NHS England is due to intervene with an enforcement undertakings notice in May on Greater Manchester’s ICB, which provides direction to the hospital trusts, GPs and councils.

The notices are implemented when the organisation is believed to be failing to carry out one or more of its functions or if there is a significant risk that it might do.

NHS England will work with the Greater Manchester body to identify key areas of concern and agree an improvement plan.

In 2015, Greater Manchester, which has about 2.9m residents, was the first English region to get full control of its annual health and social care budget.

Mr Fisher said the extra support from NHS England was “very much welcomed”.

He said it would help improve access to urgent care, reduce waiting times, achieve quality targets and bring finances into balance.

“NHS Greater Manchester is facing the most complex set of challenges our health and care system has ever faced,” he said.

“Together as a health and care system we have reduced our overspend significantly from around £400 million to £180 million – but we know we have more to do, and this improvement plan is going to help us get to where we need to be for Greater Manchester.”

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