Manchester has some of the poorest public health in England and even within the city, people die younger than expected. There are higher levels of illness in some parts of the city than others, usually linked to social deprivation and exclusion.

"This alone is a reason to act and improve health," according to the Manchester Health and Wellbeing Board. The board is reacting in order to fulfil the potential of the city. A draft strategy report says that there will be a 60% increase in the numbers of people in Manchester with three or more long term health conditions, yet there's currently a fragmented response to their treatment.

It aims to identify those at risk of attending accident and emergency departments in the future and offering them access to integrated health and social care teams. In the future, it wants more patients to be treated in the community than at acute hospitals.

The Manchester Health and Wellbeing Board now has a number of strategic priorities including getting the youngest people in our communities off to the best start in life, educating, informing and involving the community in improving their own health and wellbeing and moving more health provision into the community.

Troubled families

Turning around the lives of troubled families is another core focus. They are defined as being involved in crime, anti-social behaviour, no children in school and adults on benefits at high cost to the public purse. In Manchester, there has been 4,000 such families identified who frequently access social care, health, criminal justice, yet usually resulting in poor outcomes. Two pilot projects have been running in Longsight and Gorton and Wythenshawe that will be rolled out to 1,000 troubled families in north Manchester.

On mental health and wellbeing, the draft strategy says there has previously been a lack of coherent strategy on wellbeing in the city. It aims for the number of suicides to be no lower than three years ago. Unlike other cities, Manchester has a lower than average number of older people. But older Mancunians have higher levels of social exclusion. Admissions to hospital for urgent care are 40% higher than national levels and they tend to stay in hospital for longer. Those at risk may be social isolated, dementia or at risk of falling.

The board is the main forum for leaders in the city's health, care and community sectors to collaborate to improve the health and wellbeing of the population and reduce health inequalities. It has established a governance structure for local planning and accountability of health and wellbeing activities. The board has determined the needs of the population in order that it can develop a Joint Health and Wellbeing Strategy for Manchester. A draft strategy was published in January.

Living longer and healthier lives

The board's vision for health and wellbeing across the city is simple: "The people of Manchester are living longer, healthier and more fulfilled lives." Other priorities include providing the best treatment to people in the right place and turning around the lives of troubled families. Improving mental health and wellbeing is another objective, as is bringing people into employment so they can lead productive lives. A final, but equally important, objective, is to facilitate keeping older people well within their community, rather than having to move in to care homes.

The board is part of the Manchester Partnership, which is tackling the toughest issues that affect residents' lives, delivering a community strategy that seeks to develop Manchester as a world-class city by 2015. The Partnership is a team of public, private and third sector organisations.

The vision for children is that they will be healthy, safe and enjoy and achieve in learning and have the skills, abilities, self-esteem and outlook to access sustainable employment. Early learning is a focus integrating social care with health services and schools, thus increasing universal services to families. Midwives, health visitors and early years staff are involved.

There is growing concern regarding the impact of changes and austerity measures on the most vulnerable children and young people in Manchester. They could already be impacted by parents without work, low income or additional health needs. The board said: "We need to ensure that any austerity measures do not further disadvantage such children and young people."