The vision for Greater Manchester Health and Social Care Partnership (GMHSCP) Theme 3 Models of Care is, “The creation of ‘single shared services’ for acute and specialised services to deliver improvements in patient outcomes and productivity, through the establishment of consistent and best practice specifications that decrease variation in care; enabled by the standardisation of information management and technology”.

The NHS Transformation Unit (TU) was brought in to support the Theme 3 programme groups to co-design the following Models of Care (MoC): Benign Urology; Breast; Cardiology; Orthopaedics and MSK; Respiratory; Surgical Paediatrics; Vascular. The TU worked with clinicians and patients to develop these clinically-led MoC. By reflecting the changing needs of the local Greater Manchester population, they will also inform future service models.

Each MoC was championed and supported by a Clinical Lead/s and a designated Provider Transformation Lead, who worked as part of the core team. Design and engagement workshops involving clinicians, staff and patients have taken place over the past 12 months with each model being discussed, tested and reviewed through each stage of its development.

I really enjoyed last night, I thought you guys did a fantastic job and the facilitators were brilliant. We got the balance right of ‘being able to disagree without being disagreeable’. 

“We also had the right balance of having ‘a clash of ideas but not a clash of personalities’. The next couple of discussions are key, but getting the process done quickly with weekly meetings is the right speed for these kind of things,” Mr Naseer Ahmad, Consultant Vascular Surgeon, Manchester Royal Infirmary.

As part of the governance process, all the MoC have been externally reviewed by an External Clinical Advisory Panel. In this case the North East Clinical Senate assessed for safety and clinical standards and their feedback has been very positive recognising the clinical focus of the models with comments including:

“The model of care is cogently explained and could, if successfully implemented, be an exemplar for other health systems to follow. 

“The proposed model of care is fundamentally safe and provides a great opportunity, alongside urological cancer services, to address the challenges facing the current service and deliver the benefits identified in the Model of Care document.”

The MoC has also been through the local governance process, including the Clinical Reference Group, Workforce Reference Group and Finance and Estates Reference Group. The recognition was that the process is an iterative one and that the MoC will be reviewed again once further modelling has taken place.

Key lessons learned

As part of the lessons learned from this work, there are a number of points worth noting:

  • The clinical leads have truly led the process and acted as system leads rather than organisational leads.
  • There has been a healthy discussion around the need to maximise the future ambition of Greater Manchester alongside the need to meet national standards.
  • Recognition that Theme 3 Models of Care are closely linked with the Healthier Together programme.
  • The role of the governance groups, in particular the Clinical Reference Group (CRG) have been pivotal in helping to progress the models of care.

“We were told today at CRG that paediatrics was being led in an innovative and creative way that has such an air of collaboration about it that all of Greater Manchester could learn from us! Also, that our model was the clearest one presented yet,” Clinical Reference Group member.