FOI 2026/1628

I am writing to make a Freedom of Information request regarding the commissioning and funding of placements for adults with severe neurological injury and/or long-term airway or ventilatory dependency following discharge from acute hospital settings.

For the purposes of this request, please include adults (aged 18+) who have been discharged from acute NHS hospital settings (including ICU, neurology, neurosurgery, stroke, trauma, spinal injury or respiratory wards) and who require high levels of ongoing care due to:

• Traumatic brain injury
  • Stroke (ischaemic or haemorrhagic)
  • Hypoxic/anoxic brain injury
  • Brain tumour or post-neurosurgical complications
  • High cervical spinal cord injury
  • Severe acquired neurological disability
  • Advanced neurodegenerative disorders (e.g., Motor Neurone Disease, advanced MS, advanced Parkinson’s disease)
  • Other serious neurological or respiratory conditions resulting in long-term functional impairment

Including individuals discharged with:

• A tracheostomy in situ
  • Long-term invasive ventilation
  • Long-term non-invasive ventilation
  • Complex airway management needs

Please provide data for the most recent three financial years available.

1. Commissioned Placements and Care Packages

For each financial year, please provide:

a. The total number of adults meeting the above criteria for whom the ICB has commissioned or funded a placement or care package following discharge from acute hospital.

b. A breakdown of placement type:

• Specialist neurorehabilitation unit (Level 1 or 2)
  • Specialist ABI/neuro-disability care home
  • Specialist ventilator-dependent unit
  • Non-specialist nursing or residential care home
  • Home with a domiciliary or complex care package
  • Other (please specify)

2. Continuing Healthcare (CHC)

a. Of the above cohort, how many were funded under NHS Continuing Healthcare?
b. How many required 24-hour care provision?
c. How many required ventilator-capable or tracheostomy-capable placements?

3. Commissioning and Classification

a. Does the ICB maintain a defined list of “specialist ABI”, “specialist neuro-disability”, or ventilator-capable care homes?
b. If so, please provide the number of such placements commissioned in each financial year.

If any part of this request exceeds the cost threshold under the Freedom of Information Act, I would be grateful for guidance on how the scope may be refined.

If possible, please provide the data in Excel format.

The Greater Manchester Integrated Care Board Case Management Team have only been in place since February 2025. Prior to this team the caseload was managed by individual locality NHS Greater Manchester (GM) Integrated Care Board (ICB) Commissioners.

NHS GM can only provide historic data from the caseload that transferred over to us in March 2025 and new data from admissions since March 2025.

1.

a. The NHS GM ICB Neuro-Rehabilitation Case Management Team (CMT) commission Independent Sector (IS) placements only when existing NHS GM commissioned services cannot meet the person’s needs. This is a small cohort of people usually meet a gap between level 1 or 2 NHS services and Community Neuro-Rehabilitation Teams (CNRT). This is also sometimes termed ‘slow-stream’ rehabilitation.

This cohort of patients are placed by the CMT in Independent Sector Specialist ABI/neuro-disability care homes for a temporary rehabilitation placement.

Historic caseload: 9 Tracheostomy patients; <5 of which required ventilation.

Of these cases: 5 were admitted to the IS placement in 2024/25 (<5 vented); 7 were admitted in 2023/24 (<5 vented).

NHS GM are unable to confirm if these numbers accurately represent the number of admissions as we will not have sight of any discharges that may have occurred before March 2025 when the CMT took the caseload.

Of the historic caseload:

• 6 were discharged to a CHC funded placement
• <5 was admitted back into NHS services (one of the vented caseload)
• <5 was discharged to a LA funded residential home (post-decannulation of Tracheostomy)

New admissions from April 25: <5 Tracheostomy patients; <5 of which requires ventilation.

We currently have 7 tracheostomy patients on the caseload, <5 of which requires ventilation (mix of historic and new caseload).

b. Specialist ABI/neuro-disability care homes are used for all IS Neuro-Rehabilitation placements.

Please Note:

NHS Greater Manchester (NHS GM) does hold the information requested however, due to the low numbers involved (where patient data is less than 5 (<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 and. This exemption is not subject to the public interest test.

2.

NHS GM does not record the level of detail requested within our data systems. 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 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 your request to consider specifying a specific locality and reducing the time period. Please also 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.

3.

a. The Case Management Team have a list of “specialist ABI”, “specialist neuro-disability”, or ventilator-capable independent sector providers who can support ‘slow-stream’ or extended rehabilitation placements.

b. See above for numbers placed this financial year 2025/26 and information from the historic caseload transferred to the team.