It was reported earlier this week that the government will hand over control of an estimated £6bn NHS budget to Greater Manchester from April next year.
The new strategic health and social care partnership board, comprising local councils, clinical commissioning groups and NHS England, will decide how the budget is allocated and will be ultimately be overseen by an elected Boris-type ‘metro’ mayor. The hope is that integration of health and social care spending will enhance community based services, and reduce the pressure on the hospitals.
Announcing the move at Manchester Town Hall earlier today, Chancellor George Osborne said: “This is historic. It's exciting for Greater Manchester. It's exciting for the NHS.” Mr Osborne said the deal was about bringing the NHS and social care closer together, adding “this is just the beginning.”
However, while the devolved control of decision making and integration of health and social care spending would be unprecedented, critics have voiced concerns over the potential for another reorganisation of the NHS, and the danger of ‘postcode lotteries’.
Speaking to BBC Radio 4’s Today Programme on Wednesday, assistant director of health think tank the King’s Fund, Richard Humphries, warned: “You could either see this as a triumph for local democracy or creating real risks of yet another reorganisation of the NHS when it’s barely recovered from the last one.”
While shadow health secretary, Andy Burnham, said: “This has to be a solution that works everywhere or that could be offered to everywhere.”
The Labour MP warned of “bits of the system are operating to different rules or have different powers and freedoms” in different regions.
He added: "I am a bit worried what I'm hearing because it does point to further break-up of the idea of the National Health Service."
Further details have not yet been released, and it remains unclear as to how any reorganisation would affect community-based healthcare models or the further integration of primary care services, including optometry.
Eye health impact
Managing director of the Local Optical Committee Support Unit (LOCSU), Katrina Venerus, told OT that the organisation had been aware of the proposal but that “no detail has yet been provided.”
Ms Venerus said: “We need to see the detail of what has been agreed to assess the implications for eye health services.
“There could be great potential to improve and integrate services to the benefit of the health and wellbeing of the local population however there is a real risk that this leads to yet another reorganisation of the NHS and added bureaucracy.
“LOCSU will be supporting the local optical committees in Greater Manchester to engage with the various authorities involved during the transition period.”
Those involved at the local level are awaiting further details of the programme, but initial discussions have pointed to a transformative, devolution of decision making down to the local level, rather than any further fundamental reorganisation of the health service.
Optical lead for LOCSU and chair of the Greater Manchester local eye health network, Dharmesh Patel, told OT: “There is already a large programme of transformation in greater Manchester, across general practice, pharmacy and optometry, and we hope that this will support that agenda.”
While too early to predict what impact the changes may have on eye health services in the region, it is hoped that further integration could offer a more complete care for patients.
“It will help us try and link those social issues of sight loss and detection and management, and help us support those people,” said Mr Patel, “but it’s at an early stage to know what impact it will have on optometry in particular.”
He added: “There are lots of potential opportunities that could come out of it, and we’ll be interested to see what comes out in that detail.”
Image credit: Julius