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Manchester submits LCO bid as integrated planning moves forward

The process of setting up local care organisations (LCOs) as part of Greater Manchester’s (GM’s) health devolution is progressing smoothly, with Manchester being the latest of the region’s 10 localities to submit development proposals.

LCOs, a term developed in GM to describe how the region will secure a “proactive, preventative population health model”, are expected to take the best of local, national and international learning from accountable care organisations (ACOs) and apply them to GM.

The new model will be expected to shift care and resources from the acute sector into a “strengthened model” of health and care within the community, as well as support individuals to take more control over their own health.

GM localities have worked together over the last 10 months to share the ongoing development of each LCO, meaning a more “detailed composite picture” of the common design features is now emerging, board papers from the GM Health and Social Care (GMHSC) Partnership’s meeting today have revealed.

“Localities are at different stages of development of the LCOs and a small number of alternative approaches to establishment and mobilisation are emerging as models are built either through initial prime providers or as alliance models,” the paper said.

“In either case there is little dissonance with national frameworks for MCPs and PACs and the commonalities of the proposed contractual options through ‘virtual’ models where providers are bound by an alliance agreement; the ‘partially integrated’ model where a contract is let for the vast majority of services within a single budget; and the ‘fully integrated’ model where there is a single contract for all health & care services.”

Detailed design of the strategies of LCOs are also at varying stages of development, but “active discussion, engagement and co-design are evident” across the region, the partnership argued.

Salford and Stockport have both submitted the LCO proposals for their Transformation Fund Oversight Group to consider. According to separate board papers, Manchester has also now submitted its transformation fund bid, part of which focuses on the development of its LCO.

Assessment of the LCO proposals has already kicked off this month, and its Transformation Fund Oversight Group has been convened for January next year to support the process.

LCO proposals must abide by a series of obligations that ensure the model will function successfully. These include enabling conditions to be managed at home and in the community; securing the contributions of the full range of public service partners to provide early help and intervention; supporting individuals to take more control over their own health; and taking full responsibility for the management of population wellbeing.

GMHSC Partnership also devised a 12-stage process through which plans go through. There is an “early requirement to calibrate this development process with local leads driving the development of the individual LCOs”. These discussions are also “needed now” to ensure GM can identify how ready each locality is, as well as any opportunities available for joint work.

As previously revealed by the partnership’s chief officer, Jon Rouse, in an exclusive interview with NHE, GM is also pursuing a potential partnership with New York State in order to learn from its Medicaid reforms – which could help support LCOs by sharing learnings on value-based payment reform and patient-centred analytics, for example.

Amongst the board papers was also GM’s six-month update report, which Rouse had told NHE was expected to come out by the end of November. It explains how the region is faring across its four main pillars.

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