FOI 2026/1712

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

I am requesting the current or most recent recorded information held by the ICB in relation to ADHD and autism diagnostic assessment services, including services delivered by both NHS and independent sector providers.

To minimise burden, please provide the latest final version of each document or report requested below, and please do not search emails unless the information requested is not held in any formal document, report, paper, presentation, policy, guidance note, dashboard, assessment or board / committee paper.

If no single document exists for any question below, please confirm this and provide the recorded information in whatever existing form it is held.

Where information is held separately, please provide it separately for each of the following pathways:

1. a) Adult ADHD
2. b) Children and young people’s ADHD
3. c) Adult autism
4. d) Children and young people’s autism

Waiting times and performance

1. The current documented waiting time targets, trajectories, expected maximum waits, or other planning assumptions used by the ICB for referral to first diagnostic assessment.
2. The most recent routinely produced performance report or dashboard showing actual average waiting times from referral to first diagnostic assessment, broken down by commissioned provider where readily available.
3. The most recent routinely produced report or dashboard showing the number of individuals currently on the waiting list, broken down by commissioned provider where readily available.
4. Any current metadata, glossary or methodology note used by the ICB to define or calculate the waiting time and waiting list measures referred to in questions 2 and 3,

Demand, capacity and planning

5. The most recent final paper, report, analysis or dashboard used by the ICB to assess demand, capacity, and the impact on waiting times when deciding how much ADHD and/or autism diagnostic assessment activity to commission or fund.
6. The current plan, recovery plan, transformation plan, service improvement plan, Service Development and Improvement Plan, or equivalent document relating to reducing ADHD and/or autism waiting times and/or increasing diagnostic assessment capacity.
7. The most recent document, if any, identifying any mismatch between estimated referral demand and commissioned diagnostic assessment capacity for any of the above pathways, and setting out how the ICB intends to address that position.

Medium Term Planning Framework

8. The most recent document, paper or report that sets out how the ICB is meeting the requirements in the NHS Medium Term Planning Framework 2026/27 to 2028/29 to optimise existing resources to reduce long waits for autism and ADHD assessments and to increase community health service capacity to meet growth in demand.

National ADHD Taskforce

9. The most recent final briefing, paper, action plan, implementation document or committee paper held by the ICB that discusses the findings or recommendations of the independent National ADHD Taskforce report, including any document setting out how the ICB intends to respond to or implement those recommendations locally.

Patient choice

10. The current policy, guidance, briefing or instruction used by the ICB to ensure patient choice operates for ADHD and autism referrals, including any document used by referrers, triage teams, referral management services, or commissioning staff.
11. The most recent recorded assessment, analysis, briefing or decision paper, if any, considering whether commissioning different volumes of activity from different providers delivering comparable ADHD or autism diagnostic assessment services has the practical effect of constraining patient choice, including by limiting capacity or creating materially different waiting times between providers.

Equality and quality

12. The most recent equality impact assessment, quality impact assessment, patient safety assessment, risk assessment, or similar document relating to ADHD and/or autism waiting list management, commissioning decisions, or service capacity.

Governance and oversight

13. The single most recent final board, committee, programme or senior management paper that discusses ADHD and/or autism waiting times, capacity, provider activity levels, or actions to improve access.

ICB reorganisation / cluster arrangements

14. If the ICB is merging, clustering, being reorganised, or operating through a joint commissioning arrangement with another ICB or cluster, please confirm:.the name of the new or successor body or cluster arrangement; b. whether responsibility for ADHD and autism commissioning, service planning, or waiting list management sits wholly or partly at that level; and c. please provide the equivalent recorded information requested above where it is held at that level rather than solely by the current ICB.

If any of the above information is already publicly available, please provide the precise link.

If any part of this request is considered likely to exceed the cost limit under section 12 of the Act, please provide the parts that can be answered within the limit and provide advice and assistance under section 16 of the Act as to how any remaining part may be refined.

If any information is withheld, please identify the specific exemption relied upon and, where applicable, your reasoning on the public interest test.

Waiting times and performance

1. This national report from the Children’s commissioner for England provides a detailed account of waiting times for CYP Autism and ADHD assessments across England, the issues and rise in demand. https://assets.childrenscommissioner.gov.uk/wpuploads/2024/10/CCo-report-on-ND-waiting-times_final.pdf
2. NHS Greater Manchester (NHS GM) does not currently receive data about other waiting lists across our system. Therefore, it will be necessary for you to contact the provider organisations directly for the information you seek. To assist you please find links to their websites below.

For Right to Choose providers please contact:

For commissioned services please contact:

2. NHS GM does not hold this information. Please refer to the response to question 1.
3. NHS GM does not hold this information. Please refer to the response to question 1.
4. N/A

Demand, capacity and planning

5. 6. & 7. NHS GM has initiated large scale transformation programmes in relation to Children’s Autism and ADHD assessment and support pathways and adult ADHD. Both have involved either public engagement or consultation exercises. Information is available to the public at the below links:

ADHD and Autism Assessments | Greater Manchester Integrated Care Partnership

Supporting your child with diagnosed or undiagnosed autism and ADHD as a parent, carer and family member | Greater Manchester Integrated Care Partnership

ADHD and Autism Assessments for children and young people | Greater Manchester Integrated Care Partnership

NHS GM Adult ADHD Consultation Report Sept 2025

Get involved, adult ADHD consultation now open in Greater Manchester | Greater Manchester Integrated Care Partnership

NHS GM CYP ADHD Engagement Report

NHS GM does not hold any other documents that meet the scope of the request.

Medium Term Planning Framework

8. Whilst the Medium-Term Planning Framework 2026/27 to 2028/29 set overarching expectations in relation to elective recovery and community service capacity, it did not explicitly reference ADHD or autism assessment waiting times as a distinct planning requirement at that stage.

More specific emphasis on neurodevelopmental assessment backlogs, including ADHD, has emerged through subsequent NHS England communications and developing planning expectations, and is therefore not fully reflected in the original framework document.

As a result, detailed ICB planning in this area is contingent on the publication of further national planning guidance, and local plans will continue to evolve in line with that guidance.

National ADHD Taskforce

9. The National ADHD Taskforce was established to provide advice and recommendations to HM Government on improving ADHD services and pathways at a national level. Its report and outputs are therefore directed primarily to central government and national system leaders, including NHS England.

As such, the Taskforce’s recommendations do not in themselves constitute formal planning requirements for Integrated Care Boards (ICBs). Any expectation for ICBs to take specific action in response to the Taskforce would ordinarily be communicated through national policy, planning guidance, or operational planning frameworks issued by NHS England.

At the time of this response, the ICB does not hold a specific final briefing, action plan, implementation document, or committee paper that sets out a formal local response to the independent National ADHD Taskforce report. This reflects the position that the ICB is awaiting the incorporation of relevant recommendations into formal NHS England planning guidance or policy requirements, which would then inform local planning and prioritisation processes.

The ICB will consider and respond to any such requirements as they are formally issued through national planning processes.

Patient choice

10. & 11. The NHS GM position on right to choose is provided here ADHD and Autism Assessments | Greater Manchester Integrated Care Partnership

Equality and quality

12. An Equality Impact Assessment, Quality Impact Assessment, and Performance Impact Assessment has been produced; however, it remains in draft form and has not been finalised or approved through the relevant governance processes. Once complete and approved NHS GM intend to publish for the final EqIA.

The release of this information is therefore exempt from disclosure by virtue of section 22 of the Freedom of Information Act 2000 as it is intended for future publication.

Section 22(1) of the Freedom of Information Act 2000 states:

• the information is held by the public authority with a view to its publication, by the authority or any other person, at some future date (whether determined or not),
• the information was already held with a view to such publication at the time when the request for information was made, and
• it is reasonable in all the circumstances that the information should be withheld from disclosure until the date referred to in paragraph (a).

This exemption is subject to the public interest test and for the reasons outlined below, we are satisfied that the exemption applies.

Public interest test

Factors favouring disclosure.

There is an inherent public interest in ensuring that there is openness and transparency to increase confidence. Furthermore, disclosure of this information would also be consistent with NHS GM’s commitment to proactively publish data that is in the wider public interest.

Factors favouring non-disclosure.

However, this information is subject to review, validation and approval, prior to publication. Early release of the requested information could be misrepresentative, and it is in the public interest that this information is true and accurate.

Balancing Test.

After considering the arguments outlined above, we have decided that, on balance, the public interest is better served at this time in withholding the documents under section 22 of the Freedom of Information Act 2000, on the basis that it will be published in the future once finalised, as outlined above.

The release of this information in draft form is also considered exempt from disclosure by virtue of section 36(2)(b)(i) and (ii) of the Freedom of Information Act, as disclosure would be likely to inhibit the free and frank provision of advice and the free and frank exchange of views for the purposes of deliberation.

Section 36 – Prejudice to the effective conduct of public affairs

The Minister responsible for the Freedom of Information in the Department of Health has authorised the senior person in charge of the National Health Service bodies to act as ‘Qualified Persons’ and under Section 5 of the National Health Service Act 1977 this is the Chief Executive. Under the Section 36 exemption, the ‘qualified person’ for NHS Greater Manchester (NHS GM) is Professor Colin Scales, Acting Chief Executive.

Professor Scales is of the opinion that the information should be withheld as he considers that it would, or would be likely to prejudice, the effective conduct of public affairs.  Disclosure of the information would, or would be likely to:

• inhibit the free and frank provision of advice, and
• inhibit the free and frank exchange of views for the purposes of deliberation.

Releasing preliminary information that has not yet been approved and validated would risk undermining future decision-making by discouraging open and candid consideration of alternative approaches. Release would also be likely to prejudice the effective conduct of public affairs.

Public Interest Test

Factors favouring disclosure.

Openness and transparency: It is important that NHS GM acknowledges their responsibility to be open, transparent and accountable.

Factors favouring non-disclosure.

NHS GM consider sharing the information requested would inhibit advice, views and openness between decision makers, necessary to agree appropriate service provision for the patients it serves. It is critical that NHS GM maintain the greatest possible confidence without any concern that confidential or sensitive information provided, consulted, or relied on may be compromised. Furthermore, to divert resources to manage the impact of disclosure, would cause disruption to important services that NHS GM provides, and the organisations ability to efficiently conduct public affairs.

Balancing Test.

NHS GM has carefully considered whether the requested information could be disclosed in a redacted or partial form. However, meaningful disclosure would not be possible without undermining the protected interests. Redaction would leave the remaining material fragmentary and misleading.

As such, it is the decision of NHS GM that the public interest at this time lies in non-disclosure of the information for the reasons outlined above. NHS GM consider that the public interest in withholding the internal draft working information outweighs the public interest in disclosure. Disclosure of a draft would risk misinterpretation of provisional analysis and conclusions that may change prior to final approval.

Governance and oversight

13. NHS GM does hold a recent senior management (Chief Officer-level) paper that discusses ADHD and autism waiting times, service capacity, provider activity levels, and actions to improve access.

However, this document is an internal working paper produced to support senior leadership discussions and decision-making. It contains candid assessments of system pressures, detailed provider-level information, and early-stage options that are not yet finalised or reflected in agreed policy or published plans.

Therefore, the release of this information is exempt from disclosure by virtue of section 36(2)(b)(i) and (ii) of the Freedom of Information Act, as disclosure would be likely to inhibit the free and frank provision of advice and the free and frank exchange of views for the purposes of deliberation. Also, Section 43(2) Prejudice to Commercial Interests as its disclosure would, or would be likely to, prejudice the commercial interests of any person (including the public authority holding it).

Section 36 – Prejudice to the effective conduct of public affairs

The Minister responsible for the Freedom of Information in the Department of Health has authorised the senior person in charge of the National Health Service bodies to act as ‘Qualified Persons’ and under Section 5 of the National Health Service Act 1977 this is the Chief Executive. Under the Section 36 exemption, the ‘qualified person’ for NHS Greater Manchester (NHS GM) is Professor Colin Scales, Acting Chief Executive.

Professor Scales is of the opinion that the information should be withheld as he considers that it would, or would be likely to prejudice, the effective conduct of public affairs.  Disclosure of the information would, or would be likely to:

• inhibit the free and frank provision of advice, and
• inhibit the free and frank exchange of views for the purposes of deliberation.

The paper was developed specifically to enable senior leaders to:

• openly discuss system risks and performance challenges.
• critically assess provider delivery and capacity constraints; and
• explore a range of potential actions, including those not ultimately taken forward.

Discussions in question were held in private and form part of the ICB’s internal governance and operational decision-making processes. Disclosure of such material would be likely to lead to a chilling effect and self-censorship by officers and system partners in future, particularly where discussions involve sensitive performance issues or emerging concerns. This would reduce the candour and quality of internal advice available to decision-makers, discouraging open and candid consideration of alternative approaches.

Release would also be likely to prejudice the effective conduct of public affairs by undermining NHS GM’s ability to manage system performance and improvement through frank internal dialogue prior to formal decisions being reached.

The decision to apply this exemption has been made with the reasonable opinion of the qualified person, as required by the Act.

Public Interest Test

Factors favouring disclosure.

Openness and transparency – It is important that NHS GM acknowledges their responsibility to be open, transparent and accountable.

Factors favouring non-disclosure.

NHS GM consider sharing the internal paper would inhibit advice/views and openness between decision makers, necessary to agree appropriate service provision for the patients it serves. It is critical that NHS GM maintain the greatest possible confidence without any concern that confidential or sensitive information provided, consulted, or relied on may be compromised and ensure that senior decision-makers are able to receive full, candid, and high-quality advice. Furthermore, to divert resources to manage the impact of disclosure, would cause disruption to important services that NHS GM provides, and the organisations ability to efficiently conduct public affairs.

Balancing Test.

NHS GM has carefully considered whether the requested information could be disclosed in a redacted or partial form. However, meaningful disclosure would not be possible without undermining the protected interests. Redaction would leave the remaining material fragmentary and misleading and would not be coherent or accurate.

As such, it is the decision of NHS GM that the public interest lies in non-disclosure of the information for the reasons outlined above. NHS GM consider that the public interest in withholding the information outweighs the public interest in disclosure.

Section 43(2) – Prejudice to Commercial Interests

Information is exempt information if its disclosure under this Act would, or would be likely to, prejudice the commercial interests of any person (including the public authority holding it)”.

The document contains granular provider-level information, including activity data, capacity assumptions, and elements of provider improvement actions.

NHS GM considers that there is a real and significant likelihood of harm, rather than a purely hypothetical risk.

Public interest test

Factors favouring disclosure.

There is an inherent public interest in ensuring that there is openness and transparency in the spending of public money. Transparency is likely to increase confidence in procurement processes and the purchasing decisions made by NHS GM. It also enables the public to understand whether NHS GM was getting value for money from its purchasing decisions.

Factors favouring non-disclosure.

Disclosure of this information would be likely to prejudice the commercial interests of both NHS GM and its providers by:

• revealing sensitive operational and performance information that is not otherwise in the public domain.
• potentially impacting providers’ reputations and competitive positions, particularly where services are delivered within a mixed provider market; and
• weakening the ICB’s position in current or future contractual, commissioning, or service development discussions, where such information is used to inform negotiations and performance management.

Releasing this information would prejudice the commercial interests of both the ICB and its commissioned providers by revealing commissioning strategy, negotiating positions, and commercially sensitive data relevant to live contracts. Protecting commercially sensitive information permits fair and effective commissioning and system management ensuring that senior decision-makers can receive full, candid, and high-quality advice.

Balancing Test.

After considering the arguments outlined above, we have decided to withhold this information as the public interest in maintaining the exemptions outweighs the public interest in disclosure.

To support openness and transparency the ICB does publish information on performance and service improvement through formal Board papers and public reports where appropriate.

ICB reorganisation / cluster arrangements

14. Not applicable