Healthier Together is a wide-ranging consultation on health and social care services across Greater Manchester being conducted by Committees in Common from local Clinical Commissioning Groups. As well as implementing integrated care between NHS and local authority services the review is looking to implement networks of local hospitals, termed "single services", to provide care to a wider area between them. Under the scheme, only four hospitals in Greater Manchester will provide emergency general surgery. Salford Royal, Manchester Royal Infirmary and Royal Oldham hospitals had previously been selected as three of the specialist sites, and in July Stepping Hill in Stockport was selected as the fourth site.
However, this decision may now be challenged by the Medical Staff Committee at Wythenshawe hospital, another major hospital in South Manchester. According to local media, the medics have sent a pre-action letter to Healthier Together arguing that the decision was based on the transport links of each hospital without adequately considering the other publicised factors of quality and safety, affordability and how the transition would be undertaken. In addition, the Wythenshawe committee has stated that the consideration of transport links did not adequately take into account that Wythenshawe was the only hospital to have a helipad and a new road being built in the area. The pre-action letter gives Healthier Together until 8 September to respond; it will then be for the Wythenshawe committee to decide whether to make an application for judicial review. In the meantime, local MPs discussed the decision and potential review at a Westminster Hall debate, where it was suggested that discussions were ongoing between the staff committee and Healthier Together.
Healthier Together is part of a radical overhaul of the provision of health and social care services in Manchester as part of the "Devo Manc" devolution agreement and the Chancellor of the Exchequer's plans for a "Northern Powerhouse". As well as further powers being granted to the Greater Manchester Combined Authority in a range of areas, including transport and housing, from April 2016 the region will be given control of a £6 billion combined health and social care budget to be spent in accordance with the needs of the area. An interim Mayor for Greater Manchester has already been selected, with the first elections to the post due to be held in 2017.
Given the scale of the consultation and broader public interest in healthcare devolution in Greater Manchester, as well as the relatively short time until full healthcare devolution next year, a full judicial review could mean a significant hold-up. It is particularly interesting that the pre-action letter does not come from UHSM NHS Foundation Trust (which runs Wythenshawe Hospital, and has also publicly spoken out against the decision), but the Medical Staff Committee. While this decision may well affect the staffing levels at each hospital, that it is not being brought by the Foundation Trust itself may well lead to issues of whether the staff committee has sufficient interest to bring the judicial review. While questions of sufficient interest are normally not considered until a full judicial review hearing, in this case the unusual nature of the potential claimant could lead to the issue being considered earlier in the proceedings.