Devolution and localism: metropolitan authorities

This chapter explores the context for devolution in Greater Manchester, and why it matters in terms of residents' health and wellbeing. The authors set out some of the changes they have seen: the integration of health and social care, and the creation of local care systems; the bringing together of health and care commissioning; and the crucial role of partnerships across health, care, the voluntary and community sector, housing, police, fire, and others. One of the arguments for local authority leadership on devolution is that good health is about more than the National Health Service (NHS) — it is about good food, warm homes, decent jobs, good education, close friends, and open green and safe public spaces (to name just a few). Devolution is about connecting all these agendas through local leadership and local action. Devolution is complex, as are the relationships between Greater Manchester and local democratic leadership in each of the ten boroughs. The chapter then considers some observations about the future challenges for local leadership if good health for residents is to be sustained.