FOI 2025/1427

Under the Freedom of Information Act 2000, I request the following information relating to self monitored point of care INR (International Normalised Ratio) testing equipment (i.e. devices and test strips used by patients to monitor warfarin therapy at home) for the Greater Manchester area:
1. Does the ICB currently provide, fund, or reimburse (in whole or in part) self monitoring INR test kits (meters / strips / consumables) for patients in its area?
If yes:
a. In which circumstances / criteria (e.g. patient groups, clinical criteria)
b. How many patients are enrolled in such a scheme
c. The annual cost to the ICB of providing these (or reimbursing them)
d. Which device(s) are used / supported
If no:
a. Has the ICB ever considered a scheme to provide such kits (or reimbursement)?
b. If considered, what were the outcomes or reasons for non adoption
2. Does the ICB have a plan or policy to introduce or expand access to self monitoring INR test kits within the next 2–3 years?
o If yes, please provide relevant policy documents, projected costs, and timelines.
3. Has the ICB commissioned or participated in any pilot or research relating to self monitoring of INR in its area?
o If yes, please provide the names, dates, and brief descriptions of such pilots / studies.
4. Please provide the ICB’s current policy on anticoagulation monitoring (e.g. warfarin monitoring) and how the choice between clinic based and self monitoring is decided.

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).

Each of the former CCGs was responsible for its own commissioning arrangements in various areas. Each former CCG is aligned to a locality area within the ICB (with the exception of NHS Tameside and Glossop CCG, which became the Tameside locality, as commissioning responsibility for patients registered with a Glossop based GP transferred to NHs Derby and Derbyshire ICB on 1st July 2022

1. Yes

1a. Not applicable – there is no scheme supply is via FP10 prescriptions.

1b. NHS Greater Manchester (NHS GM) does not hold the information requested; therefore, it will be necessary for you to contact NHS Business Services Authority for the information you seek. To assist you please fin below a link to their website and information about how to make a Freedom of Information request.

Freedom of Information | NHSBSA

1c. The period of 12 months to July 2025, shows a spend of £102,781 on self-monitoring INR test kits.

1d. NHS GM does not have a formulary or support the use of any specific product(s) but the only products that have been prescribed in GM are Coagucheck.

2. No.
3. Yes – one locality (Manchester) had a pilot of a self-testing scheme in 2022.
4. NHS GM does not currently have a policy on anticoagulation monitoring (e.g. warfarin monitoring) or a single approach to provision of self-monitoring how the choice between clinic based and self-monitoring is decided.

One locality (Bolton) has an explicit policy to not provide self-monitoring kits. Choices for clinic based and self-monitoring in the other 9 localities are clinician led.