FOI 2025/1432

I am making this request under the Freedom of Information Act 2000 regarding the financial management of Continuing Healthcare (CHC) and Personal Health Budgets (PHB) across NHS Greater Manchester ICB.

Please provide the following information for the period 1 April 2010 – present (or as far back as records allow).

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Section 1 – Current and Historical Hourly Rates

1. For each of the ten Greater Manchester localities (Bolton, Bury, Heywood Middleton & Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford and Wigan):
2. The standard hourly rate paid by the ICB (or its predecessor CCG) for directly commissioned domiciliary CHC care (e.g. via agency or framework contract) for each financial year since 2010.
3. The average hourly rate approved for PHB / third-party-budget carers over the same period.
4. The range (lowest and highest) of approved rates currently in use for complex-care home support.

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Section 2 – Uplift and Pay Review Process

2. Copies of any policy, guidance, or decision-making procedure governing how hourly rate increases (“uplifts”) are requested, evaluated, and approved for PHB, notional, or third-party budgets.
3. The approval route (job titles or committees) required to sign off an uplift request and any set thresholds (e.g. % or £ limits).
4. Copies of any templates or forms used by providers or families to request an uplift, and any guidance explaining when such requests may be refused.

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Section 3 – Frozen or Static Budgets

5. The number of CHC / PHB packages in which the hourly rate has remained unchanged for five years or longer, broken down by locality.
6. Any review, audit, or policy document describing how the ICB identifies and addresses long-term frozen budgets or real terms pay erosion for PHB staff.
7. Any minutes or internal reports (2020–present) where the issue of frozen or below-market rates was discussed at CHC or finance governance meetings.

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Section 4 – Provider Management Fees and Carer Pay

8. The average management fee (%) or overhead charged by third-party PHB providers.
9. The average hourly pay received by frontline carers employed under those third-party arrangements (if held), or the typical differential between ICB payment rate and carer wage.
10. Any policy or assurance mechanism to ensure that uplifted ICB rates are passed on to frontline staff rather than retained by management organisations.

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Section 5 – Format and Exemptions

Please provide all information electronically (spreadsheet or PDF).

If information is withheld, please specify the exact statutory exemption(s) under the Freedom of Information Act and state whether a public-interest test has been applied.

NHS Greater Manchester consists of the following 10 Greater Manchester Localities: Bolton, Bury, Heywood, Middleton and Rochdale (HMR), Manchester, Oldham, Salford, Stockport, Tameside, Trafford, and Wigan (former Clinical Commissioning Groups), who currently all have their own processes/systems for recording their Continuing Healthcare (CHC) activity.

1a.

Please note

Wigan – On occasions there may be a need to commission a care package off the Ethical Framework from domiciliary care providers on a spot purchase arrangement depending upon the patients assessed needs. These rates will be agreed on an individual basis.

1b.

Please note

Wigan – these may not be the actual paid, these are recommended and based on agenda for change pay rates. Any rates that fall below the Real Living Rate will be reviewed and the PHB budget amended to ensure payment at the legal requirement.

Under the Freedom of Information Act 2000 (FOIA), this section of your request is exempt by virtue of the following exemption, Section 12(1). Section 12. — (1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

Section 12(1)

Section 12(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

The Freedom of Information Act allows Public Authorities to decline to answer FOI requests when we estimate it would cost us more than £450 (equivalent to 18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.

NHS GM consists of the 10 Greater Manchester localities, Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford and Wigan (former Clinical Commissioning Groups), and therefore documents are held on various data bases. As such a manual search of records would be required. It is estimated a search of each file would take approximately 15 mins and NHS GM holds hundreds of files across the 10 localities. Therefore, due to the volume and complexity of the data involved, it would require a disproportionate amount of time and resources to locate extract and collate the data, and therefore, on this occasion it is with regret NHS GM are not able to process this section of your request further.

Although we cannot answer your request, we might be able to answer a refined request within the cost limit. Therefore, you may wish to restrict the timeframe of your request and/or consider specifying a smaller geographical area. However, please be aware that we cannot guarantee at this stage that a refined request will fall within the cost limit, but NHS GM would do our upmost to assist you.

1c.

2.

3. The budget delegation is for localities to manage and oversee, in line with the NHS GM ICB Operating Model. The Heads of CHC, under the line management of each of the 10 Associate Directors of Quality, Nursing and Safeguarding (ADQs), manage the day to day financial management in accordance with the Scheme Reservation and Delegation (SORD), as detailed on the website: NHS Greater Manchester Integrated Care Governance Handbook
4. NHS GM does not have any specific templates or forms, that can be used by providers or families to request an uplift, or guidance explaining when such requests may be refused.

Information regarding Continuing Healthcare is available on the NHS GM website and can be accessed via the following link Continuing Healthcare | Greater Manchester Integrated Care Partnership

5, 6 & 7. Under the Freedom of Information Act 2000 (FOIA), this section of your request is exempt by virtue of the following exemption, Section 12(1). Section 12. — (1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

Section 12(1)

Section 12(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

The Freedom of Information Act allows Public Authorities to decline to answer FOI requests when we estimate it would cost us more than £450 (equivalent to 18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.

NHS GM consists of the 10 Greater Manchester localities, Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford and Wigan (former Clinical Commissioning Groups), and therefore documents are held on various data bases. As such a manual search of records would be required. It is estimated a search of each file would take approximately 15 mins and NHS GM holds hundreds of files across the 10 localities. Therefore, due to the volume and complexity of the data involved, it would require a disproportionate amount of time and resources to locate extract and collate the data, and therefore, on this occasion it is with regret NHS GM are not able to process this section of your request further.

Although we cannot answer your request, we might be able to answer a refined request within the cost limit. Therefore, you may wish to restrict the timeframe of your request and/or consider specifying a smaller geographical area. However, please be aware that we cannot guarantee at this stage that a refined request will fall within the cost limit, but NHS GM would do our upmost to assist you.

8.

Under the Freedom of Information Act 2000 (FOIA), this section of your request is exempt by virtue of the following exemption, Section 12(1). Section 12. — (1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

Section 12(1)

Section 12(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

The Freedom of Information Act allows Public Authorities to decline to answer FOI requests when we estimate it would cost us more than £450 (equivalent to 18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.

NHS GM consists of the 10 Greater Manchester localities, Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford and Wigan (former Clinical Commissioning Groups), and therefore documents are held on various data bases. As such a manual search of records would be required. It is estimated a search of each file would take approximately 15 mins and NHS GM holds hundreds of files across the 10 localities. Therefore, due to the volume and complexity of the data involved, it would require a disproportionate amount of time and resources to locate extract and collate the data, and therefore, on this occasion it is with regret NHS GM are not able to process this section of your request further.

Although we cannot answer your request, we might be able to answer a refined request within the cost limit. Therefore, you may wish to restrict the timeframe of your request and/or consider specifying a smaller geographical area. However, please be aware that we cannot guarantee at this stage that a refined request will fall within the cost limit, but NHS GM would do our upmost to assist you.

9.

Under the Freedom of Information Act 2000 (FOIA), this section of your request is exempt by virtue of the following exemption, Section 12(1). Section 12. — (1) Section 1(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

Section 12(1)

Section 12(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

The Freedom of Information Act allows Public Authorities to decline to answer FOI requests when we estimate it would cost us more than £450 (equivalent to 18 hours, calculated at £25 per hour) to identify, locate, extract, and then provide the information that has been asked for.

NHS GM consists of the 10 Greater Manchester localities, Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford and Wigan (former Clinical Commissioning Groups), and therefore documents are held on various data bases. As such a manual search of records would be required. It is estimated a search of each file would take approximately 15 mins and NHS GM holds hundreds of files across the 10 localities. Therefore, due to the volume and complexity of the data involved, it would require a disproportionate amount of time and resources to locate extract and collate the data, and therefore, on this occasion it is with regret NHS GM are not able to process this section of your request further.

Although we cannot answer your request, we might be able to answer a refined request within the cost limit. Therefore, you may wish to restrict the timeframe of your request and/or consider specifying a smaller geographical area. However, please be aware that we cannot guarantee at this stage that a refined request will fall within the cost limit, but NHS GM would do our upmost to assist you.

10.