reduction in the number of beds required. Our redesigned / re-profiled community services will adopt principles of positive behaviour support which will filter through into commissioned contracts and workforce development programmes.
Expansion of community based accommodation – This work will be made possible with an accompanying expansion in the specialist residential flat models in GM providing additional supported home placements.
Local/Integated care organisations – 3 now set up Tameside and Glossop, Salford, Stockport.
Aim to provide patients with better access to GPs, pharmacies and community care, improve mental health services and reduce the length of time patients are needlessly spending in hospitals.
£60M of Transformation Money already earmarked for Taneside and Glossop, Stockport and Salford.
Disabilities
Local/Integrated Care Organisations

14. Issues Health Outcomes Patient care Funding Workforce staff shortages
Engagement