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Greater Manchester to control its share of the NHS budget

The north-west English region accounts for 5% of the country's health spending

Manchester 

One of the biggest regions in northern England will gain complete control over its share of the healthcare budget as the delegation of healthcare spending from Whitehall to local authorities begins in earnest.

Ten councils and health groups from the Greater Manchester area will take over £6bn allocated for health and social care from next month, with full powers being devolved to them from April 2016.

Chancellor of the Exchequer George Osborne said: “We have a landmark agreement to bring the local NHS and social care much more closely together.

“I am excited about all this because not only does it mean the people of Greater Manchester having more control over the decisions that affect their lives, I believe it will also lead to better, much more joined-up health care.

“It's also a historic day for Greater Manchester. They are leading the country in this important change.”

Greater Manchester's new devolved powers include taking responsibility for adult, primary and social care and controlling mental health and community services and public health.

The region will also focus on preventative work in the community, such as treating heart conditions by community specialists in a bid to ease pressure on hospitals.

This will also be delivered by its 10 councils, 12 clinical commissioning groups (CCGS) and 15 NHS providers, who will control the budget and deliver services in conjunction with NHS England.

This group will also build strategies around governance, regulation, finances and health education to run the devolved health service.

It means local leaders, and ultimately Greater Manchester's new directly-elected mayor, will control how budgets are allocated - moving decisions, and to some extent responsibility, away from the central government in Whitehall and its presiding health secretary.

It has been suggested that this could be the tip of the iceberg, with other major areas and cities - such as London and Birmingham - potentially next in line to have budget control handed to them.

The total budget for the NHS in England is around £100bn for the year, with the 212 CCGs having 60% of that earmarked, and NHS England responsible for the remaining 40%.

But despite gaining extra power, the councils will not be gaining extra money, and health think-tank the King's Fund has been warning for many years that the NHS faces a £30bn funding gap by 2020, with no political party willing to say it can make up this shortfall during the next Parliament.

Co-commissioning 

Local councils in Greater Manchester will from 1 April work with CCGs and NHS England, but there are fears that this will add yet another layer of bureaucracy to England's commissioning system - which itself is still in its infancy - and also have the potential to politicise local health policies. 

But what does this mean for pharma? In essence, the same commissioning system for funding most medicines still exists, with decisions for this coming from NICE and the legally enforced policy of local formularies making recommended drugs available within three months of the Institute's decision.

However, there is the possibility that public pressure on elected mayors and councils could influence medicine management and optimisation, as well as local prescribing decisions and cancer services. 

This could see some new drugs gain access more swiftly, especially in areas outside of NICE's remit, such as the Cancer Drugs Fund. 

If for example a public campaign to have a drug put onto the CDF gains traction in the area, especially in an election year, this could force councils to intervene and ask for rejected medicines to be funded by the ring-fenced budget. 

Article by
Ben Adams

2nd March 2015

From: Healthcare

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