GK associate, Phil Hope, discusses the nuances of local devolution of health and social care following our report ‘Devolution Disconnected: Political Priority, Public Apathy‘.

“The Government is devolving budgets and responsibility for health and social care in different ways in different parts of the country including Greater Manchester, Liverpool City Region, London, Cornwall and the North East Region. Whilst this is genuine devolution from national decision-making, it may feel more like local centralisation to the many different social care and NHS commissioners and service providers who will experience new area-wide structures for spending decisions across the whole footprint of each devolved area.

These local areas are taking this high risk opportunity in the hope that the advantages of increased local budgetary control, strong local relationships and a shared commitment to outcome-driven reform outweigh the political and service risks of coping with massive reductions in funding at a time of rapidly growing demand and nationally imposed costs.

For devolution of health and social care to be successful some key questions have to be considered – will the new structures be given freedom to diverge from national systems of funding formulas and tariffs, means tests and eligibility criteria, and governance rules and protocols?”

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