Managing demand in health and social care through the Wigan Deal

Featured article - 01 November 2016
Donna Hall, CBE, Chief Executive Wigan Council

Head-shot of the author

Every day we hear more horror stories about the increasing failure of the NHS and councils to keep up with rising increase in demand in health and social care.

In February 2015, 38 Greater Manchester leaders in NHS provider trusts, GPs practices, North West Ambulance Service, Greater Manchester Fire and Rescue, all ten Councils and twelve CCGs signed a historic agreement for the devolution of £6bn of NHS resources to be shaped around the specific needs of the 2.8 million residents of Greater Manchester.

Since that date we have been taking charge together to radically transform all aspects of health and social care across our conurbation. For the first time, we have closed the financial gap between what NHS providers say they need each year to run safe, viable services and what CCGs say they have the resources to fund.

It is quite simply the single biggest shake up of public services I have ever witnessed. Here in Wigan, our local plan is based on The Wigan Deal; an asset-based demand-reduction model that cuts across all our services from social care to parks and open spaces and everything in between.

We started five years ago and have been pushing it relentlessly across adult social care and all ours and partners services. So far we have reduced our council budgets by over £100 million whilst improving services and improving resident and staff satisfaction. All of our 4,500 front line staff are trained in ethnographic approaches and how to have strengths based conversations with residents and communities. This is as true for a homecare worker as for a children’s social worker or a housing benefits assessor.

The Deal is our plan of plans. It is our budget strategy. It is a single unifying philosophy that holds everything we and our partners do to make families and communities self-reliant whilst taking out systemic waste. As we shrink as a council, we have invested 7.5 million into the community to grow our brilliant social enterprises and community projects that reach the parts we can’t reach.

Our Deal for Adults Social Care connects residents into cheaper, better community organisations whilst we close municipal ineffective day centres. Independence is built and institutionalisation tackled.

Last year we were one of the few adults social care budgets that balanced. We were also the 'Best Companies best council to work for' nationally with the biggest increase in staff engagement and happiness in our adult social care team. We even have the private care providers buying into the asset based approach along with GP practices, schools, the hospital and Bridgewater our Community provider and Five Boroughs our mental health provider.

Last year when my Mum was discharged from hospital just before she died at home (not in Wigan) 22 well-meaning representatives of the NHS and social care came to visit her at home on the same day. Only one of them had an asset-based conversation with her, called her Mary and asked about her six grandchildren. She was the person my Mum connected with on a human to human level. She wasn’t viewed as a unit of need but as a unique person with gifts, talents and interests.

We are passionate about our DEAL philosophy and keen to work with others to turn this into the social movement this needs to become if we are to rid the NHS and social care of the tick box, 'no further action' passing of risk we need to achieve.

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