All eyes are on Manchester as one of the biggest experiments in UK healthcare, the devolution of the city’s £6 billion health and social care budget, begins to demonstrate results. Health writer and Guardian contributor Rachel Pugh experiences innovation in action and learns more about the successes to date.
In a scene straight from Dragons’ Den, a room full of Manchester’s top cancer specialists, researchers and patients were given two hours and the chance of £150,000 by Manchester Cancer Research Centre’s (MCRC) charismatic director, Professor Rob Bristow.
Their challenge, to pin down a high-risk, high-impact breast cancer issue for research in the city-region, and to devise a 10-second elevator pitch, plus the eye-catching national newspaper headline they hoped to generate in three years’ time.
Only one year on, that ambitious goal of establishing how to identify and treat young women most at risk of developing this aggressive disease has been transformed from passionate words to a fully-fledged peer-reviewed research programme.
It sees Manchester at the heart of a Cancer Research UK early detection project involving six universities on both sides of the Atlantic and £4 million in funding. Its effects for patients will not be far behind.
The unconventional and audacious approach introduced by Bristow, which he has also applied to ‘brainstorm” five other cancer areas, typifies Manchester’s whole approach to health and wellbeing. It is focused on collaboration, thinking outside the box, and accelerating the process of turning ideas into health improvements for real people.
“It’s a whole different way of thinking about cancer. It’s a whole systems approach,” says Professor Bristow, who left Toronto, Canada to work in Manchester.
Manchester’s ability to attract talent and investment from across the world has become a significant talking point for those interested in the global health economy. The city-region has a long history of innovation in health and social care but political change has brought new opportunities which are attracting the interest of increasing numbers of healthcare professionals around the world.
Taking place in March 2019, the inaugural World Healthcare Congress Europe provided an opportunity for Greater Manchester to take stock of what has been achieved so far, while sharing its vision.
Greater Manchester’s ‘can do’ attitude was evident in the programme of the World Healthcare Congress Europe 2019, organised into three themes, playing to its strengths: Innovative health and social care ecosystems; accelerating discovery into practice and arts for health and social change.
The congress was a chance for this city of 2.8 million people to start a conversation with some of the world’s top health ‘brains’ about the strides being made to transform healthcare in a region with some of the worst health statistics in the UK because of its unique blend of assets:
- The flexibility of local control since March 2016 of its £6 billion integrated annual health and social care budget from the NHS
- Home to the largest clinical academic campus in Europe and to the only fully e-enabled NHS trust in England
- The presence of Health Innovation Manchester (HinM) – an accelerated pathway to deliver adoption of health innovations to patients at pace and scale and achieve tangible improvements in health and wellbeing for Manchester and beyond.
The possibilities opened up across the health and social care system by applying the congress themes, have a living model in Manchester’s astonishing achievements in the cancer field.
The Christie’s world reputation for excellence attracts backing from both research and business organisations, hence its portfolio of more than 550 active trials (the largest of any hospital trust in the UK). In Manchester, cracking cancer is about collaborations between academics and organisations across the regions, and even patients, rather than working in silos.
The same approach can be taken across health in general, capitalising on Greater Manchester’s population of 2.8 million (plus an additional 9 million regional catchment area) who now represent an attractive source for companies looking to carry out clinical trials.
It does not stop there. Work is currently under way at the Christie to build a ‘dashboard’ bringing together hospital, GP and genomic data, so that individuals can be looked at for suitability for specific treatments alongside other conditions such as diabetes. It has access to an 11.8 million patient data base – Roche paid £20 million for access to it because of its rich information.
Chair of WHCE and Manchester global ambassador, Professor Jackie Oldham explains: “It’s absolutely about sharing. We have created a conference which is about opening up a debate. Through collaboration across public and private sector and academia, and through the empowerment of citizens, this region is pioneering a new approach to addressing the health and social care needs of 2.8 million people. Decisions are being made about the way healthcare will be funded and provided in future. What happens here today will resonate across the world.”
The congress themes showcase Greater Manchester’s vision of health as being not only about what goes on inside clinical settings and more about improving wider determinants such as employment, transport, building a healthy environment and encouraging people to take greater responsibility for their health.
Evidence is already emerging of the success of the Greater Manchester approach to health since devolution:
- The 58% reduction in emergency department attendances and the 82% cut in non-elective admissions at Tameside hospital through enhanced support for people at greatest risk of hospitalisation
- Helping more than 3,200 long-term unemployed people to find work through the local commissioning of Working Well
- Narrowing the gap on smoking between Greater Manchester and the England average (16.9%) from 21% before health devolution to 18% today
- Rolling out personalised care approaches including innovation in personal health budgets for people at the end of life and for people with learning disabilities.
Many more areas are undergoing rapid innovation, including improvements in toddlers’ school readiness, the health of homeless people, greater access to mental health and guarantees of a GP appointment within seven days for every citizen (in 2016 it was 47%).
The whole focus is to make better use of hard-pressed health budgets. Another Greater Manchester success is a £2 million saving in Rochdale alone, by cutting non-elective admissions by 6% through its roll out of its intermediate tier services in the first year. How much more impressive will savings be when applied across the 10 health districts of the conurbation?
Warren Heppolette, who leads on innovation across Greater Manchester Health and Social Care Partnership, emphasises the need for new ways of tackling old health problems.
He said: “Global health systems are facing a series of common challenges as we seek to contain the growth in costs, tackle health inequalities and better manage the burden of disease. We need to be alert to innovation in new treatments and technologies and help people to take more control over their own health.”