Greater Manchester's visionary approach to integrated care Delivered by the Greater Manchester Health and Social Care Partnership Day Two, Pop-up University 8, 16.00

1. Greater Manchester’s Visionary
Approach to Integrated Care – Local
Care Organisations
Warren Heppolette - Strategic Director Greater Manchester GMHSC Partnership
Andrew Webb - Corporate Director, Services for People. Stockport Council
Keith Darragh/Bernadette Enright - Divisional Directors-Salford Health & Social
Care

2. GM Devolution – Background
•Greater Manchester Devolution Agreement settled with Government in
November 2014. Powers over areas such as transport, planning and
housing – and a new elected mayor
•Ambition for £22 billion to be handed to GM
•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
•From April 1st
- Greater Manchester has taken charge and taken
responsibility – in a historic first, devolution has handed the power,
responsibility and £6billion budget over to the people and the 37 local
authorities and NHS organisations, primary care and other partners

3. 3
Greater Manchester: a snapshot picture

4. Aligning reform in GM

5. | 5
Vision
To deliver the greatest and fastest possible
improvement to the health and wellbeing of the
2.8m people of Greater Manchester

7. CONTEXT
• Systemic challenges; skills, work, health, housing,
inequalities
• Healthy life expectancy considerably lower than GM &
England
• Facing unprecedented public sector austerity and
questions over future viability

8. CLEAR AMBITION
• GROWTH – post 16 learning, housing, improved transport
connectivity, investment in business, dark fibre.
• Leading INNOVATION – transforming public services / new models
of service delivery.
• PLACE focus on improving HLE
• ONE SYSTEM approach to health and social care
• Aim - professional and financial SUSTAINABILITY

9. CARE TOGETHER
• Health and Social Care REFORM, single system leadership
• Single commissioning function
• Risk stratification of population
• Active focus on PREVENTION of illness
• Increased volume and scope of care, treatment and rehabilitation in
the HOME & COMMUNITY
• Excellent, responsive acute services when necessary
• Use of FT license to create ICO

10. ICO PROGRESS
• Significant improvement in key metrics
• Successful receipt of Community Services
• Pilot schemes for transformational schemes commenced
• Development of implementation plans to create integrated
neighbourhoods
• Future organisational form (including new name) developed
• Engagement and organisational development programmes
commenced

11. COMMISSIONING PROGRESS
• Integrated Commissioning Fund of £442m
• Single, clinically led commissioning decision making
• Single commissioning management structure in place
• Co-location of commissioning teams
• Approved 5 year Single Commissioning Strategy
• Development of system wide outcome measures

13. Stockport Together structure
Joint
Commissioning
MCP Board
Joint Provision
through MCP
Integrated Multi-Disciplinary
Neighbourhood Teams
GP clinical
leadership
x8
Social
Services
Mental Health
Community
Services
Pooled budget
circa £200m

14. The business case
• Three objectives:
• Create a new provider
form
• Create a new
contractual form
• Create a new care
model
• Four workstreams:
• Healthy Communities
• Core Neighbourhoods
• Borough-wide
Services
• Acute Interface

15. Structure of the MCP
A&E All outpatients
Diagnostics Acute Medicine
All adult social
care
All adult community
services
All community mental health servicesAll Stockport GP practices
Step 1:
Loose Alliance
Step 2:
Formal Alliance
Step 3:
Integrated Care
Organisation (ICO)
Step 4:
ICO plus budgets

16. Commissioning pledge
We pledge to develop an integrated commissioning function for health and
care in Stockport that:
is designed by the local experts and supports innovation
is informed by local needs and views to look after the whole population and
address health inequalities
coproduces a system to improve outcomes for our population
ensures that we meet all our statutory duties
…….and delivers our new model of a financially sustainable,
democratically accountable, integrated system in Stockport.

17. The MCP will:
• Invest more money in Primary, Community and Mental Health Care
• Implement a new fully integrated model of health and social care that will
create the capacity and capability (the community alternatives) to deliver the
right care and support in or close to peoples homes rather than in hospital
• Deliver a new model of care that is based on the best available evidence of
what works
• Get organisations to work together to deliver this vision in a new type of
organisation : a Multi Specialty Community Provider (MCP) and ultimately
Accountable Care Organisation (ACO)
• Deliver £38m savings over the next 5 years by providing better care

18. GP Provider
Organisation and
Neighbourhood model

20. ICO Phasing
Maintain Quality and Assure Safety

21. ICO Implementation
Approvals
•Due diligence – quality and sustainability of transferring services
•NHS Improvement – authorisation required
Key plans and agreements
•Post Transaction Integration Plan – first 100 days, technical integration
•Quality Governance Plan – maintaining quality and safety
•System Governance Framework – transformation plan and decision-making
Commissioning and Operating Principles – framework for providers to integrate
and transform services
•Risk Share Agreement – managing the financial consequences of change at a
system level
Shadow arrangements - Opportunity to learn and test approach

22. ICO Quality Governance
• Framework:
• Initial focus on:
• Serious Incidents
• User experience
• Complaints
• Key Issues:
• Harmonisation of systems
and processes
• Social Care “Voice”
• Professional Accountability
• Cultural Alignment
• Quality and safety in the
supply chain

23. Local Transformation Approach
1. ICP for Older People1. ICP for Older People 2. ICP for Adults
3. Integrated
Neighbourhood
Model
3. Integrated
Neighbourhood
Model
GM Devolution Transformation WorkstreamsSalford Together
Alignment with GM Local Care Organisation model
 Enable conditions to be managed at home and in
the community
 Provide alternatives to A&E when crises occur
 Support effective discharge from hospital
 Help people return home and stay well

24. The End
Any Questions
Email - GMHSCcomms@nhs.net
Website - www.gmhsc.org.uk
Twitter - @GM_HSC
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