| Reference | FOI 2025/1378 |
|---|---|
| Description | NHS Continuing Healthcare (CHC) Delivery and Workforce Management |
| Date Requested | 18/09/2025 |
| Date Replied | 16/10/2025 |
| Category | Continuing Health Care (CHC) |
I am writing to request key information regarding Continuing Healthcare (CHC) within your ICB, with the aim of better understanding current patterns of CHC delivery and workforce management to support a sector-wide market analysis.
This information is requested solely to inform market research and business planning for consultancy purposes; it is not being sought as part of a complaint, press investigation, or direct challenge. Our intention is to build a clearer picture of sector needs and priorities.
I would be grateful if you could provide the following information, for each of the last two full financial years and any current year forecasts or snapshots where available. For ease, I have attempted to break down the information I would like to know into manageable chunks on the topics of CHC processing and current AI and digital systems.
Please provide what you can:
• If any parts of the request exceed cost/time limits, I would appreciate any partial data, aggregated summaries, or guidance on what can be supplied within statutory limits.
• If exact percentages or separate figures are not available, please provide the most recent best available summary or range.
• If any element is not held in the format requested, I would welcome whatever similar or nearest equivalent data is available.
• If it is not held centrally, I would appreciate recommendations of other organisations that may be able to help.
• Where possible, I would greatly appreciate the information in a spreadsheet or tabular format.
Specifically, I am seeking:
CHC Processing
1. The total Continuing Healthcare (CHC) expenditure in your ICB for each of the last two full financial years, and your current forecast for the present financial year.
2. The number of whole-time equivalent (WTE) staff whose primary role is CHC in each of the last two financial years, plus your current forecast.
3. Expenditure on agency and/or bank staff working on CHC in each of the last two financial years and estimated or forecast spend for the present year.
4. The number of CHC applications your ICB received and processed in each of the last two financial years, and year-to-date in the current year.
5. As of the date of this request, the number of CHC applications currently “open” (i.e., not yet concluded). Of these, how many are “active” (currently being assessed/reviewed by your team) and how many are “awaiting allocation or further information” (not currently being worked on)?
6. Of all CHC applications processed in each of the last two financial years, what percentage came via the Fast Track pathway?
7. What percentage of draft CHC assessment reports/Decision Support Tools (DSTs) required revision prior to being finalised and issued to applicants or their representatives, in the last financial year?
8. Of CHC cases approved by your ICB in each of the last two financial years, what percentage received a review at 3 months and at 12 months, in accordance with NHS England guidance? If precise figures are not available, please provide your best estimate, most recent audit or monitoring results, or a narrative description of processes and compliance with this guidance.
9. What percentage of CHC funding decisions made by your ICB were formally appealed/challenged in each of the last two financial years at ICB level (Local Resolution), NHS England level (Independent Review Panel) and Parliamentary Health Service Ombudsman (PHSO)?
10. Please estimate the total staff time (in hours, staff days, percentage of CHC team workload, or any other relevant measure) spent in the last two financial years preparing or reviewing CHC cases for Local Resolution, Independent Review Panel and PHSO. If exact figures are not held, I would appreciate your best approximation, broad summaries, or even a short narrative on the scale of work and resource required in these activities.
11. Please provide the name, job title and email address for the senior manager responsible for CHCs.
AI and Digital Systems
12. Which IT systems or software applications are used by your ICB in the management of CHC applications? Please specify the company name, product and contract end date if applicable.
13. Does your ICB currently use any Artificial Intelligence (AI) or automated decision-support tools in the creation and management of the DST? If yes, please specify the company name, product and contract end date if applicable.
14. How does your ICB capture and store information from CHC assessment of needs and Multidisciplinary Team (MDT) meetings (e.g., handwritten notes, typed notes, digital audio recordings, or an electronic casework system)?
15. Please provide the name, job title and email address for the senior manager responsible for digital systems and AI.
CHC Processing
2023/24 actual £253.3m
2024/25 actual £280.0m
2025/26 forecast £294.4m
23-24 ACTUAL 181.54 as at M12
24-25 ACTUAL 194.44 as at M12
25-26 FOT 192.53 as at M6
23-24 ACTUAL £1,174,860
24-25 ACTUAL £610,149
25-26 FOT £348,480
Statistics » Continuing Healthcare and NHS-funded Nursing Care
Open – 169
Active – 135
Awaiting allocation – 34
Statistics » Continuing Healthcare and NHS-funded Nursing Care
| Locality | |
| Bolton | Bolton locality do not hold this information as such was not recorded prior to Quarter 2 – July 2025 to September 2025.
For Quarter 2 – July – September 2025 – 12.87% reviewed CHC and Fast Track patients in the last quarter. We are not able to extract data prior to this period due to format of recording such data. The above will be an approximation. |
| Bury | 55% |
| HMR | HMR locality do not hold this information. I can confirm that all patients in receipt of funding are reviewed at 3 months and 12 months, we do not generally have issues meeting these deadlines. |
| Manchester | All reviews are conducted in accordance with the National Framework. All MDTs that have concluded where the person is eligible for CHC or FNC are scheduled for a 3-month review. All other reviews are annually or based on clinical need. |
| Oldham | Due to long term sickness absence, vacancy factor and the inability to utilize agency staff in the last 6months the 3month reviews are somewhat delayed and we have a small number of cases that have not been reviewed in the last 12 months, however we have a recovery plan in place and the case managers are prioritising the longest waits. |
| Salford | 2023-24 = 100%
2024-25 = 100% 2025-26 = 95% due to implementation of new Patient Management system |
| Stockport | Accurate answer is not possible due to the system functions. Nearest estimate is:-
2023/24 – 35% of CHC reviews completed (unable to split) 2024/25 – 93% of CHC reviews completed (unable to split) |
| Tameside | 2023/2024 – 38 CHC Approvals – 71% received reviews in line with guidance
2024/2025 – 17 CHC Approvals – 99.8% received reviews in line with guidance |
| Trafford | Trafford locality aim to complete the 3 month and annual reviews as per NHS England Guidance. |
| Wigan | Wigan locality aim to complete the 3 month and annual reviews as per NHS E Guidance. Monthly oversight review meetings take place to prioritise the longest reviews and allocate accordingly within the capacity of the team. In addition, an agency nurse has previously been commissioned to support the above work and this is also included on Wigan’s locality risk register. |
Where information is held, due to the low numbers involved (where patient data is 5 or less <5) we consider this to be exempt under section 40(2) of the Freedom of Information Act 2000 as the disclosure of this information may lead to the identification of individuals. This exemption is not subject to the public interest test.
For locality enquiries, Greater Manchester Locality Continuing Health Care Teams contact information is available on the NHS Greater Manchester website via the following link https://gmintegratedcare.org.uk/chc/
AI and Digital Systems
| Supplier | Localities | Contract Details |
| CHS Healthcare Ltd | Broadcare
Bolton, HMR, Oldham, Manchester, Salford, Stockport, Tameside |
31/03/2027 |
| CHS Healthcare Ltd | Caretrack
Trafford |
31/03/2027 |
| Adam Htt Limited (Access Group) | ADAM
Bury |
31/10/2025 |
| QA Plus Ltd | IChord Wigan |
31/03/2026 |
| Locality | |
| Bolton | Information gathered is recorded on the DST during the MDT meeting and copies of reports/assessment of needs and Multidisciplinary Team (MDT) meetings (e.g., handwritten notes, typed notes, digital audio recordings, or an electronic casework system) are saved on the N:\ along with the DST. Outcomes of eligibility are recorded electronically on Broadcare. |
| Bury | Handwritten notes would be scanned and all supporting evidence would be uploaded to our Adam case management system. |
| HMR | We are paperless so have limited handwritten information. Anything handwritten such as signatures from MDT are scanned and saved electronically on our Case Management System (Broadcare). |
| Manchester | Our ICB captures and stores information from CHC assessments of needs and Multidisciplinary Team (MDT) meetings using a combination of methods. We utilise handwritten notes, typed notes, and an electronic patient data system to ensure comprehensive and accurate documentation. |
| Oldham | Typed notes and electronic case management system – Broadcare |
| Salford | Typed information held on national templates stored within the electronic patient based system. |
| Stockport | Information is stored on Broadcare system and the CHC N drive – Typed notes |
| Tameside | Information is typed into GMICB / Dept of Health documents and then saved to the individual patients electronic file and copied onto Broadcare our data management system. |
| Trafford | Typed notes |
| Wigan | Wigan locality captures and stores information from CHC assessments of needs and Multidisciplinary Team (MDT) meetings using a combination of methods. We utilise handwritten notes, typed notes, and an electronic patient data system to ensure comprehensive and accurate documentation. |
For locality enquiries, Greater Manchester Locality Continuing Health Care Teams contact information is available on the NHS Greater Manchester website via the following link https://gmintegratedcare.org.uk/chc/
