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Healthcare Devolution – The Manchester Example

Healthcare Devolution
Andrew Delaney

Andrew Delaney

Feature writer at Chamber UK

In March, Chamber hosted the first Integrating Healthcare seminar in Manchester, a particularly salient example of healthcare devolution in action. Key figures from across Parliament and local and regional government were in attendance, as were clinicians and academics, to discuss integrated care systems (ICSs) and improving population health across the North West.

Throughout the day, several panels took place that covered areas relating to prevention, health inequalities, and cancer outcomes. Guests were treated to keynote speeches from two Members of Parliament – Andrew Gwynne and Chris Green.

Both Gwynne and Green drew on personal and professional experience when discussing ICSs and the issue of health inequalities in the UK, which left the audience engaged.

Healthcare’s Role in Devolution

The seminar opened with an address from Chris Green, MP for Bolton West. Green is the Chair of the All-Party Parliamentary Group on Medical Research and also sits on the House of Commons Health and Social Care Select Committee.

Green began his address by stating that “healthcare is always one of the most important issues we face as a country,” which has been amplified in recent years thanks to the COVID-19 pandemic. He then went on to talk about the role healthcare plays in devolution,

“Healthcare certainly fits into the devolution agenda at this moment in time. Devolution is becoming more common across the country and, in Greater Manchester, we’ve had a mayor since 2014. However, it wasn’t until 2016 that health and social care devolution came to Greater Manchester.”

“When health devolution came to Greater Manchester, it wasn’t desired locally for it to fall under the responsibility of the Mayor. Instead, there was an appetite for a local authority partnership model. Fast forward to 2022, we have the Health and Care Act, which has seen ICSs rolled out across the country and put on a statutory footing.”

In a positive outlook, Green also touched on the potential of ICSs. He said,

“Historically, if a local authority made savings on healthcare, they wouldn’t necessarily get to keep that money to reinvest in the area. ICSs have the potential to break down these barriers and to give local authorities the motivation to innovate the way they work.”

“Additionally, ICSs should allow for new relationships to be built with the life science sector, pharmaceutical companies, and universities. There is a huge opportunity for more collaborative working to get companies and organisations to invest and work in your local areas which, as a result, means a gain in expertise and finances.”

Programming, Prevention and Equity into Care Systems

The first panel of the day was titled Programming, Prevention and Equity into Care Systems and was hosted by Associate Pro Vice Chancellor for Innovation, Public Health, Policy and Systems at the University of Liverpool, Professor Iain Buchan. He was joined by three men who all have experience working with ICSs – Medical Director at NHS Cheshire and Merseyside, Professor Rowan Pritchard-Jones, Chief Executive at Mersey Care NHS Trust, Professor Joe Rafferty CBE, and local government expert, Geoff Little. A big focus within this panel was on the role of research within ICSs.

ICSs have been designed so that different parts of the health system work together as one unit to improve outcomes for patients. It means that services such as mental health and social care, for example, are now connected and work as one rather than separately.

Some have suggested that this new way of working will mean that research is less relied on but for Rafferty, this could not be further from the truth. He said,

“Research hooks into innovation and addresses issues such as young professionals who go to a certain city for university but then leave as soon as they graduate due to lack of opportunity. It’s still very much relevant and important – we need to take research and build out from it.”

“At the minute, many integrated care boards (ICBs) are dealing with urgent care. There’s a risk though, that this urgency drives out the need for a longer-term perspective. This is where research and data should come into it.”

Pritchard-Jones is also a strong believer in the role research can play within ICSs. Talking about the great work that researchers are doing in his ICS, he said,

“Our Directors of Research are currently creating an integrated research system where patients can access research closer to home, which will mean that we obtain better results, which in turn, will mean we can solve more problems.”

“As things currently stand, many deprived individuals have to take six buses to get to a research appointment, which just isn’t feasible. This new system has the potential to be a highly functional environment that works well for everybody.”

Cancer Outcomes and Health Inequalities

One of the most focused panel sessions within the seminar was on the relationship between cancer outcomes and health inequalities. This was hosted by Vice President of Strategic Planning, Northern Europe at IQVIA, Angela McFarlane, and she was joined on stage by three experts in the field.

They were Chief Executive Officer at North-West Cancer Research, Alastair Richards, Country President of Novartis UK and Ireland, Marie-Andree Gamache, and Chief Executive of Health Innovation Manchester, Ben Bridgewater.

A main focus of the seminar was the importance of addressing health inequalities at the start of people’s cancer journeys. Richards stated that this is “critical” as greater awareness around cancer signs and symptoms increases the chances of GP visits – vital for early diagnosis.

Bridgewater agreed, before addressing how innovation and data can play a key part in ensuring inequalities are addressed early on. He stated,

“You should be asking yourselves questions like ‘Have we got the right people with the right skills? Is our culture right? Do we have the right technology?’ We also need to gather data on patients who have experience living with cancer to understand what the barriers are. One size doesn’t fit all when tackling inequalities, so this data is essential.”

Moreover, Bridgewater asserted that “we still don’t have enough data expertise in the NHS”.

Another area that was discussed within this panel was the role of industry partners in a patient’s cancer journey. ICSs often utilise industry partners to provide services and support as they are able to help address specific healthcare needs.

In terms of cancer outcomes, Gamache believes that industry partners are key to understanding data. She said,

“We need to be thinking of health inequalities when first introducing new innovation and the best way to do that is to understand the patient journey and their needs. So, when partners are brought in, they are brought in knowing what they need to do so they can tailor solutions from the very beginning.”

She contended that their approach to ICSs involves a “triple win check” before suggesting solutions — a win for patients, a win for the company, and a win for the system.

Bridgewater, on the other hand, spoke about the importance of congregating a team of highly knowledgeable individuals. By including a range of people in the process, such as industry colleagues, academic colleagues, NHS staff, and digital colleagues, he stated that multidisciplinary teams can be empowered to “move things forward”.

Shadow Public Health Minister’s Address

To close the day, Shadow Public Health Minister, Andrew Gwynne MP, made an impassioned speech about his own experiences of health inequalities and how he hopes a future Labour Government would tackle them. Gwynne is the MP locally for Denton and Reddish in Greater Manchester. He said,

“I grew up in Denton West, which is one of the better areas in Denton, but my best friend at school grew up in Denton South. We went to the same school, had the same interests and hung around at the same spots, yet his life expectancy was ten years less than mine. This is a burning social injustice and it cannot be acceptable.”

“There is a feeling that if you want to be healthy, just be healthy. This line of thought doesn’t sit well with me. If it worked, then we would not be facing some of the highest obesity rates in Europe and health inequalities wouldn’t be widening.”

“Prevention is everything. Preventing people from being sick, preventing people from dying young, and preventing them from developing health complications. Departmental integration is an essential part of tackling these problems.”

“We need buy-in from every department in central and local government to make a difference because it will take more than action simply from the Health Secretary as health is linked with everything else.”

Final Thought

The Manchester seminar gave everyone in attendance invaluable insight into the thoughts and ideas of some of the biggest players in healthcare in the UK. It was a unique opportunity for political leaders to hear more from the local healthcare system about some of the key challenges impacting their population’s health.

The session also provided an opportunity for healthcare leaders to explain some of the key examples of best practice from across the North West. One of the key learnings was that partnership is critical for effective delivery of healthcare services. The public, private, and third sectors working together enable patients to receive the best access to services.

Curia is working with Chamber and a human data science company to hold more Integrating Healthcare seminars across the UK. To receive invites to the free seminars, register at www.chamberuk.com/newsletter.

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