FOI 2025/1506

Under the FOIA, please could you provide the following information.
1. Please provide in full any analysis carried out, in 2024-25 and 2025-26, by your respective ICBs on block contracts for non-elective care, which compare the ‘fixed elements’ payments to what they would have been on a price x activity basis.
The information I’m looking for includes, but is not limited to, the ICB’s responses to requests from NHS England for all commissioners to review current block contracts on an Activity X Price (PbR) basis.

2. Please provide data on what the ‘fixed element’ payments were in 2024-25 and 2025-26, and what they would have been on a price per activity basis, according to the analysis. Break this information down by specialty if this information is available.

Thank you for your freedom of information request, which has been received by NHS Greater Manchester ICB (NHS GM).
The ICB does not hold any specific analysis that would identify a proportion the block contract value for non-elective activity at specialty level that would allow for any meaningful differences against activity x price (PbR) basis. The reason for this is that NHS GM has adopted rolled over block contract values since COVID command and control as directed by NHSE, which were not disaggregated to that level.
What we can and have provided back to you is the indicative plans as set by each provider trust in GM (i.e. by default a block value, although it should be noted that these indicative plans were not subject to agreement with NHS GM) for all non-elective (“NEL”) procedures at specialty level and provided a comparison against the actual activity x price (PbR) delivered. This analysis will help the FOI requester to see the comparison with fixed to what they would be paid on a price x activity basis.
The analysis provided is for the GM system and provides a breakdown by each NHS Hospital Trust within GM that uses a consistent submission of information data using the Aggregated Contract Management (ACM) method. This ensures it is a like for like across all NHS Provider trusts using the non-elective point of delivery.
NHS GM’s response provided to NHS England to review current block contracts and activity x price was at a more aggregated level that included a much wider scope and is therefore not considered to meet the contents of this FOI request. That piece of work aligns to the deconstructing of the blocks and forward planning for a more balanced payment system.
In relation to the embedded spreadsheet please note:
• Analysis provided on NHS Acute Trusts within GM system, for core commissioned contract elements only.
• Values included for NEL ‘Fixed Payments’ are taken from provider plans submitted within ACM/PLCM data submissions.
• All activity and spend taken from ‘NEL’ Point of Delivery.
• For Manchester University FT, no plan values were submitted under NEL in 24/25 data, so values used instead are 19/20 actuals uplifted by annual CUF to get to 24/25 values.
• 25/26 information is YTD based on M1-6 freeze data.