Presented by Warren Heppolette, Chief Officer for Strategy & Innovation, NHS Greater Manchester Integrated Care.
Warren Heppolette, Chief Officer for Strategy & Innovation, NHS Greater Manchester Integrated Care presented a report that confirmed the strategic priorities of the Greater Manchester Integrated Care Partnership (ICP). The report also set out how the integrated care system had been set up and organised to deliver on those priorities.
The report was also presented to further aid the Committee when discussing its priorities for the year and also to support its understanding of the organisation and operation of the wider integrated care system.
It was highlighted that The Improving Health and Care in Greater Manchester 2023-28 Strategy (the Strategy) followed engagement and discussion with the Committee earlier in 2023.
In presenting the published Strategy, it also set the scene for activities and challenges in the health and care system over the next five years and to help the Committee set and shape its work programme for the 2023/24 municipal year.
The Chief Officer for Strategy & Innovation lead the Committee through the statutory Strategy, which was the single core duty of the Integrated Care Partnership Board (ICPB) as a statutory joint Committee between the Integrated Care Board (ICB), NHS Greater Manchester and each of the Local Authorities (LA) in the Greater Manchester system. The Strategy also aligned with the objectives of the wider Greater Manchester Strategy.
The second statutory responsibility is to develop a joint forward plan.
A Member commented about the historical background of health and care in Greater Manchester and the challenges it had successfully overcome. Additionally, it was highlighted that the Strategy reflected the ambitions of Greater Manchester, wanting to do the best for all residents despite the current and forthcoming challenges.
A Member expressed concern regarding the delegation of responsibilities to localities and questioned how the ICPB intended to delegate its responsibilities to those localities. Officers recognised the need for delegation and assured Members that they had reviewed the governance structure of the ICP, ICB and locality boards. It was envisaged that 80% target of responsibilities would be delegated to localities and place-based partnerships operating across each of the neighbourhoods. In light of the review, governance would be reset, and an accountability framework would be established for the forward plan.
A Member enquired about the innovations and research initiatives within Greater Manchester and whether any developments could assist with issues such as waiting lists and preventative work. Reference was made to the establishment of Health Innovation Manchester in 2017 and the annual agreement which sought to engage with the universities in Greater Manchester lead by the healthcare system supported by industry to identify issues that could be addressed with new treatments, among other solutions. However, given it could take 15 years for a proven new innovation to enter the healthcare system, it was acknowledged that there was work to do to close the gap from discovery to delivery. It was suggested that this might be a topic for the Committee’s work programme.
A Member recognised that ‘health was more than medicine’ and asked how health inequalities would be managed through the Strategy, particularly considering the increasing number of individuals affected by the cost-of-living crisis. Officers described the way resources were delivered to NHS Greater Manchester using a needs based formula. It was acknowledged that there was work to do around resource allocation across the system as distribution was not necessarily matched to health need across the population. Whilst the solution was being understood, it was recognised that it should be open and transparent and respond to different sectors in the health and care economy. Work was taking place nationally supporting integrated care systems around resource allocation modelling, which would support considerations in this area for Greater Manchester.
A Member enquired about how the Committee would be kept informed of new concepts and treatments that were developed, implemented, or not deployed, as some concepts, as previously mentioned, could take up to 15 years to be fully implemented. Officers acknowledged that the system was not transparent and could be more publicly visible, however suggested that the committee could engage with Health Innovation Manchester on this topic.
A concern was raised about the Strategy being too NHS-centric and neglected adult social care, specifically that if adult social care was not properly incorporated, LAs would bear the cost burden for patients. Officers acknowledged the risk of an unbalanced focus on waiting list times. However, the Strategy was trying to be more balanced and noted as being more successful in doing so than other areas of the UK, but recognised that social care was more than just a discharge pathway.
2. That it be noted that the Committee received the Strategy to support its understanding of the operation and organisation of the integrated care system in Greater Manchester.
[WN1]Just need to make sure that there is a action of the Committee within each recommendation