Integrating health and social care in Manchester

Developing a sustainable transformation plan for Manchester City Council and Manchester Local Care Organisation

July - October 2020

£18.5m

of savings identified

Reframing the problem

Task

Impact

What new opportunities to improve outcomes and save money did we identify?

Manchester were facing significant service pressures, driven by the complex impacts of Covid, poor population health outcomes and inequalities, and their underlying financial position. IMPOWER were asked to work with Manchester City Council and Manchester Local Care Organisation to:

Understand the drivers of adult social care demand in the context of an integrated health and social care system in Manchester
Articulate the do-nothing demand baseline, and forecasts for future demand
Evaluate opportunities to better manage demand to produce better quality outcomes, financial savings, and frontline empowerment
Design a sustainable whole-system change programme to deliver a 20% long-term saving, and trial an intervention to demonstrate its delivery ability

This work was required over a 3-month period, to input into budget planning timetables.

How did we approach the task and what did we do?

Using our health and adult social care ‘5 Fast Forwards’ demand diagnostic, IMPOWER and a Steering Group of systems leaders across Manchester designed a whole system sustainable transformation programme owned by social care and health colleagues.

We approached the task by:

Setting up a process for pan-Manchester decision-making, and evaluating conditions for success
- Establishing a Steering Group and Core Group to support and challenge the work
- Benchmarking the underlying conditions for success for transformation against the operational challenges posed by Covid
Building demand and intervention evidence baselines
- Demand benchmarking, focusing on social care and then moving into the wider health and care demand requirements across place
- Facilitating case reviews across different service user groups
- A cross-system survey to identify key operational challenges driving demand
- Behavioural observations across the citizen journey
Designing and trialling a learning disabilities intervention in South Manchester
Developing demand management opportunities and modelling their impact
- Utilising the range of analysis, developing demand and cost scenario options
- Testing the findings with key system stakeholders across the NHS and social care
Formulating a long-term delivery programme, implementation plan and impact scenarios

To facilitate the work we formed an experienced change team, and virtually embedded them alongside frontline teams and the senior leadership team.

What impact did our work have?

Our work demonstrated the significant opportunity that exists in Manchester to deliver better outcomes that cost less, through strength-based engagement with service users and frontline professionals. Key findings include:

Against a cost pressure of £40m over the next four years, a significant opportunity to reduce, prevent and delay demand – 49% of cases reviewed.*
A signed-off transformation programme to deliver £18.5m of savings against the do-nothing scenario by 2023/24*
An aligned and confident Senior Leadership Team, Heads of Service and frontline teams, crossing over from adult social care to the NHS*

*Figures approved by James Binks, director of Policy, performance and reform at Manchester City Council, and Bernadette Enright, Executive director of adult social services, Manchester City Council

An aligned and confident Senior Leadership Team, Heads of Service and frontline teams, working together to deliver integrated health and social care