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Devolution: what it means for health and social care in England

Devolution of powers and funds from central down to local government has emerged as one of this government’s flagship policies. The notion of devolving health care was not core to the original devolution agenda, which focused on driving local economic growth. The inclusion of health and social care in the so-called ‘Devo Manc’ agreement announced in November last year therefore came as a surprise to many. Along with powers over housing, skills and transport, the landmark deal between the Treasury and Greater Manchester paves the way for the councils and NHS in Greater Manchester to take control of the region’s £6 billion health and social care budget.

Ahead of further devolution deals expected to be announced as part of the Spending Review 2015, this briefing describes the origins of the devolution agenda and charts its progress in relation to health and social care. Before drawing some broad conclusions, the penultimate section explores some of the key policy and implementation questions that remain unresolved.

Alongside secondary research, this paper is built on insights captured at events held at The King’s Fund as well as a series of conversations with representatives from various national bodies, think tanks and local areas involved in devolution, for which we are immensely grateful.