FOI 2025/1311

This is a Freedom of Information request under the Freedom of Information Act 2000 (the “Act”). Please provide the following information you have pertaining to ADHD and Autism assessments and post-diagnostic services within your ICB.

I have included tables below so you can see how the data should be broken down. Please use these tables to fill out the data, if possible.

1. Please provide your total annual spend and total number of patients (for each of the last three financial years) on ADHD and Autism assessments, broken down by age categories as listed below. Please include volumes from any NHS Trusts within your ICB that may deliver these services and also third party private providers* (or indicate if this is not possible).

*For definition of “third party private providers” please see below. An example list of providers (for ADHD) can be found here

TOTAL Apr-22-Mar-23 Apr-23-Mar-24 Apr-24-Mar-25

ADHD assessments – patients 18 years old and over Total number of patients

Total annual spend

ADHD assessments – patients <18 years old Total number of patients

Total annual spend

Autism assessments – patients 18 years old and over Total number of patients

Total annual spend

Autism assessments – patients <18 years old Total number of patients

Total annual spend

2. For Apr-24-Mar-25, please split out the total number of patients / annual spend from question 1 by provider. Please include the pathway / contract type for each provider (e.g. block contract, right to choose).

In TABLE 2a, please include total number of patients and total annual spend with third party private providers* that are directly commissioned by your ICB, or access care through the Right to Choose programme.

In TABLE 2b, please include total number of patients and total annual spend from NHS trusts within your ICB area. If possible, please split out patient numbers and spend that is outsourced by the trust to third party private providers*.

TABLE 2a

Provider Apr-24-Mar-25

Pathway ADHD – 18 years old and over patient numbers ADHD – <18 years old patient numbers Autism – 18 years old and over patient numbers Autism – <18 years old patient numbers Total annual spend

Example: Provider A Right to Choose X X X X £Xk

Example: Provider B Block contract X X X X £Xk

TABLE 2b

Provider Apr-24-Mar-25

Pathway ADHD – 18 years old and over patient numbers ADHD – <18 years old patient numbers Autism – 18 years old and over patient numbers Autism – <18 years old patient numbers Total annual spend

Example: In-house delivery (NHS Trust) n/a X X X X n/a

Example: Outsourced delivery (Provider A) Block contract X X X X £Xk

3. For Apr-24-Mar-25, please provide your total annual spend on the following post-diagnostic services. Please find definitions for post-diagnostic services at the end of the request.  Please include volumes from any NHS Trusts within your ICB that may deliver these services (or indicate if this is not possible) and also with third party private providers.

Annual spend Prescriptions Medication Therapies Psychoeducation Other support services

ADHD – patients 18 years old and over

ADHD – patients <18 years old

Autism – patients 18 years old and over

Autism – patients <18 years old

Definitions:

1. Third-party private providers

Refers to independent, non-NHS organisations contracted to deliver ADHD and / or Autism services. These providers operate outside of NHS Trusts / ICBs / Health Boards and typically deliver services such as assessments, prescribing, post-diagnostic support, and therapy. Examples may include (but are not limited to) ADHD 360, Psychiatry UK, Clinical Partners, and Evolve Psychology. These providers may deliver services under direct contracts with the ICB, via framework agreements, or under the NHS Right to Choose pathway.

2. Prescriptions

Refers to the administrative cost of issuing and managing prescriptions. This includes clinical time spent generating repeat prescriptions, as well as costs related to digital or manual prescription systems.

Note: This does not include the cost of the medication itself (see ‘Medication’).

3. Medication

Refers to the actual cost of purchasing and supplying medicines, including stimulants and non-stimulants (e.g. methylphenidate, atomoxetine, guanfacine). This includes the drug cost, as invoiced by the provider or pharmacy.

4. Therapies

Refers to post-diagnostic therapeutic interventions, such as talking therapies, cognitive behavioural therapy (CBT), counselling, behavioural coaching, occupational therapy, or speech and language therapy, where these are part of the ADHD or Autism treatment pathway.

5. Psychoeducation

Refers to structured sessions aimed at helping patients, families and/or schools understand and manage ADHD or Autism. This may include workshops, group education programmes, or 1:1 educational support on condition management, lifestyle strategies, or behaviour planning.

6. Other Support Services

Refers to additional post-assessment services not captured under therapy or psychoeducation. This may include digital tools, care coordination, coaching, employment or educational support, or clinician-led review sessions that do not fall under prescribing or therapy categories.

NHS Greater Manchester (NHS GM) was formed on the 1 July 2022 following the merger of the 10 former Clinical Commissioning Groups (CCGs) of Greater Manchester (being NHS Bolton CCG, NHS Bury CCG, NHS Heywood, Middleton and Rochdale CCG, NHS Manchester CCG, NHS Oldham CCG, NHS Salford CCG, NHS Stockport CCG, NHS Tameside and Glossop CCG, NHS Trafford CCG and NHS Wigan Borough CCG), plus Greater Manchester Shared Services (GMSS, previously hosted by the Northern Care Alliance NHS Foundation Trust) and Greater Manchester Health and Social Care Partnership.
Commissioning responsibility for patients registered with Glossop based GPs, however, did not transfer to NHS GM, and instead transferred to NHS Derby and Derbyshire ICB. As such, data up to 30 June 2022 is in respect of the 10 former CCGs (i.e. including Glossop patients) and data from 1 July 2022 is in respect of NHS GM (i.e. excluding Glossop patients). Data presented up to 30 June 2022 is presented aligned with the relevant former CCG.
Following the merger, each of the 10 former CCG areas became a locality of NHS GM, and each locality operates its own systems and processes in respect of this area of expenditure. As such, data is not held consistently by all 10 localities, and all the information requested is not available from all 10 localities. In these instances, rather than provide incomplete data, this is instead provided at an aggregate level in respect of each question.
1. As described above, not all localities hold all of the data requested. Therefore, it is not possible for NHS GM to provide a split of data based on the age of the patients concerned or based on whether the assessment was for ADHD or autism.
Where NHS GM commissions services from NHS Foundation Trusts, this is done under a block contract, and therefore NHS GM does not hold data in respect of the volume of activity undertaken. It is also not possible to separately identify a cost of a particular service from within the block contracts. Information of the volume of assessments undertaken may be available from the Trusts themselves under the Freedom of Information Act. The significant NHS Trust providers of mental health services in Greater Manchester are listed below, together with their FOI contact information:
• Greater Manchester Mental Health NHS Foundation Trust – Freedom of Information | Greater Manchester Mental Health NHS FT (gmmh.nhs.uk)
• Pennine Care NHS Foundation Trust – Freedom of Information :: Pennine Care NHS Foundation Trust

Total		Apr-22-Mar-23	Apr-23-Mar-24	Apr-24-Mar-25
ADHD & Autism assessments (All patients)	Total number of patients
	Total annual spend	£2,220,713.70	£5,005,524.77	£12,018,122.99