A unique study led by the University of Manchester has shown that devolution deals which granted Greater Manchester increased control over a range of public services enabled significant improvements in many parts of the health system.
The study builds on previous evidence that analysed 98 measures of performance and how changes in the health system may have led to increases in life expectancy in Greater Manchester.
Funded by The Health Foundation and supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester (ARC-GM), the study evaluated changes between 2016 and 2020 compared to the rest of England.
According to the study, there were 11.1% fewer alcohol related hospital admissions, 11.6% fewer first-time offenders, 14.4% fewer hospital admissions for violence, and 3.1% fewer half school days missed from 2016 to 2020.
Same day GP appointments increased by 1.8% and unplanned A&E re-attendances were 2.7% lower, in line with increases in the GP and hospital workforce. Cancer screening rates also improved.
Adult social care effectiveness and overall satisfaction also improved by 17.6%, despite decreases in expenditure and staff.
However, adult obesity increased by 7.6% and median wait times for A&E treatment worsened by 12.2%. There were also mixed impacts of devolution on outpatient, mental health, maternity, and dental services.
Researchers say the positive changes are likely to have been a result of different aspects of the Greater Manchester devolution deals.
These include the transfer of control over transformation funding for improving services to the Greater Manchester Health and Social Care Partnership, the development of collaborative relationships between NHS organisations and local councils and the impact of wider devolved public services.
There were however indicators where no change was seen or where things did not improve. This may have been due to restricted formal powers and an inability to raise additional funding locally. Gains made during this period have been undermined through the Covid-19 Pandemic and its aftermath.
Sir Richard Leese, former leader of Manchester City Council, was one of the signatories to the city-region’s health devolution deal with Government in 2015. He held the health and care portfolio lead for Greater Manchester Combined Authority from March 2020 to October 2021 and is Chair of NHS Greater Manchester Integrated Care Board. He said:
“This latest research reinforces what we know, that working together in partnership, locally has better outcomes and supports people to live healthier and happier lives.
“It’s encouraging that our approach has seen increases to healthy life expectancy and better access in some services. However, we recognise where we haven’t seen improvements or the change we hoped for, including against the national average. We’re continuing to work together as a system to improve health and care for everyone. Our commitment to partnership working will give us the best chance of success and tackling health inequalities.”
Chair of Greater Manchester Integrated Care Partnership Board, City Mayor Paul Dennett said:
“Devolution, in health and care and other areas, has given us the ability to unlock health benefits for our Greater Manchester communities by working together to deliver good housing, good jobs and more. The power, potential and importance of locally driven integration and collaboration is clear from this report. We must maintain this.”
Further information
You can read more here: Devo Manc led to significant improvements across health system, study finds (manchester.ac.uk).
