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Wednesday 08 May 2019

NHS regulatory framework ‘broken’, says Greater Manchester health and care chief

By Matt Ross

Greater Manchester health and care chief Jon Rouse
Mark McNulty
Greater Manchester health and care chief Jon Rouse

The system of NHS competition established under former health secretary Andrew Lansley is hampering work to create an integrated care system in Greater Manchester, the city region’s health and care lead has told Managers in Partnership.

Speaking in an exclusive interview, Jon Rouse, Chief Officer of the Greater Manchester Health and Social Care Partnership, pointed out that “the things that slow us down are not in Greater Manchester: they are national processes which have just not evolved to reflect the changing landscape of integrated care systems.”

Rouse is working to promote collaboration between public services at the frontline and to build a strategic, city region-wide hospital care model. And as city-regional leaders work with trusts to reform care provision, he said, “we’re constantly having to shoehorn capital bids – these transactional processes – into a construct which is just out of time.”

The regulatory framework established under Lansley’s reforms, he explained, is “there to manage a competitive market. We’re basically saying we’re not interested: our model is one of a network that is based on principles of collaboration, of peer support, of mutual aid, of joint endeavour, of integration. And frankly the regulatory model is just broken when it comes to that reality.”

National regulatory bodies have, he stressed, done everything they can to support Greater Manchester’s work. “We have been brilliantly supported by NHS England and NHS Improvement and Public Health England and Health Education England,” he said. “They have been really facilitative and permissive, and bent as far as they can the statutory framework in order to enable us to do the things that we’ve done. My comments on the legislative framework are no comment on the organisations administering it; they’ve been great.

“But as we roll out integrated care systems across the country, that could be made easier if the legislative framework caught up with the new reality.”

Rouse welcomed the proposals in NHS England’s consultation on reforming regulatory structures, noting that his organisation is “broadly supportive of the legislative proposals that have been published.”

“The good news is that this [problem] has been recognised,” he said. “In the meantime, we’ll continue to get on with as much as we can. But these proposals would help in terms of taking costs out – frictional costs, transactional costs – and speeding things up.”

For more on how Jon Rouse is working to transform health and care across Manchester, please read our full interview

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