FOI2026/1858

For the purposes of this request, please use the following definition of Complex Care:

Complex Care refers to specialised home-based healthcare services for adults (aged 18+) with high-level, multifaceted needs requiring clinical expertise beyond standard social care. Specifically, this encompasses nurse-led home care services where registered nurses supervise and/or deliver specialised clinical interventions, care plans, and treatment regimens for individuals with conditions such as acquired/traumatic brain injuries, neurodegenerative disorders, spinal cord injuries, and other conditions requiring specialised clinical skills. These homecare packages typically involve ongoing medical monitoring, specialised clinical procedures, medication management, and coordination across multiple healthcare disciplines to support individuals with complex health conditions to remain in their home environment.

Please interpret “Complex Care – AACH (Continuing Healthcare)” as individually commissioned CHC complex care packages as defined above, excluding NHS Fast Track packages.

1. Commissioning arrangements and use of The Chest

1.1 Please provide details of the current commissioning arrangements used by NHS Greater Manchester (Manchester locality) for Complex Care – AACH (Continuing Healthcare) home‑based packages for adults, including:

• Whether these services are commissioned via a framework, DPS, preferred provider list, or on an individual spot‑purchase basis.
• Whether The Chest (Northwest procurement portal) is used for these complex care procurements, and if so, in what circumstances (e.g. new frameworks, DPS, mini‑competitions, individual tenders).selectivecarematch+1
• Any other procurement or commissioning routes used (e.g. direct award, negotiated contracts, brokerage placements).

1.2 Where The Chest is used, please provide:

• The name(s) of any current live framework(s) or DPS arrangements covering Complex Care – AACH (Continuing Healthcare) for adults in Manchester locality.
• The dates of commencement and expiry (or review dates) of these arrangements.
• The categories/codes used on The Chest for these opportunities, if recorded.manchestercommunitycentral+2

1.3 Where Complex Care – AACH packages are not commissioned via The Chest, please provide:

• A brief description of the commissioning route(s) used (e.g. direct provider approach, internal brokerage, off‑framework placements).
• Any written internal guidance or policy documents (or document titles and dates) that describe when The Chest must be used and when it may be bypassed for complex care placements.

2. Complex Care – AACH (Continuing Healthcare) costs (snapshot)

For all individual Complex Care – AACH (Continuing Healthcare) commissioned packages of care for adults (aged 18+) as of March 2026 (or the nearest available month end if March data are not yet finalised), excluding NHS Fast Track commissioned packages and including only individually commissioned traditional CHC complex packages of care:

2.1 Please provide a dataset (e.g. spreadsheet or table) containing, for each individual package:

• Weekly commissioned hours.
• Total weekly cost (£).
• Average charge rate (£ per hour).
• Provider name.

If necessary for data protection reasons, provider names may be pseudonymised, but please retain a consistent identifier so that the distribution of packages by provider can still be understood.

3. New Complex Care – AACH packages (1 January 2025 – 31 December 2025)

For all new Complex Care – AACH (Continuing Healthcare) complex care packages for adults (as defined above) commissioned between 1 January 2025 and 31 December 2025, excluding NHS Fast Track packages:

3.1 Please provide a dataset containing, for each new package:

• Commission (start) date.
• Weekly commissioned hours.
• Total weekly cost (£).
• Average charge rate (£ per hour).
• Provider name.

Again, if necessary, provider names may be pseudonymised, but please retain a consistent identifier.

4. Governance / responsible roles

4.1 Please provide the current job titles (and, if not exempt, names) of the roles responsible for:

• Strategic commissioning of Complex Care – AACH (Continuing Healthcare) for adults in the Manchester locality
• Operational approval of individual complex care packages (e.g. CHC service manager, all‑age continuing care lead, brokerage/placement lead)
• Procurement and/or provider engagement for complex homecare / CHC complex care services in Manchester locality.gmintegratedcare+1

4.2 Please confirm whether these roles are hosted within the Manchester locality team, a GM‑wide CHC/complex care team, or another organisation (such as a commissioning support unit or shared procurement service).

1.1 NHS GM ICB Commission complex home care on a spot purchase basis.

1.2 Please refer to above response. This is not applicable as the Chest is not used.

1.3 NHS GM ICB Commission care packages on a spot purchase basis.

2. 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), who currently all have their own processes/systems for recording their Continuing Healthcare (CHC) activity, and therefore, documents are held on various data bases.

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.

It is estimated to check each ledger would take a minimum of 2 hours per locality to provide the dataset in the required format. 2 hours x 10 localities = 20 hours minimum.

On this basis, section 12(1) has been applied, because this would exceed the appropriate limit prescribed in the act.

3. 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), who currently all have their own processes/systems for recording their Continuing Healthcare (CHC) activity, and therefore, documents are held on various data bases.

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.

It is estimated to check each ledger would take a minimum of 2 hours per locality to provide the dataset in the required format. 2 hours x 10 localities = 20 hours minimum.

On this basis, section 12(1) has been applied, because this would exceed the appropriate limit prescribed in the act.

4.1

• Strategic commissioning of Complex Care – AACH (Continuing Healthcare) for adults in the Manchester locality – Steven Bailey, Head of Service
• Operational approval of individual complex care packages (e.g. CHC service manager, all age continuing care lead, brokerage/placement lead) – Steven Bailey, Head of Service
• Procurement and/or provider engagement for complex homecare / CHC complex care services in Manchester locality.gmintegratedcare+1 – Steven Bailey, Head of Service

4.2 The roles listed above are hosted within the Manchester locality which is where the CHC service is delivered.