Agenda item

Presentation attached to be presented by Will Blandamer Executive Director for Health and Adult Care, supported by Kath WynneJones Chief Operating officer, IDCB

To reflect the inclusion of children’s health within the Bury Locality Plan, members of the Children and Young People’s Committee were invited to join this item. The Locality Plan is scheduled to be presented to the Locality Board in April. This Committee has been asked by the GMCA Health Scrutiny Committee to review the local document in the context of the Greater Manchester Sustainability Plan for the next five years.

Members were expected to have reviewed the presentation in advance of the meeting.

Will Blandamer, Executive Director for Health and Adult Care, supported by Kath Wynne-Jones, Chief Operating Officer of the Integrated Delivery Collaborative Board (IDCB), presented the item.

Will Blandamer provided an overview of the presentation, noting that the Locality Plan is due to be submitted to the Locality Board, which is chaired by Dr Cathy Fines and the Leader of the Council. He emphasised that what happens in GP practices has a direct impact on outcomes and opportunities for children, and that the plan offers a comprehensive overview of the health and care system, including urgent care and other key areas across the year.

He stressed the need for a strategy that supports both transformation and business-as-usual operations.

The Bury Locality Plan is embedded within the broader “Let’s Do It” strategy and reflects the integrated care partnership model shared across all ten Greater Manchester localities. The plan identifies four key priorities, which are detailed in the presentation slides, and includes references to health checks in primary care and the growing demand within the community.

Will acknowledged the ongoing challenges, describing the current situation as unsustainable for residents. However, he highlighted progress in neighbourhood working, with five integrated neighbourhood teams and community children’s services now working together effectively.

This integrated model is seen as a cornerstone of the plan and is well advanced. He drew attention to page 18 of the presentation pack, which outlines key challenges in Bury. These include the need to build greater confidence in the first 1,000 days of a child’s life and to strengthen operations around SEND services. While there are still gaps in mental health provision, investment is beginning to close those gaps. The plan also focuses on ensuring that primary care services are equipped to deliver early intervention and that services are co-designed with people who have lived experience.

The plan aligns with the “Let’s Do It” strategy and recognises the vital role of the voluntary sector in supporting health and wellbeing. Will also noted challenges around clinical sustainability and the need to consider changes to the configuration of local hospital services, particularly in relation to critical mass and clinical specialisms. Urgent mental health needs, especially in children’s services, were also highlighted.

Kath Wynne-Jones added that the team has developed a series of user case studies to illustrate the plan’s ambitions and bring the strategy to life for both the population and the workforce. She shared examples including:

• Brenda, whose case focuses on menopause awareness and how community support can improve outcomes.
• Muhammed, whose case highlights the role of social prescribing and voluntary sector collaboration in supporting patients through GP practices.
• Jack, an older adult experiencing frequent falls, who now benefits from a care plan, pendant alarm, and support from rapid response neighbourhood teams.
• Claire, who is managing anxiety and depression while preparing for surgery and is receiving specialist community-based assessment and support.

These case studies were used to humanise the strategy and demonstrate its real-world application.

Will concluded the presentation by reiterating the importance of the locality plan and its alignment with broader GM priorities.

Councillor Tariq, Cabinet Member for Health and Adult Care provided further context, noting that the locality plan reflects discussions at the city-region level and is closely linked to work across the Integrated Care Board (ICB). They highlighted the importance of supporting young people through services such as SEND and children’s social care, and acknowledged the ongoing challenges faced by local authorities. The recent changes to NHS England and the requirement for ICBs to reduce capacity by 50% were noted as significant, with questions raised about the potential impact on local services.

The Committee also discussed the need to refresh the health inequalities plan in line with the updated “Let’s Do It” strategy. The locality plan includes key highlights from the recent LGA peer review, which described Bury’s work as “outstanding.” However, members acknowledged the ongoing pressures on the system and the need to continue delivering high-quality services despite these challenges.

Two key initiatives were highlighted:

1. Work Well – a programme linking health and local businesses to support employment and wellbeing.
2. ADHD Services – Bury’s leadership in this area at the GM level, with strong national links and a focus on integrated care.

A question was raised about how the locality plan addresses non-clinical factors that influence health, such as the environment and community infrastructure. The example of the Trees Estate was cited, and the member asked how the strategy incorporates these wider determinants of health. In response, it was acknowledged that while the plan is primarily focused on service delivery, there is a growing recognition of the importance of environmental and social factors. The strategy aims to build stronger links with non-service providers and community assets to promote health and wellbeing more holistically.

Will Blandamer addressed the Committee on the broader context of NHS performance and sustainability. He noted that the health and care system particularly in areas such as mental health, primary care, and elective care is facing significant strain and is, in many respects, unsustainable. This challenge is directly linked to Priority 1 of the Bury Locality Plan. He explained that the Health and Wellbeing Board (HWBB) considers all determinants of health, including wider social and environmental factors.

The plan aims to connect NHS performance with community-level outcomes, including opportunities for physical activity and the role of the built environment.

A question was raised about the realism of the plan considering the 50% cuts to Integrated Care Boards (ICBs). Will responded that the recent announcement to abolish NHS England and reduce ICB capacity by half has created uncertainty. The ICB, as the commissioning body for NHS Greater Manchester, holds the budget and is responsible for orchestrating services locally. While the rationale for these changes may be to centralise control, the implications are not yet fully understood. Will acknowledged that a new operational model will be needed and that integration efforts to date have positioned Bury well. However, he cautioned that further guidance is awaited, and that the system is currently in a period of turbulence. Monthly meetings with the mayor and cabinet members across the ten localities are ongoing to address emerging budgetary challenges.

The Committee asked about the impact of these changes on the sustainability plan. It was confirmed that an update will be provided in April, which will clarify whether the changes involve service cuts or structural adjustments.

Concerns were raised about the implications for service users and the workforce.

A member referenced the positive experience with the falls team and questioned whether care plans are being regularly reviewed and monitored. Adrian Crook responded that Adult Social Care is monitored by a dedicated quality assurance team, with regular visits and oversight. He referenced the “State of the Care Sector” report, which shows that most agencies in Bury are rated good or better, placing the borough in the top quartile nationally. While the team cannot be everywhere at once, improvement actions are taken where needed.

The issue of GP shortages in Bury was raised. Will acknowledged that GP access remains a concern, particularly regarding face-to-face consultations. He explained that historical funding patterns have contributed to the current shortfall. Efforts are underway to make Bury a more attractive place to work, including offering additional payments and incentives to GP practices.

A question was asked about why childhood obesity was not explicitly mentioned in the locality plan, given the high levels of deprivation and the fact that 10% of reception-aged children are obese. Will clarified that childhood obesity is included in the full plan and is central to Priority 1, which addresses health inequalities. He emphasised the importance of physical activity and diet in tackling poverty-related health issues. Another member added that there had been extensive discussion around childhood obesity, including plans to pilot new support initiatives involving parents, schools, and community stakeholders.

The Committee also discussed the impact of delays in elective care, particularly in dentistry, on children’s readiness for school. Will noted that only 60–70% of children had seen a dentist during the pandemic, and that this remains a challenge. He highlighted the role of neighbourhood teams and family hubs in supporting early intervention and linking services to children and young people.

A member raised the issue of screen time and its impact on children’s health, asking how best to communicate this to parents. Will agreed to raise this with children’s services and relevant stakeholders.

The discussion returned to the case study of Brenda, which focused on menopause awareness. A question was asked about how symptoms are being recognised and monitored, given the risk of misdiagnosis. Will committed to seeking a clinical response to this question.

Another concern was raised about communication with residents who are not already engaged with services. It was noted that those within the system tend to receive better support. Will acknowledged this and said that efforts are being made to proactively reach out to residents through GP practices and the Bury Directory. He noted that while there is no formal communication plan for the locality plan, work is ongoing with communications leads to improve outreach.

The usefulness of the case studies was praised, but it was noted that none of them featured children. A member asked how co-production with children and parents could be improved. Will agreed that this was a valid point and acknowledged the need for more systematic co-production. He referenced the work of the SEND Partnership Board and various co-production groups but accepted that more could be done to include children’s voices in the planning process.

Finally, a member summarised two key challenges: the need to build greater confidence in the first 1,000 days of a child’s life, and the need for a strengthened NHS response to the operation of the Bury SEND Partnership. These were identified as areas requiring focused attention and practical action.

It Was Agreed:

·         The presentation be noted