This is what social care looks like in Burnham's Manchester - and the secret ingredient he must bring to Westminster

But the missing piece is not money alone, and it is not a timeline. He has spent nine years running the one part of England where health and social care were put under a single roof. The lesson from that is worth more to him now than any new commission.

I should declare an interest. I spent twenty-five years in the NHS as a clinician and now run a health technology company in Manchester. Therefore I have watched this from both sides.

I’ve seen patients waiting for someone to establish what care they were already receiving, from whom, and under what plan. That information existed - but it sat in another organisation's system, in a format nobody else could read. We call this a bed crisis. Much of it is a filing problem, although we have been treating it as though it were a building problem for thirty years.

In April 2016, Greater Manchester became the first English region to take control of its combined £6bn health and social care budget. Three years later it was given money to build a shared care record across the whole conurbation. Neither of those things was glamorous. But together they did something no national programme has managed: they made one body answerable for both halves of a person's care, and gave it a way for information to move between them.

I’m not saying this solved everything. Greater Manchester still has delayed discharges. It still has a care workforce paid too little to stay. Devolution did not fix the funding, because devolution was never going to fix the funding. What it changed was who can fill in the gaps - and once someone has to answer, the systems start talking to each other rather quickly.

The second thing Manchester built gets less attention and may matter more. While Westminster went round in circles on planning, procurement and funding rounds, the region quietly assembled something that works: a university research base, NHS clinicians with direct patient knowledge, and companies with the practical means to scale, supported by the Manchester Growth Hub.

Tools are shaped by clinical input, tested in real care settings, and scaled through funded support structures. The expertise, the jobs and the economic benefit stay in the north. Nobody here waited for a solution to arrive from Silicon Valley or to be handed down from Whitehall.

That is the model missing from the national conversation, and it bears directly on what the government says it wants next. The NHS 10 Year Plan's ambitions for AI will not be realised through guidance issued in hope of adoption. They will be realised where clinicians are in the room while the thing is being built, and where somebody local is accountable for whether it actually works. Every attempt to do this the other way round has produced expensive software that frontline staff quietly refuse to use.

Baroness Casey's first report lands within months. The Prime Minister told the BBC he could not give a timeline. He does not need to give one. He needs to say what the plan will be built on. A National Care Service running on records that cannot travel with the person will fail the way its predecessors failed, and that part does not need a spending review to fix. It needs a decision about standards - which is the one thing central government is genuinely good at, and the one thing it keeps declining to do.

The Prime Minister does not need more commissions to tell him what integration should look like. He has spent nine years governing the closest thing England has to the answer. The blueprint is already in Manchester - the question is whether Whitehall is prepared to learn from it.

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Dr Devan Moodley is a clinician with over twenty-five years of NHS experience and the CEO of Health Connect Global, a Manchester-based health technology company.

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