The Greater Manchester Joint Health Scrutiny Committee met on Tuesday 15 September 2026 to discuss significant updates on NHS Greater Manchester's reform and workforce programme, the Care Quality Commission's assessments of adult social care, and the ongoing review of paediatric audiology services. The committee also received progress reports on service reconfigurations, including specialist cardiac and vascular surgery, and reviewed its work programme for the upcoming year.

NHS Greater Manchester Reform and Workforce Update

Charlotte Bailey, Chief Strategy, People and Partnerships Officer for NHS Greater Manchester, presented an update on the organisation's reform and workforce programme. Phase one of the reform, which focused on redesigning the organisation and moving teams into new structures, is nearing completion. A key aspect of this phase was minimising compulsory redundancies, with two voluntary redundancy windows resulting in over 300 colleagues leaving the organisation. Mitigation strategies included role matching, ring-fenced interviews, and comprehensive health and wellbeing support.

An equality impact assessment indicated no disproportionate adverse impact on any protected groups, with an increase observed in colleagues with disabilities (from 11.4% to 13.5%) and Black, Asian, and Minority Ethnic representation (from 19.5% to 21.4%). Phase two of the programme will focus on embedding new roles, developing new relationships, and supporting individual funding requests, place teams, and population health initiatives.

Councillor Sangita Patel raised concerns about the impact of the changes on work culture and staff morale. Ms. Bailey acknowledged that periods of significant change inevitably affect staff, but highlighted ongoing efforts through pulse surveys, national staff surveys, leadership briefings, and wellbeing support to monitor and address staff sentiment. The impact on service delivery was also discussed, with a planned business continuity light period to manage staff capacity.

Councillor Patricia Dale questioned the risks associated with employee relationships and legal challenges. Ms. Bailey explained that employee relationships were a concern due to new ways of working and the adoption of matrix working, while legal challenges were being mitigated by ensuring statutory duties were covered at every stage. Councillor Basil Curley inquired about engagement with professional bodies and trade unions, and the impact on health inequalities, referencing Professor Michael Marmot's report. Ms. Bailey confirmed extensive engagement with staff side and unions through a partnership forum, and stated that addressing health inequalities was a core purpose of the Integrated Care Board (ICB), with work underway to enhance joint strategic needs assessments and health profiles.

The committee also discussed the potential for corrective action from phase one reviews and the timeline for receiving staff survey results, with an expectation of receiving intelligence from pulse surveys sooner than the national staff survey results in January/February. Mark Tobin, a councillor, asked about the recruitment levels of underrepresented groups, and Ms. Bailey committed to circulating detailed information on banding levels. Mr. Tobin also inquired about terms and conditions, with Ms. Bailey confirming that they remained the same, with exceptions for very senior managers due to national policy changes.

Care Quality Commission (CQC) Assessment Data

Rachel Tanner, Chair of GM ADASS and Director of Adult Social Services at Bolton Council, presented an update on the Care Quality Commission (CQC) assessments of adult social care provision across Greater Manchester. All ten Greater Manchester local authorities now have published CQC assessment reports. Wigan received an Outstanding rating, while most others were rated Good. Tameside and Trafford were rated Requires Improvement, and Salford was rated Inadequate.

Partnership and communities, along with learning, improvement, and innovation, were identified as areas of strength across Greater Manchester. However, assessing need remained a consistent area requiring improvement, both regionally and nationally. Ms. Tanner highlighted that variations in ratings often stemmed from local models and approaches, such as the delegation of statutory duties to partner organisations.

Regarding Salford's improvement plan, a monthly Improvement Board, chaired by Kath O'Dwyer, has been established, with financial investment approved for transformation over the next two years. This investment supports new posts, including a co-production lead and EDI lead.

Councillor Sangita Patel inquired about the use of AI in assessing need and supporting social workers. Ms. Tanner explained that AI was being used for analytics to understand neighbourhood demographics and trends, and as a tool for transcribing assessments to free up social workers' time. Councillor Patricia Dale noted Wigan's exceptionally low staff turnover of 7% and asked how this was achieved. Ms. Tanner suggested it was likely due to a combination of stable leadership, a positive culture, and staff feeling valued and engaged, rather than solely pay or terms and conditions.

The discussion also touched upon the significant investment in community capacity in Wigan, with £14 million allocated since 2014 to over 1,500 voluntary, community, and social enterprise organisations. This investment has supported neighbourhood home care, prevention and reablement services, and housing with care initiatives, contributing to Wigan's outstanding CQC rating and reduced long-term care usage.

Update on Paediatric Audiology Greater Manchester-wide Review

Claire Smith, Associate Director of Nursing and Quality Assurance, and Jenny Wilkinson, Programme Manager for Children and Special Educational Needs and Disabilities (SEND), provided an update on paediatric audiology services. Following quality visits across all Greater Manchester services, three further services – Withington (Manchester University Foundation Trust), Salford (Northern Care Alliance), and Wigan Wrightington and Leigh (WWL) – were identified as requiring look back reviews, where children are recalled for reassessment. Stockport Foundation Trust's services remain largely paused, with phased reopening planned for October 2026, supported by an independent sector provider who has seen nearly 3,000 children.

The look back clinics for Withington, Salford, and Wigan were expected to conclude by December 2026, with no significant harms identified to date. A Greater Manchester Service Specification is being co-produced to ensure equitable access to services, with a business case for a new model of care to be developed as part of a wider review of children's community services.

Councillor Mark Tobin asked about the causes of misdiagnosis, and Ms. Wilkinson explained it was multifactorial, including issues with estate and equipment, varying professional competency routes, and differing audit processes. She noted that the development of a national service specification and the pursuit of UCAS accreditation would help address these issues. Councillor Tobin also raised concerns about how practitioners might miss diagnoses at an individual level, which Ms. Smith acknowledged was complex and involved understanding a child's developmental stage alongside scientific testing.

Councillor Tetteh inquired about the involvement of families and the support provided to them. Ms. Wilkinson confirmed that representatives from the National Deaf Children's Society had been involved, providing family voice input and developing support materials. Sangita Patel asked about provision for sign language, and it was confirmed that this is commissioned through education services. Patricia Dale raised concerns about the transition from independent sector provision in Stockport back to NHS services, and Jenny Wilkinson assured the committee that a phased reopening was planned, with ongoing discussions about continued support from the independent sector if needed.

NHS Greater Manchester Monthly Service Reconfiguration Progress Report and Forward Look

Lindsay Kirby, Assistant Director of Communications and Engagement for NHS Greater Manchester, presented an update on service reconfigurations, including interim updates on specialist cardiac surgery and specialist vascular surgery. The public consultations for both services were ongoing, with a focus on engagement with affected communities.

For specialist cardiac surgery, feedback indicated broad support for centralising services at Wythenshawe Hospital, primarily due to the perceived benefits of a centre of excellence. However, significant concerns were raised regarding travel, public transport, parking, and the capacity at Wythenshawe. For specialist vascular surgery, there was a higher level of concern about the potential loss of services from Royal Oldham Hospital, with similar issues raised regarding travel, public transport, and the impact on staff at Royal Oldham.

Councillor Patricia Dale questioned the lower response rates from Heywood, Middleton, and Rochdale compared to Oldham in the vascular surgery consultation. Ms. Kirby explained that the figures were from an earlier stage of the consultation and that engagement had increased in those areas. Councillor Tetteh raised concerns about the level of engagement in Salford and the lack of data on social media reach. Ms. Kirby clarified that engagement was targeted towards areas most affected and that a final report would provide a more comprehensive overview. Sangita Patel also highlighted the low numbers of responses from Tameside for the cardiac surgery consultation.

The committee noted that decisions on these service reconfigurations were not expected until early 2027, with implementation in spring 2027.

Work Programme for the 2026/27 Municipal Year

The committee reviewed its draft work programme for the upcoming municipal year. Key items agreed for the next meeting on 13 October 2026 included an Adult Social Care Update, the NHS Greater Manchester Reform and Workforce Update, and an update on Paediatric Audiology. The committee also agreed to defer the End of Year Finance Report and include further information on Salford's improvement plans and examples of good practice from Wigan's adult social care services within the forthcoming Adult Social Care Update. A future update on the transition of Non-Emergency Patient Transport Services (NEPTS) from North West Ambulance Service (NWAS) to HATS Group Ltd was also requested. The committee agreed that issues relating to the Voluntary, Community, Faith, and Social Enterprise (VCFSE) sector would be explored through a future Task and Finish Group or deep dive review.