Manchester and South Yorkshire mayors given more powers over health

Mayors in Greater Manchester and South Yorkshire are being given greater powers to improve the health of their populations, under Government devolution plans.

New NHS ICB board chairs will be appointed for each region who will also serve as the mayor’s health commissioner to help support more joined up local services and implement the 10-Year Health Plan.

Under the trial, the health commissioners will be tasked with driving improvements that directly improve population health with accountability directly to the democratically-elected mayors Andy Burnham and Oliver Coppard.

Health secretary Wes Streeting said both mayors had placed public health at the heart of their agendas.

‘They have more influence over what determines health, in their regions, as mayors, than I do, as their health secretary.

‘Their theory of change is that if they had more levers and more control, they’d spend money more wisely and deliver better health outcomes across their regions.

‘So we’re going to put that to the test with two new health devolution deals.’

Mr Streeting said the new health commissioners would continue to drive improvements to health system performance, but the mayors would take responsibility for driving improvements to health and care ‘from cradle to grave’.

They will be expected look at a range of local factors that impact people’s health including transport and housing.

It will test ‘whether this model would be more effective at driving the shifts from hospital to community, from sickness to prevention, than the conventional NHS model’, Mr Streeting added.

Greater Manchester mayor Andy Burnham said they had already built a ‘strong model of partnership working across the NHS, local government, our voluntary and faith sectors, and community partners’.

‘A study published in The Lancet in 2022 found that, following the devolution of health and care, healthy life expectancy rose faster in Greater Manchester than other areas before the pandemic.

‘Now we have the potential to get back on track and go even further, creating the right conditions for everyone to live healthier lives.’

He added: ‘For too long our public services have been trapped in short-term cycles of costly crisis intervention.

‘We want to show that investing in early help is a more effective way of spending public money – providing support to improve people’s lives and prevent them falling into crisis in the first place.’

South Yorkshire’s Mayor Oliver Coppard for too many people, being born in South Yorkshire means growing up and growing old in poor health.

‘That’s why I’ve made health a focus of my job from day one of becoming Mayor; because I know too many people face too many barriers on their journey to becoming and staying healthy.’

He said devolution ‘gives us the chance to take control of our own future’.

Katherine Merrifield, assistant director at the Health Foundation, said the move was an important step for devolution, and the focus on shifting resources towards prevention and community services was welcome.

But how it would work in practice, including what powers mayors will actually have to influence NHS priorities and spending, ‘remains unclear’.

‘There is a risk in framing this as a test between “NHS-led” and “mayoral” models.

‘Improving people’s health is not something the NHS can deliver alone. There is clear evidence that the building blocks of health sit outside healthcare – in housing, employment, transport and the wider environment.

‘Any model that doesn’t fully integrate these levers risks falling short on prevention.’

There is also a risk that mayors are pulled too far into NHS priorities rather than considering the wider determinants of health.

‘Changes to local governance and structures will also need to be matched with changes in national policy, for example, to establish a coherent strategy for improving health alongside sufficient resources for local areas to deliver it.’

Last week, the Government announced the first 27 sites for the new neighbourhood health centres pledged in the 10-year plan.