As part of the UK government's devolution agenda, English regions are being given the opportunity to bid for full control of their health and social care budgets. This potentially has significant implications for the NHS and presents both opportunities and risks for doctors.
The BMA is working to gather information about these regions to enable us to properly support doctors locally. We are also engaging with MPs and local political stakeholders so that they understand the views of doctors. The public affairs team is also actively lobbying on the Cities and Local Government Devolution Bill, which allows the Secretary of State to devolve healthcare functions to local authorities.
A number of other areas have also signed devolution deals. We have concentrated on the ones that involve health in a significant way.
The BMA's patient liaison group has been considering the appropriate level of patient engagement in the devolution of healthcare. Read more about the patient perspective on devolution.
Devolution - a patient perspective
Manchester's pioneering role
The move to deliver the devolution of health and social care in Manchester was formalised in March 2015, when a Memorandum of Understanding (MOU) was signed between NHS England, the Association of Greater Manchester Authorities (AGMA) and all Greater Manchester Clinical Commissioning Groups (CCGs), together known as GM. Responsibility for the £6 billion combined budget for health and social care in Greater Manchester was devolved at the start of April 2016.
The Greater Manchester Devolution Agreement, also known as 'Devo Manc', which will see responsibility for services such as planning, housing, transport and policing handed over to a directly elected mayor by 2017, will also see local authorities and health providers create an integrated health and social care system for the region.
Read about Devolution Manchester
Read our policy statement on delegation and devolution in Greater Manchester
The plans for transforming health and care provision across London, intend to address the inequalities in health and wellbeing across the capital. The London health devolution agreement and the London Health and Care Collaboration agreement have recently been published. The proposals have a number of structural and policy similarities to Manchester. However, there are also differences including the approach to requesting and establishing any formal devolution of powers through the Cities and Local Government Devolution Bill. Due to the complex nature of London’s health landscape, transformation will be a gradual process. It will involve piloting different elements of health and care devolution across London.
Cornwall signed a formal devolution deal with Government in July 2015. It commits Cornwall to ‘co-design’ a business plan to move toward the integration of health and social care in Cornwall and the Isles of Scilly, including plans to reduce pressure on accident and emergency and avoidable hospital admissions.
Liverpool City Region
Liverpool City Region signed a devolution deal with Government on 17 November 2015. The Chancellor announced the devolution of further powers and responsibilities on 16 March 2016.
Since the deal was signed the Liverpool City Region Combined Authority and all NHS partners have been in ongoing dialogue about greater health and social care integration, focussing on prevention. The CCGs across the Liverpool City region have formed a Committee in Common and they expect to shortly publish an interim report on the case for change across a number of health priority conditions with a strategy for tackling the issues in the report.
The North East Region
The North East region has established a Commission for Health and Social Care Integration. The aim is to establish the scope and basis for integration, develop deeper collaboration and devolution across the Combined Authority’s area, with the reported objectives of improving outcomes and reducing health inequalities. The Commission has carried out a call for evidence from local individuals and organisations to inform their work and will report later in 2016. The report is expected to look across the whole system, including acute care, primary care, community services, mental health services, social care and public health.
Read more about the devolution proposals as a whole in the North East region
Contact your regional co-ordinators below:
East of England - Hugh Townsend, [email protected]
East Midlands - Jim Stringer, [email protected]
London - Andrew Barton, [email protected]
North East - Ursula Ross, [email protected]
North West - Peter Forster, [email protected]
South East - Glyn Jones, [email protected]
South West - Sean Cusack, [email protected]
West Midlands - Alan Roberts, [email protected]
Yorkshire and Humber - Ursula Ross, [email protected]
What do you think about healthcare devolution?
Do you think Devo Manc is a model 'for others to follow'? Do you think there are any further opportunities or risks?
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