Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, with reference to his plans to devolve health and social care provision and expenditure in Greater Manchester, what safeguards he plans to put in place to ensure minimum standards of care and treatment within NHS services in that area remain when that devolution of powers has taken place.

This is a genuine and historic partnership between local organisations in Greater Manchester, with general practitioners as clinical leaders working with elected leaders to improve services for people living in the area.

These proposals, welcomed almost universally, build on Greater Manchester’s long history of collaboration which has provided evidence of how joint working can support improvements to all public services. They also build on this Government’s focus on innovation and integration between health and social care services, set out in the Care Act 2014, Health and Social Care Act 2012, the devolution of public health budgets to local authorities and the Better Care Fund. It is also a major step forward in delivering the Five Year Forward View published by NHS England.

The NHS bodies involved, including NHS England and the relevant clinical commissioning groups (CCGs), will remain accountable for the exercise of their functions. The Secretary of State’s powers of intervention in the case of failure in relation to NHS England, and NHS England’s similar powers in relation to CCGs, will remain as now.

During 2015/16 funding arrangements will not change. However from April 2016, CCGs, local authorities and NHS England pool even greater resources to allow integrated, local decision-making. There may be some exceptions to the services and funding streams which are in scope but this detail is being worked through between the local partners. The fundamental national policies, inspection regimes, guidance and regulations will continue to apply to Greater Manchester but, in line with the Five Year Forward View, Greater Manchester will exercise greater freedom in how they are implemented so that local services better reflect the priorities of local patients and service users.

There are legal duties on NHS England to consult before entering into the partnership arrangements on which Greater Manchester’s plans are based. There are also wider legal duties on National Health Service commissioners to consult and involve patients and the public in their plans. These duties will continue to apply and consultations will be brought forward in due course. Guidance is explicit that commissioners should also fully engage with providers when developing plans for service changes.

Employers in the NHS are already free to determine pay and conditions for their staff. They may choose to use national contracts or to adapt these locally. NHS staff’s employment contracts are protected by employment law in the same way as for other employees.