FOI 2026/1685

I am sending this request under the Freedom of Information Act to ask for the following information.

Please could you supply data for each of the ICBs you manage FOIs for, where applicable.

If all questions cannot be answered in the appropriate time limit, please answer the questions in order until the time limit is reached.

1. In 2025, how many referrals of any form were made to the ICB for Fast-Track Continuing Healthcare (CHC)?

2. How many of the referrals in question 1 were rejected as inappropriate by the ICB?

3. Please explain, in general terms, the main reasons for which referrals were deemed inappropriate

4. How many of the referrals in question 1 were withdrawn/closed by a) The referrer, or b) The patient/their family.

5. How many of the referrals in question 1 were withdrawn/closed as a result of the patient dying before any funding was put in place?

6. In 2025, how many referrals were accepted for Fast-Track Continuing Healthcare?

7. In 2025, what was the average timeframe – for Fast-Track CHC referrals that were accepted – between receipt of the completed Fast Track Pathway Tool and the care package being commissioned. Please provide the answer in hours where possible, or otherwise in days.

If data for calendar years cannot be provided, please instead give the average timeframe for the most relevant period for which data can be compiled (for example, December 2025).

8. In 2025, what was the average timeframe – for Fast-Track CHC referrals that were accepted – between receipt of the completed Fast Track Pathway Tool and the funding for the care package being put in place. Please provide the answer in days.

If data for calendar years cannot be provided, please instead give the average timeframe for the most relevant period for which data can be compiled (for example, December 2025).

9. Please can you explain the decision-making process for Fast-Track Continuing Healthcare referrals, giving details of all criteria involved in the process between receiving the referral and commissioning support?

As part of this, please could you explain:

1. The criteria you use for who can make a Fast-Track CHC referral (for example, are non-NHS medical professionals, care home nurses and/or GPs able to do this?)
2. Whether Fast-Track Continuing Healthcare referrals made by an appropriate clinician are subject to further checks by professionals working for, or on behalf of, the ICB before being granted? Please explain this process if so.
3. Whether a patient referred by an appropriate clinician is required to meet further criteria, such as having a primary health need, in order to qualify for Fast-Track support?

1. The information requested is publicly available on the NHS England website. To assist you please find a link to the information below.

Statistics » Continuing Healthcare and NHS-funded Nursing Care

2. Please refer to the response to question 1.
3. This information is not officially recorded, but reasons are generally that patients do not meet the NHS fast track criteria as set out in the National Framework guidance, fast track completed at an inappropriate time or a CHC checklist would be the most appropriate referral type.
4. In line with Section 12 of the Freedom of Information Act 2000, NHS Greater Manchester has refused your request 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.

I would like to explain that 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.

The scope of the request has been carefully considered. NHS GM does not hold the information in the format requested. The work would involve manually reviewing 100s records across ten localities for questions 4, 5 7, and 8, and It is estimated a search of each file would take approximately 15 mins (100 x 15mins = 25 hours). 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, it is with regret that on this occasion NHS GM cannot process this section of your request further.

5. Please refer to the response to question 4.
6. Please refer to the response to question 1.
7. Please refer to the response to question 4.
8. Please refer to the response to question 4.
9. The national framework – National framework for NHS continuing healthcare and NHS-funded nursing care – GOV.UK clearly sets out the decision-making process which is followed by all 10 of our GM locality CHC teams.

9a – The National Framework stipulates the individuals that are able to complete a fast-track referral and it is either an NHS nurse or doctor that knows the individual and can assess their needs. We would not accept a referral from a care home nurse but if we were alerted by a care home of an individual rapidly deteriorating, we would ask the District Nurses’ or hospice services to review and if not involved, the locality CHC Nurse assessor would undertake the review – similar to if they were in a nursing home.

9b – All Fast Track referrals that come into the locality service are considered by a CHC Practitioner also known as a Duty Nurse system which runs Mon-Fri 9-5pm. Referrals for the FT pathway are considered against the National Framework criteria to ensure this is met.

9c – As per the National Framework for NHS Continuing Healthcare, The Fast Track pathway must only be used when the individual has a rapidly deteriorating condition, and the condition may be entering a terminal phase. Individuals referred for fast track still have to have a primary health need as they are still being assessed for CHC eligibility, it is just a faster mechanism for decision making as fast track patients may not have the 28 days to wait for the decision or may require immediate access to care.