Intended for healthcare professionals


The Greater Manchester experiment

BMJ 2016; 352 doi: (Published 22 March 2016) Cite this as: BMJ 2016;352:i1611

This article has a correction. Please see:

  1. Richard Vize,
  2. freelance journalist
  1. London
  1. richard.vize{at}

On 1 April, Greater Manchester takes control of its £6bn health and social care budget in a historic devolution of power that it hopes will dramatically improve the health of the local population. Richard Vize reports

A huge experiment is about to begin in Greater Manchester. On 1 April, power to manage the £6bn (€7.7bn; $8.7bn) budget for health and social care in the metropolitan county will be devolved, and an ambitious plan will be put in motion to change every aspect of the health and care system in the next five years.

Foundation trusts will have surrendered their autonomy in the interests of planning hospital care across the city region; GPs will no longer be independent businesses but part of locality focused hubs (see box) providing a wide range health and social care outside hospitals; and a projected £2bn hole in finances will have been filled.

Taking Charge,1 the blueprint for change published in December by the Greater Manchester Combined Authority, said that GPs will become leaders of local care organisations (LCOs) running primary, community, social, and mental healthcare services, as well as some acute services, as part of a determined plan to move the centre of gravity away from hospitals.

In a few years’ time GP services “will be fairly unrecognisable,” says Tracey Vell, chair of the Association of Greater Manchester Local Medical Committees. The plans have “largely landed well [with GPs] because we’re seeing the crisis coming in some areas of general practice; everyone’s worried,” she says.

Overhaul of services

The overhaul of GP services typifies the shift in thinking and ways of working that all health providers across Greater Manchester are about to undergo, in one of the most radical NHS experiments since local authorities were stripped of health responsibilities in 1948. Greater Manchester negotiated the devolution …

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