Joint Forward Plan

The Joint Forward Plan sets out how we will deliver the Greater Manchester Integrated Care Strategy and what we will focus on.

Contents

Introduction

Our Strategy

What we will do – our missions

Strengthening our communities

Helping people stay well and detecting illness earlier

Helping people get into, and stay in, good work

Recovering core NHS and care services

Supporting our workforce and our carers

Achieving financial sustainability

How We Will Deliver

Appendix 1

How this plan addresses the statutory requirements for a JFP.

Appendix 2

Our locality plans.

Footnotes

Introduction

The way in which health and care services are organised in every part of England changed on 1st July 2022, as new national legislation came into force. Greater Manchester (GM) is now an Integrated Care System (ICS) – a partnership of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in GM.

There is a requirement for all ICSs to develop a strategy. NHS organisations and local authorities must then have regard to this strategy when making decisions about the use of health and care resources. The five-year Strategy for the GM Integrated Care Partnership (ICP) was approved in March 2023 and can be found here.

National guidance states that each Integrated Care Board (ICB) must publish a five-year Joint Forward Plan setting out how they propose to exercise their functions. This should include the delivery of universal NHS commitments address ICSs’ four core purposes and meet legal requirements. The guidance encourages ICSs to develop the Joint Forward Plan as the delivery plan for the ICP Strategy – and this is the approach we have taken in Greater Manchester.

JFP Principles

This plan describes how GM will achieve the outcomes described in the ICP strategy. Achieving these outcomes involves not only integrated health and care services but also action on the things that determine good lives. The strategy and plan describe a complex system which includes, but is not limited to, the activities under the direct influence (and resourcing) of NHS Greater Manchester Integrated Care (NHS GM) Our ICP strategy describes our GM model for health, which builds on the strong partnerships already in place with wider public services, the VCSE and people and communities.

The Strategy was developed through extensive engagement with communities, partner agencies and staff, across all ten localities. Its development adapted to the feedback received and it reflects the needs and expectations of our communities. This Joint Forward Plan is built from the results of that engagement.

The GM Context

Greater Manchester is home to more than 2.8 million people with an economy bigger than that of Wales or Northern Ireland. Our population in the 2021 Census was estimated to be 2,867,800. This is an increase of 185,272 on the 2011 Census and represents a growth of 6.9% in ten years, higher than the growth across England and Wales (6.3%) over the same period.

There are ten councils in Greater Manchester: Bolton, Bury, Manchester, Oldham, Rochdale, Salford, Stockport, Tameside, Trafford and Wigan. All are unitary authorities, eight are metropolitan borough councils and two, Salford and Manchester are city councils.

The Greater Manchester Combined Authority (GMCA) is made up of the ten Greater Manchester councils and the Mayor, who work with other local services, businesses, communities and other partners to improve the city-region as described in the Greater Manchester Strategy (GMS)[1].

The composition of our Partnership

The Greater Manchester Integrated Care Partnership (this is the name of our integrated care system) connects NHS Greater Manchester Integrated Care, the Greater Manchester NHS Trusts and NHS providers across the whole of primary care with the GMCA, councils and partners across the VCSE, Healthwatch and the trades unions.

Greater Manchester Integrated Care Partnership Board is a statutory joint committee made up of NHS Greater Manchester Integrated Care and councils within Greater Manchester. It brings together a broad set of system partners to support partnership working and it is the responsibility of this Board to develop this Integrated Care Strategy – a plan to address the wider health, and care needs of the population.

NHS Greater Manchester Integrated Care, or NHS Greater Manchester (our integrated care board) is a statutory NHS organisation leading integration across the NHS, managing the NHS budget and arranging for the provision of health services in a geographical area. It supports ten place-based integrated care partnerships in Greater Manchester as part of a well-established way of working to meet the diverse needs of our citizens and communities.

Within Greater Manchester we have arrangements for providers to work together effectively at scale, including:

What the Data is Telling Us

The Greater Manchester Integrated Care Partnership Strategy gives a comprehensive picture of the data about our system. This includes:

We have also drawn on our locality plans and local Health and Wellbeing Strategies which together identify the needs of our population and the plans in each locality to address these, aligned with our strategy and this plan (see section 10.5)

What residents are telling us

We carried out a major engagement exercise ‘The Big Conversation’ to inform the development of our ICP Strategy and this plan.

The Big Conversation had two phases. Phase one ran between March and May 2022 with the aim of consulting on the proposed vision and aims that had been suggested by the ICP leaders following a stakeholder engagement event they took part in. 1,332 people gave their views and consensus was most respondents agreed with the proposed aims and visions.

Phase two ran in October 2022 with the aim of ensuring the GM ICP had the insight it needed to be able to understand what matters most to communities across all ten localities – to help shape the priorities and actions for the strategy. Find out more about the Big Conversation.

Our Strategy

Overview

The Integrated Care Partnership Strategy outlined the key challenges facing the Greater Manchester health and care system:

The Strategy is clear that we must both meet these immediate pressures and continue to address their underlying causes through improving the health of our population. The missions in the strategy were developed to ensure a recognition of these challenges.

This Joint Forward Plan will describe how we will realise these aims over the next five years – with a greater emphasis on years one to three. We will revise and update this plan each year. The Plan covers all ages as we support people to start, live and age well.

Our vision and outcomes

As partners in Greater Manchester, we share the Greater Manchester Strategy (GMS) vision of wanting Greater Manchester to be a place where everyone can live a good life, growing up, getting on and growing old in a greener, fairer more prosperous city region.

For the Greater Manchester Integrated Care Partnership, this means we want to see a Greater Manchester where:

The Greater Manchester Model for Health and Wellbeing

Underpinning all our work is the Greater Manchester Model for Health and Wellbeing. This shows how we work with communities to protect against and prevent poor health and ensure support is available before crises occur to reduce demands on formal NHS and social care services. It is a social model for health and wellbeing with people and communities at its heart. It recognises that Greater Manchester will make the most progress in improving health if steps to tackle the social causes of health complement our clinical interventions.

Our challenge is that this Model is not universally realised across Greater Manchester. Our aim through the strategy and this delivery plan is to confirm the actions and approaches necessary to achieve this and maximise the efficiency and effectiveness of how we work together to improve our outcomes.

What we will do – our missions

Our missions

Our strategy sets out the following missions in response to the current challenges, within the context of our vision and outcomes

Strengthening our communities

We will help people, families and communities feel more confident in managing their own health and wellbeing. We will act on this with a range of programmes, including working across Greater Manchester to support communities through social prescribing, closer working with the VCSE and co-ordinated approaches for those experiencing multiple disadvantages.

Helping people stay well and detecting illness earlier

We will collaborate to reduce smoking rates, increase physical activity, tackle obesity and drug and alcohol dependency. We also want to do more to identify and treat high blood pressure, high cholesterol, diabetes, and other conditions which are risk factors for poor health. Working in partnership and with targeted interventions, we will embed a comprehensive approach to reducing health inequalities.

Helping people get into, and stay in, good work

One of the purposes of Integrated Care Systems is to support wider social and economic benefits from NHS investment. We will act on this by expanding our Work and Health programmes, working with employers on employee wellbeing, through the Greater Manchester Good Employment Charter[3] and developing social value through a network of anchor institutions[4].

Recovering core NHS and care services

We will work to improve ambulance response and A&E waiting times, reduce elective long waits and cancer backlogs, improve access to primary care services and core mental health services, improve quality and reduce unwarranted variation for adults and children alike. Consistent delivery of NHS constitutional standards is a priority as our system recovers.

Supporting our workforce and our carers

We will promote integration, better partnership working and good employment practices, as well as supporting our workforce to be well and addressing inequalities faced in the workplace. We want more people choosing health and care as a career and feeling supported to develop and stay in the sector. We will consistently identify and support Greater Manchester’s unwaged carers.

Achieving financial sustainability

Financial sustainability – ‘living within our means’ – requires a focus on financial recovery of the health system to achieve a balanced position. We will identify the main reasons for financial challenges in our system, and implement a system wide programme of cost improvement, productivity, demand reduction and service transformation. Our work needs to address the current significant challenges we face across health and social care as well as taking the steps to make our system more sustainable for the long-term.

For each of the missions, we have set out the key areas of focus and the actions to deliver our vision and outcomes. These are described in greater detail in the next six chapters of this document. We have set out the accountability for the delivery of the missions. We describe this as:

The proposals on accountability in this document will be revisited as part of the leadership and governance review that took place in the first quarter of 2023/2024. We expect to complete the process of implementing the recommendations by October 2023.

Our ways of working

The way that we work together will play an important part in achieving our vision through our missions. To transform public services and integrate care we need to change the way we work with communities and fundamentally challenge our approaches to delivery. These ways of working run through all our missions.

Behaviours:

Strengthening our communities

We will help people, families and communities feel more confident in managing their own health. Our approach recognises that the organisation of the delivery of health and care services is only one of a range of contributors to the health and well-being of residents. The quality of housing, the availability of quality work, the extent to which residents are connected to their communities, and whether people feel safe also make a significant contribution.

Being deprived of these helps create and exacerbate the persistent health inequalities we see in many communities in Greater Manchester. Tackling these issues will play a key part in securing long term stability for our system – principally through keeping people well and independent in their homes and communities and reducing demand on expensive, acute services.

Our approach to this mission is underpinned by the Greater Manchester People and Communities Framework which defines our strategic approach to public engagement and involvement including key principles and commitments that support our ways of working.

Key details

Delivery Leadership:

System Leadership:

Population Health Boards

Areas of focus and actions:

1. Scale up and accelerate delivery of person-centred neighbourhood model

2. Develop collaborative and integrated working

3. Develop a sustainable environment for all

[5] 2023/24 is the final year of Mental Health Long Term Plan Indicators and we will review the metrics in this plan as the new national indicators are published.

Area of Focus: Scale up and accelerate delivery of person-centred neighbourhood model

Neighbourhood and place-based working provides the closest connection to the broadest range of factors affecting people’s health and wellbeing. Most people will receive most of their day-to-day care for most of their lives in the neighbourhood or locality. The only place where local authority spend and planning, not only on care services, but also on the wider determinants of health, comes together with NHS spend is at the locality level.

We have a locality model in place in Greater Manchester, comprising:

Our localities are made up of neighbourhoods of 30,000 to 50,000 population – with Primary Care Networks at their heart. The neighbourhood model ensures that support is available before crises occur, to reduce demands on formal NHS and social care services. This is pivotal to our social model for health.

Health and Wellbeing Boards play an important role across our localities (HWBB) – including providing support and challenge to Locality Boards to ensure that a focus on health inequalities flows through all aspects of the locality’s work. This key to our work to address wider societal and economic issues through local partnerships

Action: Continue to develop Live Well and Social Prescribing

Only by working alongside people and communities to create healthier happier lives will we see sustainable improvements in the health of our population. Live Well is our programme to support this across Greater Manchester, as a key component of the person-centred neighbourhood model.

Every day, people help each other, and take part in activities that keep them moving, creative, and sociable – improving their physical health and mental wellbeing. Many people, particularly those experiencing inequalities, do not have the same chances to access these opportunities – this is where Social Prescribing can help.

Social Prescribing is a way for local organisations, services and professionals to refer people to a worker who acts as a ‘link’ between the health and care system or wider public services and the community. There are now over 200 Social Prescribing Link Workers in Greater Manchester working alongside GPs and other community organisations. Over 30,000 people a year directly access this. Through Live Well, we are committed to expanding this offer, and to ensuring it makes a targeted difference to people who experience inequalities.

We will work with, and build, on the community-led work in all our localities to expand the ‘Live Well’ offer so that all residents, particularly those experiencing inequalities, are offered the chance to maintain and improve their health, wellbeing, resilience and social connections through access to information, activities, volunteering and support. This will include:

Measuring our Delivery

Accountability

Action: Continue to Embed Creative Health Approaches

In November 2022, the Integrated Care Partnership launched the Creative Health Strategy, setting out a commitment to creative health as a core tool for addressing health inequalities and for improving access to and, in some cases, the effectiveness of specific clinical pathways

Measuring our Delivery

Action: Enhance the Role of NHS GM in Tackling Poverty as a Driver of Poor Health

Poverty is the single biggest determinant of health outcomes and health inequalities. Building upon a ‘deep dive’ into poverty and health that was undertaken by the GM Population Health Board, the GM Integrated Care Partnership approved a range of actions aimed at addressing this issue.

A key feature of this response has been the development of a strategic partnership with Greater Manchester Poverty Action and tapping into their nationally recognised expertise to support NHS GM to establish an approach which can serve as an exemplar to other ICSs.

Our focus during 2023/24 is on completing the ongoing strategic review of the role of NHS GM in tackling poverty, including:

In addition, during 2023/24 and 2024/25 we will:

Measuring our Delivery

In the long term, the impact of our activity will be measured by:

In the shorter term, the impact of our activity will be measured by:

Accountability

Action: Expand Community-Based Adult Mental Health Provision

As part of our neighbourhood model, we will expand provision of multi-disciplinary, strengths-based teams for mental health. We will aim to build resilience in people and communities and intervene earlier before people reach a point of crisis. Our approach is based on addressing historic under-investment in mental health, learning disability and autism.

Our Mental Health and Well Being Strategy sets out our aim to provide clear, accessible care pathways for people, integrating mental wellbeing, social care and physical health. We will further integrate mental health offers into Early Help, family support, housing and schools.

In line with the national Community Mental Health Transformation Framework, we are working across all ten localities to develop new and integrated models of primary and community mental health care which will support adults and older adults with severe mental illnesses and reach over 20,000 more people. A key area of work is scaling up the Living Well model across all GM localities which was successfully piloted in Salford and Tameside between 2018-2021.

Our ambition is to increase our community Mental Health offer so that fewer people escalate to crisis point. We will know we have achieved this when we are able to reduce our crisis offers and reduce the number of inpatient beds in GM without adversely impacting our communities.

Over the next five years, we will:

Measuring our Delivery[5]

Accountability

Action: Living Well at Home

Adult Social Care in Greater Manchester is rooted in the power of co-production with people, carers and families to enable better outcomes for people. The primary focus is on supporting people to live well at home, as independently as possible, making sure that the care and support people experience is built on their own strengths and those within the community, and is of the best quality.

The key elements of the programme are:

Market Development and Sustainability

Measuring our Delivery

Accountability

Action: Take an inclusive approach to digital transformation to ensure equity for all

GM has significantly advanced the use of digital approaches across health and care, but there are still many people who cannot easily access or benefit from digitally enabled services and tools. In an increasingly digital world, people who are digitally excluded are at risk of worse access to services and poorer health outcomes, deepening inequalities.

People who are most likely to experience digital exclusion are:

A lack of digital access and skills can have a huge negative impact on a person’s life. As many as 1.2m residents in Greater Manchester could be excluded in some way to access the benefits digital brings.

The GM Digital Inclusion Action Network (DIAN) has been established by the Greater Manchester Combined Authority to ensure digital inclusion is built into the transformation of public services, place-making and economic growth. It is focused primarily on getting all under-25s, over-75s and people with disabilities online.

NHS GM will continue to work in partnership with the DIAN and Health Innovation Manchester to build inclusion into the design and development of digitally enabled services and pathways, develop targeted approaches for key communities and boosting digital capabilities and awareness of inclusion barriers.

Measuring our Delivery

Accountability

Area of Focus: Develop collaborative and integrated working

Action: Embed the VCSE Accord

Voluntary, Community and Social Enterprise (VCSE) sector providers are part of a three-way agreement (the VCSE Accord) between the GMCA, NHS Greater Manchester and the VCSE sector.

The VCSE Accord delivery plan for 2023 to 2026 sets out the future of the Accord over the next three years. The central themes of delivery are:

Measuring our Delivery

Accountability

Action: Deliver a GM-wide consolidated programme for those experiencing multiple disadvantage

Through the Devolution Trailblazer Deal in early 2023, the Government confirmed its support for GM’s ambition to develop a city region-wide approach to supporting people and families experiencing multiple – social, economic and health –disadvantages. To support this work, the Government has agreed to review the secondary legislation that underpins pooled and aligned budgets (section 75 of the National Health Service Act 2006), with a view to amending the scope and simplifying the regulations where needed.

Demand on public services, including health and care, is often driven by cohorts of residents who are in contact with multiple agencies – for instance, people with drug and alcohol problems; people who are homeless; people with a range of complex long-term conditions who frequently present to acute services through A&E and other routes.

They are among the most vulnerable in our communities, and often experience entrenched disadvantage, long term unemployment, trauma and health inequalities. The most at-risk adults and children and young people in this situation are estimated to cost the public purse five times more than the average citizen per year.

These plans will support our aim to move from a system characterised by responses to cycles of chronic illness and exacerbation to one focused on a proactive model that keeps people well at home and in their communities. They build on learning from the Supporting Families (Troubled Families) programme, Rough Sleeper Initiative, Housing First, Changing Futures and Working Well.

Our key actions in 2023/24 are:

Measuring our Delivery

For the identified cohort:

Accountability

Action: Embed the GM Tripartite Housing Agreement

The home is a driver of health inequalities. Inadequate housing causes or contributes to many preventable diseases and injuries. Direct effects of an inadequate home on a person’s health can include heart attacks, stroke, respiratory disease, flu, falls and injuries, hypothermia and poor mental health. Poor quality housing is estimated to cost the NHS at least £1.4 billion per year in first year treatment costs alone.

The GM Tripartite Agreement ‘Better Homes, Better Neighbourhoods, Better Health’, is a collaboration between Greater Manchester Housing Providers, Greater Manchester Combined Authority and NHS Greater Manchester Integrated Care to deliver positive change across the city region. The Agreement sets out a collective vision to work alongside local people, neighbourhoods and stakeholder organisations to create lasting solutions to complex issues and challenges centred on housing and health.

Measuring our Delivery

Accountability

Action: Giving every child and young person the best start in life

Greater Manchester is passionate about ensuring that all our children and young people get the best start in life and are cared for, nurtured and supported to grow up well and achieve their ambitions in life.

We will support our children and young people to get the best start in life through a joined-up approach to their early years’ development. We will wrap support around our most vulnerable young people to give every child the opportunity to live their best life through access to quality education and opportunities that respond to their needs. We will give young people a voice in how we develop policy and make decisions that affect their lives.

There are strong foundations to build on. This includes work over the last decade to develop common practice standards for groups of young people (for example Children with Special Educational Needs and Disabilities and Care Leavers). The specific health case for investment in children is extremely strong. The life course costs of late intervention have been estimated at £17bn across England and Wales (including nearly £4bn borne by the NHS).

Around 1 in 4 children and young people continue to live in poverty, according to Department of Work and Pensions (DWP) data on the percentage of children age 0-15 living in low-income households. There are disproportionately high numbers of children and young people across GM who are at risk, vulnerable or have complex needs.

GM partners (health education, voluntary, criminal justice sectors, GMCA and local authorities) have adopted a system-wide approach, delivered through a combined Children and Young People Plan. The GM Children Board, reporting to the Integrated Care Partnership, and GMCA acts as a system board that represents the range of accountabilities brought together to deliver on the priorities in the Children and Young People Plan.

We have set out our priorities for children and young people:

To give every child the best start in life, we will continue to improve maternity services. In doing so, we will:

Measuring our Delivery

Accountability

Action: Ageing Well

The pursuit of an age-friendly Greater Manchester is in line with the UN Decade of Ageing and the WHO (World Health Organisation) Age-friendly cities and communities’ programme. Our approach focuses on improving financial security, tackling inequalities, and creating places for people to age well through healthy, active, and connected lives. We do this by championing the voice of older people, challenging ageism, growing the GM age friendly movement, and delivering changes across our city region to improve later life. The key themes within the Greater Manchester Age-Friendly strategy are work and money (financial hardship), places, ageing well, and working together.

A unique cross-sector Ageing Hub partnership brings together the Greater Manchester system leadership at the Ageing Hub Executive Group and a range of task groups, to collectively deliver on the strategy, supported by the Ageing Hub team at GMCA. The Ageing Hub works alongside the 10 districts of Greater Manchester to integrate age-friendly approaches at a neighbourhood, district, and Greater Manchester level.

The Greater Manchester Ageing in Place Pathfinder is a £4 million investment (2022-25) by partners, led by GMCA, in eight neighbourhoods to create strong and supportive neighbourhoods to improve connection, health and wellbeing of residents over 50 years of age. The Pathfinder is designed to support the GM, district and neighbourhood partners to test evidence-based approaches and learn to sustain and scale this work across Greater Manchester.

Measuring our Delivery

Accountability

Action: Increase identification and support for victims of violence in all health care settings

We are working collaboratively with partners to develop community-led, whole system approaches to violence reduction, and to refine our ways of working through a Trauma Informed and Responsive lens to enhance wellbeing and prevent the cyclical nature of Adverse Childhood Experiences (ACE).

In response to our statutory safeguarding duties and legal duties (Serious Violence Duty and Domestic Abuse Act) and to fulfil the NHS commitments in the GM Gender Based Violence Strategy[7] and emerging Violence Reduction strategy we will:

Measuring our Delivery

Accountability

Area of Focus: Develop a sustainable environment for all

Action: Delivering the NHS Green Plan

Climate change is the greatest global health threat facing the world in the 21 st century, but it is also the greatest opportunity to redefine the social and environmental determinants of health (Lancet Commission, 2009).

In May 2022, we published our Green Plan 2022-2025, aligning priorities and carbon budgets with the national NHS Delivering a ‘Net Zero’ National Health Service report and the GMCA 5 Year Environment Plan. Two overarching goals are outlined:

Over the next five years we will focus on delivering and scaling up activities outlined in the Green Plan, refreshing this as necessary to ensure it remains current, and maximising the opportunities from collaboration.

Measuring our delivery

Accountability

Helping people stay well and detecting illness earlier

There is a strong rationale for the NHS to increase its focus on prevention and improving population health outcomes. For the past decade, improvements in life expectancy and healthy life expectancy have stalled, and inequalities have widened.

Life expectancy and healthy life expectancy for people born in GM is significantly lower than the England average. Importantly, much of this burden of poor health and early death (borne disproportionately by the most deprived and marginalised communities) can be attributed to conditions that are preventable through coordinated action across the health and care system.

Key details

Delivery Leadership:

System Leadership:

Clinical Effectiveness and Governance Committee (CEG); Population Health Board

Areas of focus and actions:

1. Tackling inequalities

2. Supporting people to live healthier lives

3. Upscaling secondary prevention

4. Living well with long-term conditions

The complexity and breadth of activity that is required to drive change through prevention and early detection is set out in our GM Framework for Prevention below:

For the purposes of the framework, we have used the broader definition of secondary prevention, used by the UK chief medical officers, to include “evidence based, preventive measures to help stop or delay disease, taken during an interaction between an individual patient and a clinician” [8].

Our framework has four distinct areas of focus:

  1. Tackling inequalities and reducing unwarranted variation through Core20Plus5 and the GM Fairer Health for All Framework
  2. Supporting people to live healthier lives by implementing comprehensive approaches to tackling behavioural risk factors for illness
  3. Upscaling secondary prevention across the NHS (including the early identification of risk and diagnosis of illness, and the effective management to prevent progression).
  4. Supporting people to live well with long term conditions through the equitable, effective, and efficient management of diagnosed health conditions

We need to put in place more upstream models of care and integrated neighbourhood models that better address the needs of those at higher risk of illness, and those not currently in contact with services. This will require increased population health management capability.

Secondary prevention must be an integral part of all patient care pathways. All medical and allied professionals have an opportunity to ‘make every contact count’. Prevention activities also need to be extended to population groups with historically low uptake, and those not in contact with NHS services, to ensure delivery within communities and neighbourhoods.

As set out in the GM Prevention Framework, the NHS also has an important role to play in working across the system with partners to address the root causes of ill health (relating to factors such as poverty, education, work, and housing), and to shape GM as a place that is conducive to good mental and physical health.

Area of Focus: Tackling health inequalities

Action: Implementing a GM Fairer Health for All Framework

Health inequalities mean that some groups have significantly worse health outcomes and experience than others. These inequalities are avoidable, unfair, and systematic.

Reducing health inequalities is a priority for NHS GM and we continue to work in partnership across the NHS, local government, and voluntary sector to take comprehensive approaches to address the socio-economic causes of poor health. In doing so, we must ensure that we address the profound inequalities experienced by those communities that face specific challenges in accessing health and care services and those at greatest risk including rough sleepers, migrants and people in prescribed places of detention.

We have worked with system partners and communities to codesign a Fairer Health for All Framework to ensure that health equity and equality and sustainability are embedded systematically at the heart of our decision making, system leadership and governance. The Framework outlines our shared principles and provides a set of intelligence, workforce development and leadership tools in the Academy and Intelligence hub which will enable coordinated action to reduce inequalities.

The Fairer Health for All Academy is creating opportunities for partners to share learning on how they are developing social models for health that go beyond clinical intervention and create upstream models of care that are

The GM Health and Care Intelligence Hub is a web-based portal that is being co-designed to bring together data, community insight, web-based tools, guidance, shared learning and workforce development resources to support people working in health and care to better understand health inequalities and variation in care in their areas and implement upstream models of care.

Cross-sectoral intelligence (data and insight from public and VCSE partners accessed via the GM Health and Care Intelligence Hub), supports a shift in how we understand health inequalities across the life course and for people with multiple conditions to inform allocation of resources according to need. This cross-sectoral approach is facilitated through a GM VCSE intelligence group, and investment in VCSE capacity and skills to collate and analyse data and insight.

The Intelligence Hub contains Population Health Management tools which facilitate a shift in how we understand health inequalities across the life course for people with multiple conditions and how we understand the inter-section between different protected characteristics. These tools will support people planning and delivering care to identify and enrol individuals onto acute and chronic disease remote monitoring programmes; mitigate risks of health deterioration; and support the identification of appropriate population level or prevention interventions.

Our key delivery actions are:

Measuring our Delivery

Accountability

Action: Delivery of CORE20PLUS5 (adults)

The CORE20+5 framework for adults outlines the key clinical areas that should be targeted to reduce health inequalities.

Of the five clinical areas of health inequalities, severe mental illness annual health checks, chronic respiratory disease, early cancer diagnosis and hypertension case finding are covered in Area of Focus: Upscaling Secondary Prevention

We have developed a Maternity Equity and Equality Action Plan. The plan has been carefully co-designed and co-produced with the people we serve. It is an ambitious and dynamic plan with particular focus on those areas that make the biggest impact:

In 2022 the GM Equity and Equality steering group was established which brings together clinical, VCSE, education colleagues to oversee and deliver the Maternity Equity and Equality Action Plan.

The group have already delivered on improvements identified in the plan including the development of Black and Asian Maternity Equity Standards, public facing information materials, working with Maternity Action to support pregnant women at work and the commencement of a student mentor scheme.

GM Cancer Alliance established a Cancer Health Inequalities Working group in 2021, and it leads on the health inequalities work programme for the cancer system in GM.

Examples of work include:

The strategy and implementation plan for 2023-24/5 was approved by the GM Cancer Board in May 2023.

Key priorities are:

Measuring our Delivery

Accountability

Action: Equity in access to care and improved experience and outcomes for all children and young people (CORE20PLUS5 clinical priorities)

The national CORE20PLUS5 framework for children and young people (CYP) outlines the key clinical areas relating to secondary prevention that should be targeted to reduce health inequalities

Over the next five years, we will:

We will draw on the #BeeWell survey to inform and develop our priorities. #BeeWell, the youth-led survey of young people’s wellbeing and experiences, was co-designed with 150 young people to provide an insight into how pupils in schools across Greater Manchester. Almost 40,000 pupils in Years 8 and 10 responded to the survey when it was launched in 2021. The survey is the largest of its kind in the country and we plan to expand it further.

Measuring our Delivery