FOI2026/1870

The June 2026 care model change:

1. Copies of all instructions, guidance, bulletins or other communications issued by NHS Greater Manchester to GP practices since 1 April 2026 concerning referrals to Right to Choose providers for adult ADHD, including any list of providers to which practices may or may not refer.
2. Your response to FOI 2026/1771 (published 11 June 2026) lists ADHD360 among the Right to Choose providers currently delivering adult ADHD services to NHS Greater Manchester patients. Please provide any recorded decision, notice or communication made since 1 June 2026 that changes ADHD360’s ability to accept new Greater Manchester Right to Choose referrals, or confirmation that no such record exists.
3. The current list of providers able to accept adult ADHD Right to Choose referrals from Greater Manchester patients under the revised care model announced in June 2026 requiring in-person ADHD physical health checks.
4. The criteria used to assess whether a provider meets the revised care model, and the names of any providers whose ability to accept new Greater Manchester referrals ended as a result of the change.
5. The decision record for the revised care model: the board or committee papers and minutes recording its approval.
6. Details of any public involvement or consultation exercise undertaken in relation to the June 2026 change, and any equality and health inequalities impact assessment carried out, or confirmation that neither exists.

Capacity and waiting:

7. For 2026/27, the total planned or funded activity for adult ADHD under Right to Choose in Greater Manchester as set out in Indicative Activity Plans or equivalent, in aggregate. I note per-provider allocations were withheld in FOI 2026/1738; I am requesting the aggregate figure only.
8. The most recent recorded figures NHS Greater Manchester holds for the number of adults currently waiting for an adult ADHD assessment or treatment (a) via Right to Choose providers and (b) via the locally commissioned NHS adult ADHD service, with current average waiting times if recorded.
9. The current status of the locally commissioned NHS adult ADHD service covering Stockport: whether it is accepting new referrals, and its current recorded waiting time.

Pathways and prescribing:

10. Any recorded policy, pathway or guidance held by NHS Greater Manchester on how adults with an existing private ADHD diagnosis who are already undergoing or stabilised on medication transfer to NHS-funded care, whether via Right to Choose, the local service or otherwise, or confirmation that no such recorded pathway exists.
11. Any local guidance NHS Greater Manchester has issued on applying NHS England’s 2026/27 ADHD and autism payment guidance, including the annual review without shared care arrangement.
12. A copy of, or link to, the current GMMMG or NHS Greater Manchester position on shared care for adult ADHD, including the agreed list of shared care protocols in effect for Stockport that GP practices reference.

1.There has been one communication to Primary Care relating to right to choose providers – the text is shown below, along with the attachment sent alongside it.

The table shows current compliance with the NHS GM Commissioning Policies. These are providers operating in the right to choose market, who hold NHS contracts with other ICBs, but not with NHS GM, therefore are eligible to deliver services under the right to choose process.

The commissioning policies operate as prior approval schemes for both ADHD and Autism, so providers have been notified that they will not be paid for activity that is not delivered in line with these. Referrals should no longer be made to those providers not compliant with NHS GM Policies. Work is currently underway to increase commissioned resources and providers within the GM footprint

The primary compliance challenge that providers have are clinically grounded:

– that they expect GPs to complete health checks. We are very clear this is a responsibility of the specialist provider, prior to ADHD medication being commenced, and needs to take place in a CQC registered facility within 60 minutes travel of the person’s home

– that a part of the autism assessment needs to be conducted face to face in a CQC registered facility within 60 minutes travel of the person’s home

Referrals can continue to those noted as green and amber as they hold a relevant NHS contract, and demonstrate compliance with the commissioning policies, but do continue to be impacted by 26/27 Indicative Activity Plans, as per previous correspondence.

Adult NHS GM Commissioned providers:

The following services are directly commissioned by NHS GM

Optimise Healthcare (ADHD and Autism)

Axia Limited (Autism)

Dr Leach (ADHD)

GMMH (Manchester , Salford and Wigan)  ADHD

PCFT (Stockport and Tameside)  ADHD

More information to follow on CYP commissioned services

PDF documents were sent to the requester with this response.  If you require a copy of the full response, together with the attachments, please contact NHS GM’s FOI team – nhsgm.foi@nhs.net 

2.   NHS Greater Manchester confirms that no recorded decision, notice or communication exists since 1 June 2026 that changes ADHD360’s ability to accept new Greater Manchester Right to Choose referrals.

3. Please see response to Q1

4. NHS Greater Manchester has not introduced a revised care model. The relevant change is a commissioning policy

The commissioning policy sets out the requirements that providers must meet in order to receive referrals under the commissioning arrangements. These include, for example, the requirement to provide face-to-face physical health checks for ADHD services and face-to-face autism assessments where applicable.

Providers that were unable to meet the requirements of the commissioning policy were not able to continue accepting new Greater Manchester Right to Choose referrals under these arrangements. NHS Greater Manchester does not hold a separate recorded document setting out assessment criteria beyond those contained within the commissioning policy itself.

5. The decision was considered by the NHS Greater Manchester Clinical Effectiveness and Governance Committee on 21 January 2026.

NHS Greater Manchester holds information within the scope of this request. However, the committee papers and minutes are exempt from disclosure under Section 36(2)(b)(ii) of the Freedom of Information Act 2000, as disclosure would, or would be likely to, inhibit the free and frank exchange of views for the purposes of deliberation.

Section 36 is a qualified exemption and is subject to the public interest test. NHS Greater Manchester recognises the public interest in transparency and accountability in relation to commissioning decisions. However, there is a stronger public interest in ensuring that officers and committee members are able to engage in candid and robust discussions when considering clinical and commissioning matters. Disclosure of the detailed deliberations would be likely to inhibit the quality and openness of future discussions, to the detriment of effective decision-making. On balance, the public interest favours maintaining the exemption.

NHS Greater Manchester can confirm that the decision was approved by the Clinical Effectiveness and Governance Committee on 21 January 2026, but the committee papers and minutes are withheld under Section 36(2)(b)(ii) of the Freedom of Information Act 2000.

6. There was no consultation exercise undertaken in relation to a June 2026 change. The policy formalised NHS Greater Manchester’s existing commissioned pathways and clarified the requirements expected of any provider delivering these services to Greater Manchester residents. It did not introduce a new clinical model of care and, as such, no public involvement or consultation exercise was undertaken.

NHS Greater Manchester does not hold any recorded information relating to a public involvement or consultation exercise within the scope of this request.

NHS Greater Manchester also confirms that it does not hold a separate Equality and Health Inequalities Impact Assessment specifically relating to this policy for the same reason outlined above.

7. NHS Greater Manchester does not hold the requested information in the form requested.

Indicative Activity Plans are held at provider level and may cover a range of commissioned services, including adult and children and young people’s services and/or both ADHD and autism services. NHS Greater Manchester does not hold a recorded aggregate figure for the total planned or funded 2026/27 adult ADHD Right to Choose activity across Greater Manchester.

8. NHS Greater Manchester does not hold recorded information on the number of adults currently waiting for an adult ADHD assessment or treatment through Right to Choose providers or the locally commissioned NHS adult ADHD service. It also does not hold current average waiting times for these services.

This information would need to be sought from providers. Please see list below:

Commissioned Providers

RTC

9. NHS Greater Manchester has not received any recorded information indicating that the locally commissioned NHS adult ADHD service covering Stockport is no longer accepting new referrals.

NHS Greater Manchester does not hold information on the service’s current waiting time. This information would need to be obtained directly from the service provider. The relevant contact details are provided in response to Question 8.

10. How adults with an existing private ADHD diagnosis who are already undergoing or stabilised on medication transfer to NHS-funded care:

Prescribing arrangements for ADHD medicines are supported by the Greater Manchester Medicines Management Group (GMMMG) Shared Care Protocols, which set out the responsibilities of specialist services and primary care in relation to prescribing and monitoring. These are publicly available on the GMMMG website:

GMMMG Approved Shared Care Protocols

Information on GMMMG clinical guidance and pathways is also available here:

GMMMG Clinical Guidance and Pathways

11. NHS Greater Manchester has not issued any local guidance on the application of NHS England’s 2026/27 ADHD and autism payment guidance, including in relation to the annual review without a shared care arrangement.

12. See response to Q10