I spent last Friday with the NHS thinkeratti, at the Nuff's policy summit; a beautiful country house in the Surrey Hills... the Davos of health conferences.

As absorbing as the conference was (and it certainly was) I got the feeling the delegates had one eye on the PowerPoint and the other pointing north to developments in Manchester.

The combined brain-boxes seemed to conclude that everything Manchester was poised to do, could be done, pretty well everywhere, right now.

If the key objective was getting Health and social care together there is no impediment stopping joint anything and shared everything... right now. Money, resource and agendas can be committed, communal, collective and co-operative. Devo-Manc will make it happen. 'Make it happen'.... That's the difference.

My guess is Devo will appeal to other regions. Too bad if it doesn't because this is not about health, it's about devolution. In Scotland and Wales health is a devolved responsibility; devolution in England means health will be devolved to regional government. We might end up with eight or ten versions of the NHS.

Whilst the thinkers in Surrey were thinking about what the thinkers were thinking in Manchester this document surfaced; the memorandum of understanding that will give birth to the Greater Manchester Health and Social Care Devolution.

Just fifteen pages that could change the NHS forever. It is a thoughtful document, careful and clever. Expertly drafted. The opening sentence sets the tone:

"The overriding purpose of the initiative represented in this ... (document)... is to ensure the greatest and fastest possible improvement to the health and wellbeing of the 2.8 million citizens of Greater Manchester."

If it's not the sort of thing you'd normally bother with, please do, just this once; in the spirit of '...where were you when the NHS broke up...' you'll be able, at least, to say you were an informed spectator!  Flick though it or I'll tell yer grand-kids...

Go to page 10 (Para9);

"...the (Council) is responsible for designing and creating the provider structure and form, to support its commissioning intentions."

What? Yup and if you think that is a 'read it again' moment, you should see the rest of it...

"... the (Council) to play a clearly defined leadership role in the oversight of its provider community working in close partnership with Monitor, TDA and CQC."

Got that? 'Leadership role'. The TDA is a dead duck anyway but Manchester is saying to Monitor and CQC, get your tanks off our lawns; 'We will lead oversight'.

Devolved funding must mean Manchester will set their own tariffs and model their own commissioning. Manchester's Smithfield Market in Whitworth St East is quite enough thank you.... they won't want a healthcare market as well.

The CQC? Devo-Manc will develop services that entwine social care, end2end, including; the voluntary sector, primary, community, housing, highways and secondary care, seamless and one piece... the flat-earthers will be scratching their heads. They can't see beyond the end of a bed, never mind down a care pathway. The Manchester maze will finish them off.

My guess is the Manchester will focus on the good stuff and outcomes. Good stuff and outcomes... that's what we want isn't it?

One of the Surrey-Davos stars, Dr Brent James Chief Quality Officer and Executive Director, Institute for Health Care Delivery Research, Intermountain Healthcare, US, showed the audience the way to quality;

"...key process analysis, evidence base, best practice protocols, embedded data tracking systems, recognising no 2 patients are the same so anticipate variations based on need and creating a learning loop."

(Make a cuppa-builder's and watch this, it's excellent).

Note: He doesn't talk about spending �300k marching 80 people through a hospital for three days looking for an empty glass out of the reach of a sleeping patient or a knackered nurse leaving a curtain ajar. I wonder why?

In the dizzy heights of the Surrey Hills I detected a shift.  What Dr Brent James, the thinkeratti and the leaders of Manchester have grasped is; 16 years of regulation has improved diddly-squat and the way to fabulous healthcare is finding good stuff and repeating it not repeatedly bashing people with the bad.

Result!

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After 'Davos' I came back to the amazing news;

24,000 pages of good stuff have been visited at the

Academy of Fabulous Stuff;

hundreds have searched for ideas and shared their successes.

How about you?

Put it on your to-do-list; be a sharer this week. 

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TV doctor and comedian Phil Hammond in conversation with Roy Lilley

59 minutes to save the NHS - can they do it?

 RCN HQ London 1st April - details here.  

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