FOI 2025/1450

Please treat this as a formal request for information under the Freedom of Information Act 2000.

Please note that this request covers CHC-funded packages across all ten boroughs within the NHS Greater Manchester Integrated Care Board footprint: Bolton, Bury, Manchester, Oldham, Rochdale, Salford, Stockport, Tameside, Trafford and Wigan.

I am requesting information about NHS Continuing Healthcare (CHC) packages funded by your Integrated Care Board (ICB), whether managed directly through Personal Health Budgets (PHBs) or delivered through third-party providers commissioned by the ICB, such as complex-care agencies, co-operatives, or other external providers.

Vehicle, fuel, and driver arrangements

1. Please confirm how many current CHC-funded patients have a vehicle, fuel costs, or a driver included within their package (either PHB-managed or third party-managed).

Please state the number of patients or packages where:

1. a vehicle is provided or funded directly.
2. fuel or mileage reimbursement is included.
3. a driver role is funded within the care package.

Eligibility, assessment, and recording

2. Please provide the criteria, policy, or assessment guidance used to decide when a vehicle, fuel allowance, or driver can be included in a CHC package.
3. Please state which professionals (for example, case manager, occupational therapist, or MDT) may recommend these items, how such arrangements are justified and recorded within the care or support plan, and how they are reviewed during annual CHC reviews or PHB audits.

Third-party and provider-managed packages

4. Please confirm whether any third-party providers (for example, Amore Complex Care, Key Care Support, My Support Worker, Future Directions CIC, or others) deliver CHC packages that include a vehicle, fuel cost, or driver funded by the ICB.
5. Please outline how the ICB approves or monitors such transport-related costs, distinguishes between direct patient PHB costs and provider-managed transport costs, and ensures equality and consistency across different provider types.

Vehicle deposits, electric vehicles (EVs), and specialist needs

6. Please confirm whether your ICB contributes to:
7. vehicle deposits or lease costs, including large deposits of £3000 or higher;
8. electric vehicle (EV) deposits or leases, noting that Motability has confirmed a national transition to electric-only vehicles for new leases from its cut-off date;
9. larger or specialist vehicles required for non-wheelchair users, such as autistic adults who require a driver and two carers or need additional space for sensory regulation and staff safety.
10. Please confirm what criteria, if any, your ICB applies when deciding whether to fund or contribute towards a vehicle within a CHC package, including where a vehicle is required for clinical, behavioural, or safety reasons.

In particular, please confirm whether your ICB distinguishes between:

1. vehicles required for staff safety or patient risk reduction;
2. vehicles required to support access to community or therapeutic activities; and
3. vehicles considered “lifestyle” or “non-essential.”

Some CHC patients require vehicle adaptations to ensure safety during travel. For example, a fitted safety screen may be installed to protect the driver and staff while the vehicle is moving. In at least one case, an ICB accepted the use of a full-body harness for transport, but the family did not agree and instead used a fitted safety screen as a safer, less-restrictive alternative.

8. Please confirm whether your ICB has any written policy, clinical guidance, or approval process covering:
9. how such decisions are made and funded;
10. how restraint options such as body harnesses are assessed under the Mental Capacity Act 2005 and Equality Act 2010; and
11. whether vehicle safety adaptations (for example, fitted safety screens) are recognised and funded as a reasonable and lawful alternative to restraint.

The reason for this request is that the standard 5-seat vehicle option offered through Motability (usually with no or low deposit) is not suitable for some CHC patients, particularly where care plans require a driver and two carers to accompany the patient safely, additional internal space to prevent injury to staff or the individual during sensory or behavioural episodes, or secure equipment storage and consistent seat configuration for autism-related safety needs.

In such cases, a larger vehicle (for example, an MPV or van-based EV) may be essential to ensure staff safety and patient wellbeing. With Motability’s transition to electric-only vehicles, these larger models often attract very high advance payments or deposits, making them inaccessible without ICB or local-authority support.

In many CHC cases, the use of public transport or taxis is not a viable or safe option due to behavioural, sensory, or clinical risk factors. For example, patients with autism or unpredictable behaviours may present significant safety risks to themselves or others in shared transport environments.

9. Please confirm whether your ICB has any guidance or assessment process for identifying when public transport or taxis are unsuitable, and how the ICB then considers vehicle provision or mileage support as a reasonable and necessary adjustment within the CHC package.

Electricity charging and reimbursement

10. As the Motability Scheme transitions to electric-only vehicles, please confirm how the ICB manages or funds the electricity-charging costs associated with EV use within CHC packages.

Specifically:

1. where an EV is charged at the patient’s home, does the ICB reimburse electricity costs (for example, via PHB or provider payment) or expect these to be covered from the patient’s domestic bill;
2. where charging occurs at public service-station charge points, does the ICB provide or allow a top-up or mileage allowance to cover those costs;
3. is there a standard rate or policy for calculating EV-charging reimbursement (for example, £/kWh equivalent to fuel mileage rates);
4. has the ICB carried out any equality or cost-impact assessment of this transition to ensure CHC patients are not disadvantaged by higher home-energy bills or public-charging costs.

Policies, guidance, and templates

11. Please provide copies or extracts of any:
12. CHC or PHB operational policy or commissioning guidance referring to transport, vehicles, drivers, or fuel;
13. template care plan or provider service specification including such provisions;
14. audit, review, or internal report evaluating transport-related elements of CHC packages.

If possible, please provide this information in an electronic format (Word, PDF, or Excel).

If any part of this request is held by another organisation, such as NHS England or a local-authority partner, please confirm this and transfer the request in line with Section 45 of the FOI Code of Practice.

1.This information is not recorded on the NHS Greater Manchester systems/data bases. Therefore, this section of your request is exempt by virtue of the following exemption, 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 Greater Manchester (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. 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. 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 your request to the last 12 months 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.

2. NHS GM does not have a policy.
3. Needs can be identified by the Multi-Disciplinary Team (MDT) working with the patient needs will be the responsibility of NHS GM. The patients’ needs are reviewed as part of the initial assessment process and then again at each review where the support plan is revisited.
4. This would be reviewed on individual case by case basis.
5. NHS GM does not complete a comparison on these costs.
6. This information is not recorded on the NHS Greater Manchester systems/data bases. Therefore, this section of your request is exempt by virtue of the following exemption, 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 Greater Manchester (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. 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 your request to the last 12 months 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.

7. Decisions relating to funding or contributing towards a vehicle within a CHC package, is based on an individuals need and how that need is met.
8. NHS GM does not have a written policy, clinical guidance or approval process covering these funding decisions are made.