Sarah Price, Executive Lead, Population Health and Commissioning Greater Manchester Health and Social Care Partnership, shares how population health is being implemented across Greater Manchester at The King's Fund 2018 annual conference.
This is Greatest Manchester, the ten local care organisations based on ten local authorities. They are very separate places, but they come together as a whole and have a huge amount of work that they do alongside each other.
The vision for Greater Manchester was set out in our plan, taking charge for health and social care in 2016 and the basis of that plan was building localities in those ten areas, devolving responsibility as far as we could into those places and that we looked and built upon the work that they were doing across organisations. Somewhere like Thameside where they’ve managed, they can’t pool, but they’ve aligned about a £1 billion worth of council spend, of hospital spend, of CCG spend and bringing that together.
The trick for us really is taking the £6 billion worth of devolved funding and building that together with the 22 billion of public sector funding that’s available to the residents of our conurbation.
We’ve spent about £30 million now, or committed £30 million of money into population health specifically. We’re going to be looking at things like incentivisation for behaviour change through points providers, but we’re looking at those wider determinants as well as the sorts of investments one would traditionally make to improve the populations health and the coming together of our organisations means that we have less of a debate about where the money’s going to come from. One of the programmes that we’ve really focused on is work, getting people back into work. About 240,000 people are out of work in Greater Manchester and about 150,000 of those are there for health reasons and by putting a small amount of money into our early help scheme, we hope to be preventing people from falling out of employment when they go to the GP for a fit note, for example by providing them with support and help at that early stage which evidence shows really does make a difference.
Some of the more traditional things that we’re doing around health improvement are around smoking and tobacco have been in the hospital sector we’re just rolling out a cure programme which is based on the Ottawa model of treating tobacco addiction as that, an addiction and really actively managing people within hospital but that goes alongside a huge amount of work outside of hospital around thinking about illegal tobacco, looking at what we might do to change the attitude to smoking within the population. People are really up for more change about banning smoking in more public places, in parks, outside public buildings etc. and with that sort of support behind us, we think we can apply to, for national legislation around extension to smoking ban, control of tobacco sales through licencing of tobacco.
We are seeing early signs of this joined up working having an effect. We are seeing a reduction in smoking prevalence we think on the latest data we’ve got, that we’re reducing the gap between Greater Manchester and the rest of England. We’ve got a big programme, the first in the country, to do joined up commissioning with the police around liaison and diversion, so if you’re arrested and you have a health issue, mental health particularly, then you will be diverted out of the criminal justice system and supported rather than being left to go through the court system, and that’s having a really big impact on what we’re doing. That would not have been possible without the sort of joined up working that we’ve got in Greater Manchester.
Our biggest advocate is our Mayor. He sees the power of a city region as something that’s fundamental and he gave a very fantastic speech a couple of months ago now, about what it is to develop a vision for health and social care in Greater Manchester and he said as a Secretary of State for Health you can have a vision for health services, but as mayor of Greater Manchester you can have a vision for people’s health and I think that’s a real powerful statement to make and something that he is actually living through the devolution agenda and that he thinks that a real difference between those two that devolution holds the key to breaking down the silos between public services and moving from a picking up the pieces to a preventative approach and if we can achieve that in Greater Manchester, I think we’ll be doing a fantastic job.