2026/1999

Freedom of Information request – commissioned community nursing specification (Wigan locality) and NHS Continuing Healthcare Fast Track procedures

I am writing under the Freedom of Information Act 2000 to request the recorded information listed below.

I am not seeking the personal data of any identifiable individual. If any document within scope contains personal data, please redact it under section 40(2) and release the remainder.

Part 1 – District / community nursing commissioning (Wigan locality)

1. The current service specification(s), the relevant schedule(s) of the NHS Standard Contract, and any other commissioning agreement between NHS Greater Manchester ICB (or a predecessor body, if that is still the operative document) and Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust covering adult district nursing / community nursing services for the Wigan locality, as in force at any time between 1 April 2025 and the date of this request. I am not seeking pricing or financial schedules.
2. If no current service specification for this service is held, please confirm that in terms, and provide the most recent specification you do hold, together with its date, its stated review date, and any recorded decision or note that it is outdated or requires updating.

For context on items 1 and 2: I am aware of the ICB’s published response to FOI 2025/1441 (“Commissioned Scope of District Nursing Services”, replied 2 December 2025), which stated that no current district nursing specification was held for the Tameside locality and that the specification held was outdated. I am seeking the Wigan-locality position, not a restatement of that response.

3. The recorded position, within the documents at items 1 and 2 or in any related commissioning guidance you hold, on whether each of the following is an in-scope commissioned activity for adult district / community nursing in the Wigan locality:

(a) washing and drying of the lower limb;

(b) application of a prescribed emollient to the lower limb;

(c) removal of hyperkeratotic scale;

(d) ongoing skin-integrity care of a dry or thickening high-risk lymphoedematous limb where there is no wet or open wound on the day of attendance.

If the documents are silent on any of (a) to (d), please say so.

4. Any equality impact assessment, quality impact assessment, gap analysis, or risk register entry held by the ICB and created since 1 April 2023 concerning a gap in commissioned provision for lower-limb hygiene, hyperkeratosis management, or lymphoedema skin care in the Wigan community.

Part 2 – NHS Continuing Healthcare, including Fast Track (Wigan locality)

5. The current local operating procedure or standard operating procedure for NHS Continuing Healthcare as applied in the Wigan locality (or the Greater Manchester-wide document if that is what is used in Wigan), covering:

(a) completion of the Fast Track Pathway Tool and the CHC Checklist, including which roles (for example: district nurse, GP, hospital clinician, duty matron, “appropriate clinician”) are authorised to complete each;

(b) any local eligibility criteria or thresholds that supplement the national Fast Track Pathway Tool, including any reference to a specified life expectancy, a three-month period, or a requirement that the person already be receiving palliative care;

(c) any local instruction on how the skin-integrity / wound domain is assessed, including any requirement that a wound be open on the day of assessment;

(d) whether the person concerned, or their authorised representative, is entitled to a copy of a completed CHC Checklist or Fast Track Pathway Tool, and on what timescale.

6. Training materials, guidance notes or briefing slides issued since 1 January 2024 to district nursing or CHC staff working in the Wigan locality on Fast Track eligibility or completion of the Fast Track Pathway Tool.
7. Any recorded local divergence from, or local supplement to, the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care and the national Fast Track Pathway Tool, as applied in Wigan in 2026. If the only documents held are the national Framework and Tool themselves, please say so in terms.

Handling notes

For each numbered item, please confirm whether the information is held, not held, or withheld; where anything is withheld, please cite the exemption relied on and, where it is a qualified exemption, the public interest balance.

If a document I have described does not exist, please say so in terms rather than summarising other material.

Please provide the information by email in electronic form.

If this request would exceed the cost limit in section 12, please treat it as confined, without further reference to me, to items 1 to 3 and item 5, and advise me under section 16 which of the remaining items could be answered within the limit.

NHS GM does not hold the specification requested as it is Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust that is responsible for the community nursing services in Wigan. Whilst we have provided what information we can, you may wish to contact the provider directly to obtain the requested information.

Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust – WWL Teaching Hospitals NHS Foundation Trust | FOI Disclosure Log

1. Wigan locality Individualised care (IC) do not hold a specification or contract for the adult district nursing / community nursing services for the Wigan locality, IC commission services for individuals and this does not include NHS funded core services.
2. See response to Q1
3. Wigan locality IC do not hold and are not responsible for any commissioning guidance for the scope of community nursing and district nurse activities
4. Wigan locality IC do not hold and are not responsible for the equality impact assessments for identifying gaps in community nursing or district nursing services relating to those conditions.
5. The standard operating procedures in locality relating to the fast track process and Continuing health care CHC are currently under review by Greater Manchester ICB
6. Completion of the fast track and checklist tool is governed by the National framework for NHS CHC and NHS Funded nursing care
7. See response to 5a
8. The completion of the decision support tool would include the assessments provided by the lead health professional with the clinical expertise and knowledge regarding wound care if appropriate and/or evidence to support the necessary care and treatment regime required.
9. IC would consider the request which would be subject to the data protection laws, consent and legal authority or request the representative/person concerned to contact the author of the document
10. Training on the fast track tool and process is a mandatory requirement for CHC staff and is provided through the NHS England e learning for healthcare hub. Wigan Locality IC has not provided training on the fast track tool completion and process to the district nursing service since January 2024 however prioritising training and IC support to partners including the community nursing and district nursing teams has been highlighted to the GM ICB and support/feedback is given to partners through the duty process on a daily basis if required
11. Please see response to Q5