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Manchester Local Care Organisation

The new Manchester Local Care Organisation (MLCO) took over the runnng of statutory community health and social care services from April 2018. 

In some ways, MLCO will be “all the parts of health and social care which aren’t a hospital” – but it will clearly be more complex than that and especially it will have to play a leading role in trying to change the way services and support are delivered through community based health, primary and social care services – and in how it works with the voluntary, community and social enterprise sector. Further information can be found here: https://healthiermanchester.org/how-health-and-care-services-will-change/mlco/

May 2018 - MLCO have finalised their report outlining how they will work across and in the 12 neighbourhoods in Manchester. This will enable the neighbourhoods, residents and frontline staff to have the opportunity to raise new ideas and influence strategies from the neighbourhoods with a direct connection straight up to MLCO. 

This is very much a work in progress. From a VCSE sector perspective, the story so far is:

  • An open letter was sent from commissioners to Manchester’s VCSE sector in November 2016 inviting views on a draft LCO Prospectus
  • Macc convened a meeting where a group of sector leaders met with commissioners to discuss ways the prospectus could be strengthened
  • Macc drafted comments, circulated them to sector colleagues and submitted the final version to commissioners as a response – published below
  • The final LCO Prospectus was formally issued in February 2017 (a copy is available below) as part of a process of issuing a contract for the LCO. This was a tender process – Commissioners had been advised that because of the £6bn scale of the 10 year contract for the LCO, procurement law required it to be put out to tender through the standard EU process. This was in two stages:
    • Stage 1: identifying a suitable provider. Expressions of interest and proof that you can deliver everything required (from social care to GP services). This closed at the end of April 2017
    • Stage 2: Submission of a business case. The selected provider had to explain how they would deliver the LCO. This took place over the summer with submissions in September 2017
  • Since early 2016, the VCSE sector has been represented on the Manchester Provider Board by Simone Spray from 42nd Street and Mike Wild from Macc. We have been working with the Board to increase awareness of the VCSE sector’s role in the city and particularly in the LCO etc. This is a long process of contributing to conversations, trying to influence plans, care model discussions, etc. Some VCSE sector leaders contributed to a number of workshops during summer 2016 – and we are trying to ensure there will be more opportunities for co-design of services with the VCSE sector in future. The Manchester Provider Board membership comprises:

    • Central Manchester University Hospitals NHS Foundation Trust
    • Pennine Acute Hospitals NHS Trust
    • University Hospitals Of South Manchester NHS Foundation Trust
    • Greater Manchester Mental Health NHS Foundation Trust
    • Manchester City Council
    • Northern Health GPPO Limited (North Manchester GP Federation)
    • Primary Care Manchester Limited (Central Manchester GP Federation)
    • SMGPF limited (South Manchester GP Federation)
    • North West Ambulance Service NHS Trust
    • Greater Manchester Fire And Rescue Service
    • Southway Housing
    • Greater Manchester Local Pharmacy Committee
    • Local Medical Committee
    • Local Dental Committee
    • Manchester Local Optical Committee
    • Go To Doc Healthcare
    • …and the voluntary, community and social enterprise sector represented by the CEOs of Macc and 42nd Street.
  • Manchester Provider Board has built an Executive Team and put together a bid to deliver the LCO. This was successful.

November 2017: Update
Michael McCourt, Interim CEO for the Manchester Provider Board, has written a blog (attached below) giving an update on progress with the Local Care Organisation. It also provides information on the care strategy, which is being developed and will sit within the overall Our Manchester strategy. 

September 2017: Update
Over the summer, the Manchester Provider Board worked with partner organisations, neighbourhood communities and staff, to shape the strategy for the new Local Care Organisation in Manchester, and to develop a business case for their commissioners with an aim to ‘go live’ from April 2018. The Manchester Provider Board sent out a September 2017 Update letter and set of Stakeholder Update slides, and there was also a set of slides, information and a series of mind maps from the recent Future Search workshops. 

June 2017: Update
A letter from Ian Williamson, Chief Accountable Officer, Manchester Health and Care Commissioning, confirmed that there had been a single submission at qualification stage for Local Care Organisation procurement. This submission was from the Manchester Provider Board and there would be a dialogue in which they would invite a detailed proposal. It was anticipated that a 10 year contract would be awarded in early 2018. The full text of the letter is attached below along with a confirmation letter from Manchester Provider Board.

May 2017: Update
A briefing note from Michael McCourt (Interim Chief Executive of Manchester Provider Board) has been circulated to partners, recapping progress so far and next steps. Click here to download (PDF)

April 2017: Status of the VCSE sector in the new LCO
Macc has had lots of enquiries from local VCSE leaders about our sector’s involvement with the LCO and the Provider Board – particularly about how it will affect future commissioning / funding, whether they need to be signed up to a bid, etc. It’s fair to say that this is all a work in progress.

Here’s a message from the Provider Board’s Executive Group confirming the commitment to working with the VCSE sector and the current status of the bid:
“We would like to invite colleagues from the VCSE sector to meet in the near future to discuss the work of the Manchester Provider Board, as we bid for the Local Care Organisation. The VCSE sector is a key stakeholder in our work going forward and we want to build effective relationships to inform the strategy and subsequent plans. Critically, we need to discuss how we make this a reality and the lived experience of the VCSE sector. Through working together we can find a positive way forward to ensure the VCSE sector is a co-producer in the LCO. The procurement process currently underway is a qualification questionnaire. If we are successful, we will then be invited to develop more detailed plans. At this stage there is no requirement to formally set out the VCSE involvement. However, we are stating the importance of effectively working with the VCSE sector if the LCO is to be successful. We would envisage closer engagement as we move to the next stage of this process.” (April 2017)

At present (for Stage 1 of the tender) there is no requirement for individual VCSE organisations to sign up to the bid. The VCSE members of the Provider Board are ensuring that our sector is well represented – as noted above - but are quite clear that we can’t sign any legal documents on behalf of other organisation. So for the present there is nothing you are formally required to do – we will make sure updates are circulated as and when this changes.

We’re also looking at how the LCO process will abide by the new Memorandum of Understanding with GM (see Greater Manchester Health and Social Care Devolution).

Some VCSE organisations with CCG or City Council funding or contracts will have received letters about how the LCO will affect their future arrangements. There is nothing to do about that now. If you haven’t received a letter and are unsure please contact your funding / contract manager for clarification.

It’s clear that the LCO will need to work with our sector so it’s worth taking some time to read the Prospectus (available below) and think about how your organisation can contribute to improving the health and wellbeing of the people of Manchester.

March 2017: Blog
Mike Wild, Chief Executive of Macc, has written a blog on the development of the Manchester Local Care Organisation

January 2017: One Team Prevention Programme
Macc, in partnership with a range of organisations, has recently resubmitted the One Team Prevention Programme proposal (attached below) that will form part of the Transformation Proposal to be put forward to the Greater Manchester Health and Social Care Partnership. The One Team proposal takes a community centred, asset based approach to delivering care, and promoting health and wellbeing for residents of the 12 One Team neighbourhoods. This approach is fundamental in transforming the care we deliver to one that is person-centred and enables people to live as independent a life as possible. This will reduce demand on health and care services, whilst promoting community resilience and improving health outcomes. The programme will consist of three main areas:

  1. Neighbourhood health and wellbeing development - The aim of this area is to enable the leadership teams of the 12 Neighbourhoods to develop and implement neighbourhood plans that (i) make the most of local assets to target local needs and (ii) are co-produced with local community groups and residents. The projects that may be part of this work could promote physical and creative activity and address social isolation or be place-based activities to identify people with long-term conditions who have not been diagnosed. GP registration would also need to be facilitated, particularly among vulnerable groups, in order to maximise the population health impact of the programme. This work will build on existing engagement mechanisms e.g. Age Friendly Neighbourhoods, and on existing assessments of health needs and asset mapping.
  2. Community Links for Health - A coherent city wide social prescribing model will be developed, to give people who access health and care services a link to social and non-medical support within the community. One clear referral system or single point of access will allow One Team health and care practitioners (starting with GPs) to connect people with various sources of support that address the social determinants of health.
  3. City wide transformation team - This is a short-term investment in a team and programme of work to develop and deliver the transformation required over the next five years.

Also, this approach will be adopted separately in North Manchester soon as the CCGs have recently agreed to adopt the One Team Prevention Programme proposal. The tender for provision of this programme will be released shortly.

December 2016: VCSE Response to Manchester Local Care Organisation Prospectus Consultation
Macc has provided a strongly critical response to the consultation on the Manchester Local Care Organisation Prospectus based on discussion with a small number of voluntary sector organisations and a meeting with a number of key health and social care commissioners in the city. Some of the main criticisms were:

  • Failure to include the VCSE in writing the prospectus;
  • Lack of clarity on the benefits of commissioning a Local Care Organisation;
  • Insufficient recognition of the impact of proposed cuts of £49 million;
  • Failure to describe a mechanism for transferring resources from hospital-based services to community-based services;
  • Lack of a coherent or persuasive vision of services.

The response then details an alternative vision of the three pillars of an approach to better services:

  • A focus on how services can help to transform neighbourhoods which continue to experience the long-term effects of deindustrialisation and worklessness;
  • Developing an integration and workforce development model that includes carers and staff and volunteers from VCSE organisations rather than focusing predominantly on public sector employees;
  • Developing a rich understanding of asset-based approaches and using this to inform the development of locally-based services.