Report of the Executive Director of Strategy / Deputy Chief Accountable Officer, Manchester Health and Care Commissioning

Part one of the report provides an update on the establishment of a Greater Manchester Integrated Care System/Integrated Care Board (ICB) and Manchester Locality Board. The Chair Designate for the ICB will attend the Scrutiny meeting.

Part two of the report provides an update on the refreshed Manchester Locality Plan which will ensure that local priorities continue to be delivered during the transition to the new arrangements in 2022/23.

The Committee considered the report of the Executive Director of Strategy & Deputy Chief Accountable Officer, MHCCthat provided an update on the establishment of a Greater Manchester Integrated Care System / Integrated Care Board (ICB) and Manchester Locality Board.

Key points and themes in the report included:

·         Subject to legislation passing through parliament, Integrated Care Systems (ICS) would be established in England from 1 July 2022;

·         The report described the four aims of the ICS and the national core building blocks of an ICS;

·         Greater Manchester would witness a shift from the Greater Manchester Health & Social Care Partnership (GMHSCP) arrangements to a new Greater Manchester ICS and Integrated Care Board (ICB);

·         Integrated Care Board would take on the functions of Clinical Commissioning Groups (CCGs) which would be disestablished on the 30th June 2022;

·         Manchester City Council and NHS leaders had both contributed to the developing GM ICS and ICB arrangements and worked to develop locality arrangements for the City of Manchester;

·         Describing the arrangements and function of the Manchester Partnership Board, noting that it would comprise of political, clinical and managerial leadership;

·         Sir Richard Leese had been appointed Chair designate of the Greater Manchester ICB along with two non-executive directors; and

·         An update on the refreshed Manchester Locality Plan which would ensure that local priorities continued to be delivered during the transition to the new arrangements in 2022/23.

Some of the key points that arose from the Committee’s discussions were: -

·         Recognising the sound foundations that had been established within Manchester to continue to support the continued integration of health and social care to deliver the best health outcomes for Manchester residents;

·         Did the Chair Designate of the Integrated Care Board recognise the concerns expressed that the model would present an opportunity for privatisation of the NHS;

·         Who would be responsible for the commissioning of dental services, noting the importance of commissioning preventative dental services;

·         Would the new model be more transparent and accountable in its decision making process;

·         The need to address the issue of staff recruitment and retention, recognising that this was a local and national issue;

·         The need to improve the physical infrastructure of the health service estate, noting that this also related to the climate change report that was on the meeting’s agenda;

·         The Board needed to reflect the diversity of the city; and

·         The need to recognise the significant impact the previous two years had had on staff working in the NHS to respond to the pandemic and any reorganisation needed to be managed sensitively with support offered to all staff impacted by change.

The Chair Designate of the Integrated Care Board stated that the proposed Manchester Locality Plan model and governance arrangements were a positive development to deliver improved health and care. He stated that this built upon the established and trusted relationships across partners in the city. He advised that he recognised the comments raised regarding the privatisation of services, however commented that he did not share these concerns. He further addressed the question regarding transparency and accountability by advising that the establishment of the Locality Boards as part of the GM Operating Model and governance arrangements would be accountable to both the Council and the ICB. He further commented that there would be increased public engagement as the model became established and encouraged local Councillors to be the voice of their residents also.

The Chair Designate of the Integrated Care Board stated that the wider determinants of health were fully recognised and the Marmot Beacon Indicators would be used as a measure to report progress and outcomes, adding that he remained committed to addressing health inequalities in Manchester and the wider city region.

The Chair Designate of the Integrated Care Board acknowledged the comments regarding the estate infrastructure, adding that he had undertaken a number of visits to various sites and witnessed the challenges. He commented that the NHS had been significantly underfunded for a number of years and required appropriate funding from central government. He further recognised the comments regarding the issue of recruitment and retention of staff and the challenge this presented, adding that work was ongoing to best manage and work with existing resources.

The Chair Designate of the Integrated Care Board stated that the removal of competition between local NHS Trusts was a positive improvement, adding that there was now a duty for them to collaborate.

The Executive Director of Strategy & Deputy Chief Accountable Officer, MHCC acknowledged the comments made regarding staff wellbeing during the organisational changes. He commented that this was fully appreciated and recognised.

The Executive Director of Strategy & Deputy Chief Accountable Officer, MHCC refereed to the discussion regarding the provision of dental services and noted that the Committee had considered this item at their meeting of 8 September 2021 (see minute ref HSC/21/35). He advised that currently NHS England commissioned dental services, however the legislation did allow for the commissioning of certain functions to be delegated to the ICS.

The Deputy Leader thanked the officers for the report and recognised the significant amount of work that had been undertaken to progress this work. She reiterated the point that Manchester had already established strong partnership working across the city to integrate health and care services. She commented that all partners continued to demonstrate their stated commitment to addressing health inequalities and that the Marmot Beacon Indicators would be used to measure outcomes and progress.   

Decision

To note the report and recommend that an update report be included on the Work Programme and scheduled for consideration at an appropriate time.