Combining the health care and social care budgets is allowing the Greater Manchester Combined Authority (GMCA) to drive savings and pursue a more innovative approach to public health.
Through the Greater Manchester Health And Social Care Partnership (HSCP), GMCA is combing the public health budgets of its different agencies to maximise the benefit it gets from its healthcare spend, according to its procurement lead Neil Hind.
The structure also allows it to be more flexible about the projects it funds, allowing it to focuse on preventative measures, he said.
Speaking at the YPO World of Procurement conference, Hind said: “We are pushing on this integration between health and social care, which is very new and isn’t without its challenges.
“[It’s] not easy, but it will give us big savings and allow us to buy exactly what we need for the region, so I think it’s quite exciting.”
HSCP, which sits within NHS England but is more aligned to GMCA, is a mix of organisations responsible for public health. These include clinical commissioning groups (CCGs), acute and specialist trusts, GPs and local authorities among others.
Although all collaborating organisations are still in control of their own budgets, the arrangement allows the GMCA to make spending decisions as if from one central budget.
Since 2016 GMCA has also been the only region to have completely devolved control over its NHS budget, some $6bn, providing more flexibility.
“It means we can do things now a bit differently than we’ve done in the past,” said Hind. “Some of the things we’re doing you might think, ‘That sounds a bit odd, why are you spending NHS budget on this?’ But it’s because we think it’s going to give us benefits elsewhere in the system.
“If we can do more to keep people out of the NHS system it will be more efficient. There’s lots of work going on trying to get people more healthy, keep them healthy and keep them out of the NHS system.”
One way GMCA has used this flexibility is to use its NHS budget to buy toothbrushes and toothpaste for all under-fives. Manchester has one of the worse oral health records for under-fives in the country, so spending money to improve the way children brush their teeth will reduce the need for expensive treatment later on.
“It stacks up money-wise, but it’s also very good for the child. It’s a win-win,” said Hind.
HSCP is also using NHS money is to improve social housing, because living in a house with damp or poor heating increases the chance of being admitted to A&E, and to help people with mental health problems to get back into work, because evidence shows people in work are less likely to have poor mental health.
Hind said part of the project is the creation of combined corporate services, including procurement. Currently there are 11 buying teams and more than 200 people involved in the purchasing and supply chain operation, which Hind wants to consolidate.
“This is about us trying to buy as a region,” he said. “We are looking to merge into one shared service. We are starting to standardise on systems, on processes and are looking at more and more shared contracting.”
Hind is also working with local authorities and CCGs in the region to find where there is an overlap in buying and to merge spend. “We’re buying on behalf of the system, not on behalf of the NHS,” he said.