FOI 2026/1836

Arrangements between NHS Greater Manchester ICB and Clinical Partners in circumstances where appointments have already been booked and confirmed but funding is subsequently paused or activity restricted.

In particular, I would like to understand whether there are any policies, guidance, protocols, or agreed procedures which address:

1. Whether previously booked appointments are ordinarily permitted to proceed.
2. Whether patients who have already been offered appointments are protected from subsequent funding pauses.
3. How such situations are managed between the ICB and the provider.
4. Whether there are any arrangements in place to prioritise patients whose appointments have been cancelled as a result of funding or activity restrictions.

I am not seeking any commercially sensitive pricing information, but rather an understanding of the governance and operational arrangements relating to the management of existing appointments and patient care.

If the ICB does not hold this information, I would be grateful if this could be explicitly confirmed.

1. Whether previously booked appointments are ordinarily permitted to proceed.

NHS Greater Manchester Integrated Care Board (ICB) provided Clinical Partners with an indicative activity envelope in March. The provider chose to utilise the majority of this activity during April.

Where appointments have already taken place and patients are awaiting titration, these patients are likely to be seen in the near future. Arrangements for this cohort are currently under review.

Where appointments had been booked but do not fall within the agreed indicative activity plan (IAP), these appointments are unlikely to be rebooked at the present time, as available activity is being prioritised for patients with the highest clinical need.

2. Whether patients who have already been offered appointments are protected from subsequent funding pauses.

No. There is no policy that provides protection for appointments that have been offered or booked where they fall outside the agreed indicative activity plan. Activity is managed within the agreed commissioning arrangements and available capacity.

3. How such situations are managed between the ICB and the provider.

The ICB and provider manage activity through the agreed Indicative Activity Plan (IAP). This sets out the agreed level of activity to be delivered. Where demand exceeds the agreed activity envelope, discussions take place between the ICB and the provider regarding delivery within the commissioned activity.

4. Whether there are any arrangements in place to prioritise patients whose appointments have been cancelled as a result of funding or activity restrictions.

Patients are not prioritised solely because an appointment has been cancelled or deferred. Available activity is currently being prioritised according to clinical need.