The commencement of regional devolution of commissioning of health and social care to Greater Manchester from the United Kingdom national government.

In February 2015 the UK government announced that powers and resources for health and social care would be devolved to Greater Manchester (GM) a metropolitan area in the North West of England. This hugely significant event is being watched closely by all involved in health and social care across the UK and particularly in England which has a long tradition of healthcare top down from the Minister and Department of Health policy development and implementation. There has been a lengthy call over the last 40 years from academics, practitioners and politicians for the greater integration of health and social care (Hudson et al, 1997; Bailey and Kooney, 2000; Benson, 2003; Klein, 2013) Ham, 2015) there is a strong evidence base that local authorities can effectively commission healthcare services and many examples of this are to be found in Scandinavia (Figueras, Robinson, and Jakubowski, 2005). This UK policy of localism and regionalism was designed to ensure that local authorities were in control of commissioning healthcare with the help of established healthcare organizations. This will mean that new governance structures across this region will have to be created which will come hard on the heels of a recent and deeply unpopular and contested major national healthcare top down reorganization in 2012 to 2013. UK healthcare has a long history of little democratic input from citizens apart from people voting in a general and national election every 5 years for Members of Parliament and the establishment in England from 2004 of publicly owned healthcare organizations with a membership of citizens, patients and staff. These are known as NHS Foundation Trusts which now represent approximately a third of NHS provider organizations. Their model of governance is to recruit local citizens including patients as members who elect governors. Foundation Trusts have struggled in engaging the public with this new model of membership organization and new governance structures. These are called public benefit corporations. This conference paper will report by the use of the theoretical model of receptive and non-receptive contexts for strategic change Pettigrew, Ferlie, and McKee (1992) will be used to analyse data from this elite interviews (Robson, 2011). This application gives a theoretical framework to help explain what may be happening in GM as the implementation of DevoManc is attempted and is important therefore as other English Regions are given be given similar powers.