Greater Manchester (GM) is pitching itself as a prevention demonstrator for the rest of the country, its Mayor Andy Burnham has said.
Speaking at the Care closer to home conference, held by NHS Confederation yesterday (30 April), he said prevention has ‘never’ been done properly in the country because the system is not set up for it, but that GM has an opportunity to do so due to devolution.
This will be through a ‘live well’ service, which will bring together public services to enable people to live healthier, better lives.
Mr Burnham said: ‘This is our most exciting decade yet [2025-2035], because we’ve [GM] actually got the structures to do something. The combined authority model is the right vehicle, a body that is built from the councils, from the bottom up and then is in a position to look at housing, work, education, policing, crime, all in the mix,’ he said.
He added that if GM can get everything it wants in the current spending review, which would be full devolution of ‘everything that can be devolved’, including employment support, technical education funding, and the affordable homes programme, then it will have the power to ‘lift up communities and get stronger and stronger’.
This would also be a way to use funding that was not in the health budget, he said, for example the £6bn employment support budget, which he said was ‘absolutely the thing to look at to start really investing in prevention’.
‘We’re saying route that employment support funding through our local community and voluntary sector, and we will get more people back to work, but then the health benefit comes with that,’ he said.
As part of this service, job centres would be renamed ‘live well’ centres where people could access social prescribing alongside housing, debt and employment support.
He added that the live well service would be an ‘all services’ referral, and so would include health, council and police staff.
‘You’ve got to turn the narrative around by empowering people to move forward and improve their health, rather than passing them from pillar to post within the different silos and the negative interactions they sometimes have with public services, particularly the DWP,’ he said. ‘If we land this, I think prevention becomes possible.’
‘I want to get to a point where it’s hard wired into the systems,’ he added. ‘What I mean by that is at the 8am rush for appointments at the GP surgery, I want GP receptionists to be able to say I can’t get you an appointment with the doctor today or even this week, but I can get you a live well appointment today.
‘That’s what I have in my mind, a system that that front door can provide that instant social support as instant as a prescription. That is the kind of paradigm shift that that is the shift from treatment to prevention that the health secretary is rightly talking about.’
However, Mr Burnham also raised concerns about the upcoming 50% cuts to ICBs, saying it posed the risk of putting health ‘back in a silo’ in GM.
‘I have concerns about the reorganisation that came out of nowhere,’ said Mr Burnham. ‘I would urge a bit of stepping back.
‘Does this mean ICBs get shrunk back to a sort of chasing targets type [organisation]? I would argue against that very much, slimming them down with a very narrow focus. I think that it’s almost to put the health service back in a silo in GM and I would be very worried about that, that would be the wrong way to go.’
GM was given control of the region’s £6bn health budget in a devolution deal in 2015.
A study last year found that this devolution of power had led to improvements in health services and outcomes, partly due to the development of collaborative relationships in the area.
