Place matters. People who understand and are committed to improving the lives of local communities have always been the most effective leaders of meaningful change that makes a lasting difference to the quality of life for local people.
That is especially true of care and support services that are so central to the lives of many of the most vulnerable members of local communities and their families and carers.
Different areas will have different needs, from what services are in greatest demand, to how those services are delivered, to the ways in which providers work together to give the best integrated care. What works in an inner city council estate may not be best for a remote rural or coastal community.
Devolving health and social care powers to locally agreed geographical areas therefore makes absolute sense in terms of encouraging local people and public services to work together to make the most of available funding and deliver the very best and most appropriate care with and for the local population.
However, it must be recognised that some areas will have far greater needs than others, whether that is because there are more people needing care, people with more complex problems, or both, and funding must match the ambition in order provide the personalised, dignified care that our most vulnerable residents require. Even as powers and responsibility for delivery are devolved, there will need to be a national overview of funding to make sure this is distributed fairly, according to the levels of need in different localities.
The devolution of £6bn of health and social care funding to Greater Manchester is an exciting development. Providers there are aligning themselves around shared objectives to enable a ‘place-based’ integration of primary, community, mental health, social and acute care, and other public services. Those services will have prevention and early intervention at their heart and will be provided on the most appropriate levels – from neighbourhood or locality, up to cluster or area-wide.
Providers in Greater Manchester have a vision to deliver the fastest and greatest improvement in the health and wellbeing of the 2.8 million residents there, delivering high quality, joined-up, evidence-based and affordable health and care support.
A transformation of this scale and pace will require fundamentally different ways of working across the system, so £450m of the transformation fund secured from NHS England will support the implementation of new service models, and the adaptation of existing ones, to change the nature of demand and keep services safe and sustainable. The coming months in Greater Manchester will offer some valuable lessons, and we will be in close contact with our North Western colleagues to see what we can learn from their experiences.
Devolution offers some exciting opportunities for health and social care. The West Midlands Commission on Mental Health is another example of key people coming together across places, organisations and systems to examine how best to work collaboratively towards the same objectives to deliver the best options for local residents.
Ultimately, place-based approaches, based on meaningful coproduction with local people who have lived experience of services, should create the conditions within which we have the best possible chance of delivering lasting solutions with and for local people.
Ray James is president of the Association of Directors of Adult Social Services