The government has given a very clear message: devolution is a critical route to reforming public services.
The chancellor’s first major post-election speech endorsed his commitment to delivering “radical devolution to the great cities of England”. It was no coincidence that he chose Manchester as the location to deliver his speech. It was in Manchester’s Museum of Science and Industry, 12 months ago, that he first challenged our cities to raise their game in delivering economic growth.
By building on several years of conversations with the government, Manchester has led that charge by signing a significant devolution agreement. It’s a wide-ranging deal but one of the biggest parts is the devolving of the health and social care budgets by April 2016. Manchester will take control of an estimated £6bn per year, allowing it to deliver new models of integrated care which reflect the needs of the local population.
The route Manchester is taking has the main providers as partners in the process of delivery rather than simply being the recipient of commissions. Public bodies will need to incorporate elements of both the private and public sectors to create new delivery models and possibly new services.
Reaching April 2016 will not be easy, not just because there is a huge amount to do in a short time period. The plan will challenge organisational boundaries and current delivery structures.
This means that strong and adaptive leadership and relationships will be crucial. With so many stakeholders involved it will be easy to get diverted or make compromises. Those involved cannot be diverted from the end goal, even when they feel like reverting to old ways of doing things, as this will only lead to short-term gains.
With complex delivery structures, it is often the people served by the organisation that has not invested who would benefit the most from that investment. For example, local councils do not have the funding to invest in preventative social care services that could reduce the need to deliver services in a different part of the system. However, if all beneficiaries were to pool budgets for, say, five years, they would have funds with which to deliver improved services.
As both budget and targets are shared, partners would need to take steps to ensure that appropriate measures are in place for those who would want to use that pooled resource. This means allocating those shared funds in line with the needs of the locality.
The deal provides the opportunity to move towards a preventative approach to health and social care, therefore it will require data to be used in a more intelligent way. Public organisations collect huge amounts of data, but many don’t have enough resources or expertise to turn that data in to meaningful information.
Once their working agreement has been reached, they will need to find a way around this shortcoming, and then use that information to tailor services to meet the needs of those who most need them.
Mike Blackburn, chair, Greater Manchester Local Enterprise Partnership, and BT regional director for the north-west