FOI 2025/1327

Please could you provide me with the following information under the Freedom of Information Act 2000
Cost and number of referrals for ADHD diagnosis for providers who have a contract with the ICB.
1. For those providers of ADHD services with a contract with the ICB please provide the following information:
1a) The total amounts paid by the ICB to NHS providers of ADHD diagnosis for each of the financial years: 2022/23, 2023/24, 2024/25, broken down according to each NHS provider organisation.
1b) The total number of patients referred to NHS providers of ADHD diagnosis for each of the financial years 2022/23 2023/23 2024/25, broken down according to each NHS provider organisation.
1c) The total number of patients referred to non-NHS (private) providers of ADHD diagnosis for each of the financial years 2022/23 2023/24 2024/25 broken down according to each non-NHS (private) provider organisation.
1d) The total amounts paid by the ICB to non-NHS (private) providers of ADHD diagnosis for each of the financial years: 2022/23, 2023/24, 2024/25, broken down according to each non- NHS (private) provider organisation.

Cost and number of referrals for ADHD diagnosis deemed to be “non -contract activity”.
2. For those providers of ADHD services without a contract with the ICB – otherwise known as“ non-contract activity” please provide the following information:
2a) The total amounts paid by the ICB to NHS providers of ADHD diagnosis for each of the financial years: 2022/23, 2023/24, 2024/25, broken down according to each NHS provider organisation.
2b) The total number of patients referred to NHS providers of ADHD diagnosis for each of the financial years 2022/23 2023/23 2024/25, broken down according to each NHS provider organisation.
2c) The total number of patients referred to non-NHS (private) providers of ADHD diagnosis for each of the financial years 2022/23 2023/24 2024/25 broken down according to each non-NHS (private) provider organisation.
2d) The total amounts paid by the ICB to non-NHS (private) providers of ADHD diagnosis for each of the financial years: 2022/23, 2023/24, 2024/25, broken down according to each non- NHS (private) provider organisation.

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 (previously hosted by NHS England).
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.
Whilst data has been requested in respect of referrals to providers, where data is held, it is held in respect of assessments conducted, rather than referrals or diagnoses. As such, throughout this response, where data is available, it is presented as in respect of the number and cost of assessments performed, unless separate stated.

1.
a. NHS Greater Manchester ICB (NHS GM) commissions Mental Health care from two primary NHS providers in Greater Manchester, being Greater Manchester Mental Health NHS FT, and Pennine Care NHS FT. Payments to these providers are made under a block contract basis, and therefore it is not possible to identify the cost to NHS GM specifically associated with ADHD diagnoses. NHS GM therefore does not hold data in respect of this part of the request.
b. As with question 1a), NHS GM does not hold data as to the number of referrals to NHS organisations for ADHD assessments. This information may be held by the organisations themselves, who can be contacted under the Freedom of Information Act as follows:
• 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

c&d. NHS GM held or holds contracts with non-NHS bodies as per the details below. However, NHS GM does not hold information in respect of the number of patients treated by each provider (question 1c). In respect of the financial value of these contracts, for some providers, the information held is not specific to the assessments of ADHD cases, and the nature of the contract means it includes spend in respect of the treatment of such patients as well. In these cases, the full value of the contract relating to ADHD is included.

2.
a. Where NHS GM commissions services from other NHS bodies in England, this is done under contract with the NHS Providers. Larger, local NHS providers are commissioned under a direct contract, agreed with the Trust. Providers who provide services to a low volume of NHS GM’s patients, and consequently would be entitled to a low value of payment and contracted under a Low Volume Activity (LVA) contract, which includes payment for all services by the Trust to NHS GM. These contracts are set by NHS England, and it is not possible for NHS GM to identify the volume of ADHD assessments or assign a value to those assessments from within these LVA contracts. As such, NHS GM does not hold data in respect of question 2a.
b. As in question 2a, NHS GM does not hold data in respect of this question.
c. NHS GM does not hold complete data in respect of the volume of ADHD assessments performed. Where data is held, it is not held in a structured format (e.g. on copy invoices) which would allow NHS GM to identify the volume of assessments performed. In addition, where data is held, this does not separately identify the volume of ADHD assessment from the volume of ASD (Autism Spectrum Disorder) assessments. As such, NHS GM does not complete data to enable it to answer this question.
d. NHS GM does hold information in respect of expenditure with non-NHS providers for ADHD assessments. However, the data held is the combination of ADHD assessments, and ASD (Autism Spectrum Disorder) assessments, and therefore NHS GM is unable to provide specific data for ADHD in response to your request. Instead, data presented below includes both ADHD and ASD assessment costs for the years given. However, for the year 2022/23, separate data was not collected for all localities, therefore NHS GM is not able to provide a complete picture of expenditure for that year, as data could not be separated between ADHD assessment and other spend. As such, any data provided for 2022/23 would be incomplete and therefore inaccurate. However, based on the trends across locality teams, the spend for the localities who are unable to provide data for 2022/23 is anticipated to be low.