Agenda item

Will Blandamer Executive Director (Health and Adult Care) to support.

NHS Restructure paper

Appendix 1 Model ICB blueprint

Appendix 2 NHS Reform slides

Will Blandamer, Executive Director for Health and Adult Care, delivered a presentation outlining the significant changes being implemented across Integrated Care Boards (ICBs). He explained that NHS England is being dissolved, with its responsibilities transferring to the Department of Health. As part of this national restructuring, ICBs are required to reduce their running costs by 50%, with Greater Manchester’s ICB budget expected to fall from £109 million to £65 million. A new operating model is being developed during June and July to determine which functions are best delivered at the Greater Manchester level and which should remain local. Will emphasised the importance of maintaining strong partnerships and local relationships during this transition.

Councillor Tariq provided additional context for new members, explaining the role of the Greater Manchester Integrated Care Partnership (ICP), which includes political leadership from across the region. He noted that he represents Bury within this structure and highlighted the importance of ensuring that the transition does not become overly Manchester-centric. He also referenced the leadership of Andy Burnham in steering the partnership forward.

Councillor McBriar raised concerns about whether Bury would be able to maintain its current position and performance under the new arrangements, given the scale of the reductions. In response, Will Blandamer acknowledged the risks but expressed confidence in the strength of Greater Manchester’s alignment with local government structures and its 10-year plan, which focuses on wider determinants of health. He stressed the importance of nurturing local relationships and expressed doubt that a fully centralised model would be adopted.

Adrian Crook added that while significant improvement work has been undertaken, halving the workforce poses a real risk to service delivery. He reminded the committee of their powers to request further reports, make recommendations and ultimately write to the secretary of state requesting a consideration of a “call in” of any proposal.

Councillor Fitzgerald highlighted the need to invest in prevention and ensure that people are treated fairly. She warned that without proper investment, there is a risk of medicalising conditions unnecessarily and incurring higher long-term costs. She also noted that these issues are on the radar of the Greater Manchester Health Scrutiny Committee.

Councillor Ryder asked about the potential impact of staffing reductions and whether any plans were in place to address gaps. Will Blandamer responded that there is no nationally funded redundancy scheme and that while efficiencies may be possible, there is a risk of having the right number of staff in the wrong places. He assured the committee that business continuity would be a priority.

Councillor Boles raised concerns about the future of safeguarding if responsibilities were moved away from the ICB. Will acknowledged these concerns and emphasised the importance of safeguarding roles, noting that NHS Greater Manchester will retain statutory safeguarding responsibilities for both adults and children. He explained that the question remains whether safeguarding is best delivered centrally or locally. Adrian Crook reinforced that safeguarding remains a statutory duty and that any changes could pose risks.

Further concerns were raised about the streamlining of SEND services. Will explained that NHS Greater Manchester and local partners have statutory responsibilities for the SEND partnership. He referenced Bury’s recent SEND inspection and noted that many of the required improvements fall within the remit of local and regional health partners. Adrian Crook added that health services for children are commissioned by NHS GM and that any changes to commissioning could pose risks to the SEND cohort in the future.

Councillor Fitzgerald asked how these changes align with service reconfigurations in children’s services. Will confirmed that NHS GM remains the commissioning body, though with reduced capacity. Councillor Boles expressed concern that Bury’s voice could be lost in the new arrangements. Adrian Crook noted that while duties could be delegated, there is a risk that local input and influence could be diminished. Will concluded by stating that the 10 local authorities are working together to ensure effective commissioning.

Councillor FitzGerald thanked Will for his leadership during this challenging period, and Will in turn thanked his team and staff for their continued efforts.

It Was Agreed

• The update be noted
• Will Blandamer be thanked for the update

·         A task and finish group on the structural (ICB) and service changes