7. Greater Manchester
What issues have been raised about this STP?
Services cut for patients with serious congenital heart conditions at Manchester Royal Infirmary due to a lack of staffing. Those with awaiting operations will need to travel up to 150 miles.
Two walk-in centres will shut in Bury and Prestwich and resources moved to NHS 111, GP surgeries and A&E departments. This decision has prompted widespread condemnation from local citizens: 2,000 people signed a petition to save Moorgate Primary Care Centre and Prestwich Walk In Centre.
83% of people disagreed with the plans in the CCG's survey on the closures.
What are the proposed aims of the STP?
- Elimination of a projected 2020/21 deficit of £897 million;
- Strengthening of primary care to manage patients in the community more proactively;
- Increased integration of primary, community, social and secondary care;
- Increase in prevention services;
- Overall, the STP aims to move care from the acute sector to the community/primary care sector, reducing hospital visits and admissions.
Greater Manchester had already compiled a five-year plan by 2016 and this was put forward and accepted as the STP. This means that the changes in Manchester are further ahead than in most other areas.
Primary and community care:
There are now a number of primary care hubs offering seven day additional access across Greater Manchester.
NHS England and the 12 CCGs of Greater Manchester have collaborated to develop nine Greater Manchester primary care medical standards, which will be implemented by December 2017.
Programmes are in development to improve the population's health incorporating dentists, optometrists and pharmacists, as well as primary care.
The plans include the development of fully integrated Locality Care Organisations (LCOs), which include all health and social care providers in a locality who will work together to provide care to a defined population with primary care at the centre. The establishment of LCOs should enable conditions to be managed at home and in the community.
Greater Manchester is an early implementation area for the new national Multispecialty Community Provider (MCP) contract. The MCP contract provides a new care model based on the population and patient needs and backed by new arrangement for funding, commissioning and contracting.
A reconfiguration of urgent and emergency care is underway, which could lead to closures of some urgent care centres.
Eight clinical areas have been identified - paediatrics, maternity and obstetrics, respiratory and cardiology, MSK and Orthopaedics, breast, urology, neuro-rehabilitation and vascular - and service redesign is being investigated.
Greater Manchester is one of four sustainability and transformation plan areas which will lead plans for regional back office mergers across the NHS.