GP services will be commissioned by local authorities working alongside CCGs in Greater Manchester, with NHS England devolving all responsibilities for the £6bn budget under plans announced today.
The plans, which are currently being discussed by NHS England, CCGs and local authorities, would see the Treasury handing over a joint budget to 10 local authorities and 12 CCGs for providing joint health and care services, with no role for NHS England’s area team.
It comes as NHS England has announced that 67 CCGs will take control of commissioning GP services, but this latest announcement goes further than this, and would leave Manchester councils as being the only ones in the country to commission general practice.
The plans follow a November 2014 ‘devolution settlement’ announced by chancellor George Osborne to create a ‘powerhouse’ in the north of England.
NHS England said this move to devolve the NHS budget would require no further changes to legislation.
Simon Stevens, chief executive of NHS England, said: ‘NHS England is working on this groundbreaking offer to the local NHS in Greater Manchester and elected local authorities because we want to back local leaders and communities who come together to improve the health and care of their residents and patients.”
Dr Hamish Stedman, chair of Salford CCG, said: ‘This is a genuine opportunity to enhance health outcomes for the people of Greater Manchester by aligning health and social care and public sector reform. Treating a person as a whole – rather than by separate conditions – is designed to bring long-term benefits and independence.’
However, local leaders warned that primary care services could be at risk from the move.
Dr John Hughes, a GP in Manchester who has recently retired from the GPC and the LMC, said: ‘The first impression is that it is unexpected. It has been announced very close to the election and it is probably an attempt to dump the blame for any failures due to underfunding of services in the Manchester area to local authorities rather than the Government. As you’re probably aware from life expectancy data, life expectancy is pretty bad.
‘I suspect there will be a number of consequences for GP practices but I suppose the main concern is that the primary care budget may well be raided to support social care.’
The BMA said that this will stretch an already overstretched budget.
BMA chair Dr Mark Porter said: ‘There is no doubt that patients would benefit from more joined-up health and social care. However, any plans to do so would have to be underpinned by clear funding to ensure that an already dangerously over-stretched NHS budget isn’t used to prop up a woefully underfunded social care budget.
‘These wide sweeping changes will affect millions of people. We need to look carefully at exactly how they will affect the commissioning and delivery of services, and what the impact on patient care will be. We must also ensure clinicians have a central role in decisions over health care, something which was undermined by the Health and Social Care Act 2012.’