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Devolving health and social care decisions to local politicians and professionals adds further complexity to an already complex system.

This is the argument researchers Julia Segar, Anna Coleman and Kath Checkland from the University of Manchester's Centre for Primary Care in the Institute of Population Health make in a recently published article about the inclusion of health and social care as part of Greater Manchester devolution. In 'Like a circle in a spiral, Like a Wheel within a Wheel’: The Layers of Complexity and Challenge for Devolution of Health and Social Care in Greater Manchester published by the journal Representation, they say "The inclusion of health and social care practitioners and managers have been working together in differing ways across the conurbation for many years. The formalisation of this working in a set of new organisational structures brings both opportunities and challenges. The devolution proposals add an extra layer of organisational complexity and they rely heavily on collaboration and co-operation rather than competition. In their paper, researcher explore areas of potential tension and difficulty focussing on: public participation in health and care devolution; the imperative to simultaneously compete and collaborate; and blurred lines of responsibility and accountability between new organisations."

In the blog post: Health and social care devolution: it’s complicated, the authors discuss the case of Wythenshawe and the Keep Wythenshawe Special’ campaign led by clinicians from Wythenshawe Hospital which responsed to the Healthier Together programme that seeks to rationalise hospital care across Greater Manchester (GM) ensuring equality of provision across the conurbation.

Former SPCR training lead for Manchester, Kath Checkland is Professor of Health Policy and Primary Care, in the Centre for Primary Care at the University of Manchester. Her research focuses upon the impact of health policy changes on the NHS.

Further news from the department:

GM Health and social care devolution
Kath Checkland on NW Tonight (6-30pm and 10-30pm, 31/3/16) and The Today Programme (7:50am, 1/4/16 )


Guardian Comment

Animation for cities@manchester is being used by the BBC:

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