IT issues for Manchester NHS devolution

Plans to give Greater Manchester control of an integrated £6 billion NHS and social care budget will need to overcome the technological obstacles of systems integration and data sharing, health IT experts say.

The government has revealed that it is working with NHS England, Manchester’s councils and ten clinical commissioning groups to establish a pooled health and social care budget controlled by the region.

The £6 billion budget will be the responsibility of a Greater Manchester Strategic Health and Social Care Partnership Board, which will establish strategies and priorities for the region and manage its whole health and social care system.

The board will sit above a joint commissioning board comprising NHS England, the CCGs and councils, charged with agreeing on region-wide spending for health and social care.

Sir Richard Leese, leader of the Manchester city council, told 'The Guardian' that the new umbrella organisation will be given control over public health, social care, GP services, mental health, and acute and community care from April 2016, tasked with improving efficiency and integration between services.

“Instead of it all being commissioned by a mishmash of bodies, it will be commissioned in a joined-up, coherent way,” Leese told the paper.

Management magazine 'HSJ' reported that a draft memorandum of understanding between NHS England and the region’s local authorities and CCGs lays out a proposal to establish the partnership board in statute by the end of the 2015-16 financial year. The document states that pooled budgets at a local level – between individual CCGs and borough councils – would be in place from April 2016.

There has been a recent drive towards better integration of health and social care, with the King's Fund calling for an end to the division between the two and the Department of Health choosing 14 areas as "integrated care pioneers" to lead the way on new models of care.

However, questions remain over the governance, finances and risk sharing associated with the Greater Manchester proposal. Karl Grundy, head of EHI Intelligence, told EHI News that more work will be needed on the technological aspects of joined-up care if the plan is to prove a success.

“Joined-up evidence will be great, but owning a budget is very different from owning joined-up services and technologies to deliver them. With no common ID of a citizen between health and local government, tracking patients though the care life cycle remains the biggest challenge for integrated care, not who has the budget.”

Natalie Bateman, head of health, social care and local government at TechUK, told EHI News the proposal is a positive step towards better integration between health and social care but should not be seen as a “silver bullet”.

Bateman said the Greater Manchester proposal will face the same IT problems as other integrated care projects, such as a lack of interoperability between disparate health and social care systems. “Another issue is that when patients move from inside Manchester to outside Manchester, their information still needs to follow them through those boundaries.”

Chancellor George Osborne said the government is currently discussing the proposal as part of a plan to better integrate health and social care and give the region greater control over its own services.

“It’s early days, but I think it’s really exciting development.  We’ll be working hard now with Greater Manchester and NHS England on getting the details right so the arrangements work best for patients.”

Dr Hamish Stedman, chair of the Salford Clinical Commissioning Group, said the proposal “is a genuine opportunity to enhance health outcomes for the people of Greater Manchester by aligning health and social care and public sector reform." He added: “Treating a person as a whole – rather than by separate conditions – is designed to bring long-term benefits and independence.”