FOI 2026/1767

I am writing on behalf of Optegra under the Freedom of Information Act 2000 to request information held by NHS Greater Manchester ICB relating to the Greater Manchester Eye Care Navigation Service and non-emergency ophthalmology referrals.

Please provide:

1. Please provide all information, whether in the form of emails, documents, letters or otherwise, which evidence that patients are being offered a choice of provider via the Greater Manchester Eye Care Navigation Service for non-emergency ophthalmology referrals.

2. Please provide all information, whether in the form of emails, documents, letters or otherwise which confirms the number of patients who have been referred to Manchester University NHS Foundation Trust compared to other providers offered to patients via the Greater Manchester Eye Care Navigation Service in the last 12 months. Please provide this information broken down by provider and, where available, by month, for each of the communication stages with the patient referred.

3. Please provide all information setting out the ICB’s rationale for setting different waiting time targets for NHS providers and independent sector providers in respect of non-emergency ophthalmology referrals.

4. All recorded information explaining how those different waiting time targets are intended to achieve equity between providers.

5. Any contractual reporting information held by the ICB, or obtainable by the ICB from the provider of the Greater Manchester Eye Care Navigation Service, relating to patient choice, referral volumes by provider and waiting time performance.

If any of the requested information is held by a third party, including the Single Point of Access provider, please confirm who holds it and whether the ICB has a contractual right to obtain it. If the ICB has not obtained such information, please provide any recorded explanation as to why.

Please provide the information electronically. If any exemption is relied upon, please identify the exemption and explain its application.

1. Primary Eyecare Services send patient choice letters or SMS to patients for clinically appropriate adult routine referrals. These communications include a unique patient link that shows them the nearest 10 provider clinics for the sub-speciality that they require referral to. For those patients that cannot make a choice via this method they provide a telephone service where patients can speak to an administrative hub to aid them with this choice. If a patient has a specific reason that they require a choice outside of the 10 provided to them via the link the administrative team can facilitate this request as needed. Patients are sent a minimum of two written communications (either via SMS or letter) with a phone call attempted for those that fail to engage with this process before a referral is closed as failed to engage.

An example of the patient choice letter and text message as shown below.

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2. We do not hold all this information as not all referrals go through the Eye Care Navigation Service. This is available from Manchester Foundation Trust. The table below is the referral information we hold since the SPOA was commissioned.

3. NHS Greater Manchester commissions ophthalmology services from a range of NHS and independent sector providers operating under different service models, contractual arrangements and patient populations.

The minimum waiting time arrangements form part of the ICB’s wider ophthalmology commissioning approach and are intended to support the effective management of elective demand, delivery of system waiting time objectives, equitable access to services and the effective utilisation of commissioned capacity across Greater Manchester.

In developing these arrangements, the ICB has regard to a range of factors including referral demand, available capacity, patient choice, system affordability, delivery of national elective recovery objectives and the need to ensure that patients are treated within clinically appropriate timescales.

The ICB recognises that NHS and independent sector providers may operate under different contractual arrangements, accountability frameworks and service models. As a result, waiting times are not necessarily directly comparable between providers.

The purpose of the arrangements is to support the management of demand and capacity across the wider ophthalmology system rather than to establish identical waiting times across all providers.

4. Where commissioning documentation refers to equity, this is generally in the context of equitable access for patients and the equitable management of demand and capacity across the wider healthcare system, rather than achieving equal waiting times between providers.

The ICB’s commissioning approach recognises that providers may operate under different service models, contractual arrangements and patient populations. Consequently, waiting times may vary between providers and are not necessarily directly comparable.

The purpose of the arrangements is to support system-wide commissioning objectives, including the effective utilisation of available capacity, delivery of elective recovery objectives and equitable access to services for the population of Greater Manchester

5. The Eye Care Navigation Service is not responsible for waiting list information from Providers and does not hold it. The referral information we receive is in the table above.