The health and social care systems in Greater Manchester were under pressure with poor population health and high levels of provider activity alongside major financial pressure across health and social care. As a result, the system faces a £2bn financial challenge by 2020/21.

  • Secured commitment from the Chancellor to a bold proposition for devolution
  • Secured a £450m transformation fund for Greater Manchester based on the strategic financial framework
  • Supported Greater Manchester localities to develop coherent plans for transformation

Requirements to transform health and care services

Following the well-publicised devolution agreement with the government, Greater Manchester is the first English region to gain significant powers and responsibilities over health and social care spending. Greater Manchester has developed a strategy, ‘Taking Charge’, for the transformation of health and care services to achieve clinical and financial sustainability.

Working from beginning to end

We worked with Greater Manchester from inception, through the development of a strategic plan and negotiations with NHS England to the early stages of implementation. Delivering the following four things:

1. Development of a strategic financial framework

We developed a strategic case for an integration investment fund that would facilitate service integration and transformation in primary, community and social care. As part of this, we supported negotiations between Greater Manchester and NHS England on the development of a Memorandum of Understanding for the devolution of NHS resources and decision-making. Specific outputs included:

  • Working with Finance Directors of CCGs and Local Authorities to capture current spending plans
  • Analysing spend to identify problems and understand the size of the ‘financial gap’ across Manchester’s 37 organisations
  • Developing plans for improvement by quantifying potential opportunities for change
  • Producing a strategic financial framework

2. Development of a Greater Manchester -wide estates ledger

We developed an estates ledger and a high-level estates strategy then examined the scope to build, refit or exit estates to better fit future requirements. The ledger contains properties with a total of 2.2m m2. This includes:

  • 575 mental health and community sites
  • 503 GP practices
  • 281 acute site
  • 181 local authority sites
  • 129 ambulance sites

3. Design of the transformation fund

The transformation fund supports the transition to new models of care. We supported decision-making about all elements of the fund, including the process for applications, the criteria for making awards and how to ensure a strong return on investment. Specific outputs included:

  • A comprehensive list of design questions and ‘to-dos’ for the transformation fund
    Proposed models for the most important processes e.g. applications and awards
    A rapid assessment of early proposals for Greater Manchester-based vanguard

4. Coordinating finance and activity planning for the five-year strategy

The top-down five-year strategy needed to be reflected in the detailed plans of 10 ‘localities’ across Greater Manchester. We supported this planning through the following:

  • Templates for five-year finance and activity planning, completed by 37 organisations across Greater Manchester
  • Provided analytics support, comparing the aggregation of these 37 templates to the strategic plan
  • Workshops with leaders across Greater Manchester to understand the strategy in detail