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RCN North West Region

Integrated care in England: North West region

Integrated care has become a key focus of reform in England as a response to a need to deliver further efficiency savings. Devolution is part of a number of wide range of new initiatives to develop and deliver integrated care. Find out more below. 

Help shape and influence devolution, integration and sustainability and transformation plans (STPs) and get involved with our North West Devolution Network. Find out more about the network and how members use their nursing knowledge, skills and experience to make a real difference to patients and communities.    


Greater Manchester Devolution
In April this year (2016), Greater Manchester became the first English region to get full control of its health spending.

The ten local authorities that make up Greater Manchester and its Combined Authority (GMCA) include Bolton, Bury, Oldham, Rochdale, Salford, Stockport, Tameside, Trafford, Wigan and Manchester City councils.  Part of the deal includes a directly elected Mayor from 2017, who will represent the entire city region and provide governance.  Until then, there is an interim Mayor providing management across the entire city. Read more about the GMCA and Mayor here.

As part of the devolution of Great Manchester’s £6bn Health and Social Care budget, the NHS and GMCA published a Memorandum of Understanding (MOU) about their plans in 2015. Read the MOU here.

As part of the health devolution agreement, the 37 NHS organisations and local authorities in Greater Manchester have committed to produce a comprehensive plan for health and social care. The final draft of this plan ‘Taking Charge of our Health and Social Care in Greater Manchester’ was endorsed by the Health and Social Care Strategic Partnership Board in December, 2015 and sets out their collective ambition for the region over the next five years. Read more about the plan here.

The Greater Manchester Commissioning Strategy outlines a five-year plan to deliver improvement and reform of health and social care services across GM. Read more about the Strategy here. 

Merseyside Devolution
In July 2015, as part of the Spending Review, the government asked local areas to submit their devolution proposals by early September 2015. They received 34 bids from English areas and after prioritising negotiations in some areas, they announced five deals, one of which was Liverpool City Region.

The Liverpool City Region consists of the six local authority areas covering Halton, Knowsley, St Helens, Sefton, Liverpool and Wirral with West Lancashire and Warrington are Associate Members. 

Although negotiations about the devolved powers are ongoing, like Greater Manchester, a new, directly elected Liverpool City Region Mayor will act as Chair to the Liverpool City Region Combined Authority.

Cheshire Devolution
Warrington Borough Council, Cheshire West and Chester Council, and Cheshire East Council are currently in discussions about a potential devolution deal with each other and the Government to enable them submit a proposal in the next round of submissions.  

Lancashire Devolution
Early in 2016, the 15 councils in Lancashire discussed the idea of creating a Combined Authority. They went out to public consultation and each council is taking a report of the findings to their full council meeting. The collective councils will then make a decision as to whether they want to progress to submitting a formal bid to Central Government.

Sustainability and transformation plans (STPs)

The North West has three STPs with an associated ‘footprint’ lead reflecting the recognised sub-regional areas of:

  • Lancashire and South Cumbria - Dr Amanda Doyle OBE (Chief Clinical Officer, Blackpool CCG
  • Greater Manchester - Sir Howard Bernstein (Chief Executive, Manchester City Council)
  • Cheshire and Merseyside - Louise Shepherd (Chief Executive, Alder Hey Children’s NHS Foundation Trust)

View a list of all STPs on the NHS England website.

Vanguard sites

The North West has ten vanguard sites piloting new models of care in different areas and health care settings. Click on the links for information about each one.

Integrated primary and acute care systems – joining up GP, hospital, community and mental health services

Multispecialty community providers - moving specialist care out of hospitals into the community

Urgent and emergency care - new approaches to improve the coordination of services and reduce pressure on A&E departments

Acute care collaboration vanguard sites

Integrated care in England

Find out more about the three ways integrated health and social care is set to be delivered in England and what it all means for you.

North West Devolution Network

Get involved and help shape devolution and STPs