| Reference | FOI2026/1877 |
|---|---|
| Description | Adult Developmental Coordination Disorder Assessment Pathways |
| Date Requested | 08/07/2026 |
| Date Replied | 21/07/2026 |
| Category | Specialised Commissioning |
Please respond to each numbered question separately.
If no dedicated adult dyspraxia service is commissioned, please provide any recorded information explaining what NHS assessment pathway is available for adults with suspected developmental coordination disorder within the ICB area.
If no dedicated adult assessment pathway exists within the ICB area, please provide any recorded information held by the ICB regarding alternative referral options. This should include any guidance, policies, or procedures relating to:
Referrals to providers outside the ICB area where clinically appropriate; and whether the NHS Right to Choose may be available for adults with suspected developmental coordination disorder, and if so, under what circumstances.
If responsibility for commissioning any aspect of adult assessment or support for developmental coordination disorder lies with another NHS organisation, please identify that organisation and specify which aspects fall outside the ICB’s commissioning responsibilities.
no dedicated adult assessment pathway exists within the ICB area, please provide any recorded information held by the ICB regarding alternative referral options. This should include any guidance, policies, or procedures relating to:
Referrals to providers outside the ICB area where clinically appropriate; and whether the NHS Right to Choose may be available for adults with suspected developmental coordination disorder, and if so, under what circumstances.
If responsibility for commissioning any aspect of adult assessment or support for developmental coordination disorder lies with another NHS organisation, please identify that organisation and specify which aspects fall outside the ICB’s commissioning responsibilities.
In keeping with the request and to ensure NHS GM lives the four organisation values of collaboration, compassion, inclusion and integrity, where other documents have been deemed relevant, specific sections have been referenced and provided accordingly.
Listed questions.
If no dedicated adult dyspraxia service is commissioned, please provide any recorded information explaining what NHS assessment pathway is available for adults with suspected developmental coordination disorder within the ICB area.
There are no directly commissioned services, as defined as being for adults with suspected or confirmed developmental coordination disorder. However, NHS GM commissions a variety of providers across community and mental health services, which may be clinically appropriate for referral into, and onward service provision. This is a clinically based decision, for a referring health and care professional, such as a GP to refer a patient. NHS GM would strongly advise and recommend that any patient in this situation, seeks health and care guidance from an appropriate clinician, such as a GP, to be referred into the correct service and onward pathway of care.
As described within the answer to question 1, there are various health and care services commissioned by NHS GM, which may be a clinically appropriate referral option, depending on the individual’s presentation and clinical need. Once again, any onward referral and discussions are usually undertaken within the primary care setting and assessed initially by a patient’s GP.
As listed within the answer to question 1, NHS GM does directly commission occupational therapy, physiotherapy, rehabilitation medicine and neurology services from NHS acute, community and mental health service providers. However, any referral into such services is commissioned based on the correct assessment and signposting of patients. For example, should a patient require a referral into physiotherapy, a GP would refer a patient into the locally commissioned NHS community physiotherapy service, with a usual referral to treatment (RTT) time with up to 18 weeks.
NHS GM does not hold any specific commissioning policy, clinical pathway, referral guidance or service specification relating solely to the assessment or management of adults with suspected developmental coordination disorder.
GPs across the NHS GM footprint will be able to utilise their advice and guidance function within whichever clinical system they operate. For example, a GP can seek advice and guidance on the correct physiotherapy referral process, by seeking advice and guidance from the locally commissioned service. Once again, this would be subject to the appropriate discussion between a patient and their respective GP as to the clinical service in question.
If no dedicated adult assessment pathway exists within the ICB area, please provide any recorded information held by the ICB regarding alternative referral options. This should include any guidance, policies, or procedures relating to:
Referrals to providers outside the ICB area where clinically appropriate; and whether the NHS Right to Choose may be available for adults with suspected developmental coordination disorder, and if so, under what circumstances.
NHS GM does not hold recorded information specifically identifying an adult developmental coordination disorder assessment pathway within GM. As outlined in responses 1 and 2, NHS GM commissions a range of community, therapy, rehabilitation, mental health and acute services. Although NHS GM does not hold a dedicated adult developmental coordination disorder assessment pathway, adults may receive assessment and support within NHS commissioned services where this is clinically appropriate. Referral options available to a patient would ultimately be determined through a clinically led discussion with the patient’s GP.
Moreover, in the spirit of living our value of collaboration, you may wish to reach out to the NHS trusts within NHS GM’s footprint for a similar FOI request. However, to manage your expectations, there may be a variability in information available from the NHS trusts, based upon the sophistication to extract data from within their respective clinical systems. NHS GM have provided all of the FOI Teams for each of the NHS trusts in GM at the bottom of this request.
In respect of referrals to providers outside the NHS GM’s footprint, where clinically appropriate, NHS GM does not collect this data set as part of our statutory and legal requirements, as required under the Health and Care Act 2022. For completeness, NHS GM have provided the following link, which provides a high-level overview of the legal duties placed upon Integrated Commissioning Boards (ICBs). There is no legal requirement to collect data for services which they are not commissioned to provide: https://www.legislation.gov.uk/ukpga/2022/31/part/1/crossheading/integrated-care-boards-functions
NHS GM wishes to draw your attention to Section 1(1)(a) of the Freedom of Information Act 2000, which relates to the duty to confirm or deny whether requested information is held. NHS GM can confirm that it does not hold recorded information in relation to this element of your request.
Eligibility for NHS Right to Choose is determined in accordance with national NHS England guidance. The following link provides patients with the information regarding Right to Choose. However, the most pertinent section has been extracted and provided further below: https://www.nhs.uk/nhs-services/hospitals/about-nhs-hospital-services/#choice
“If you wish to be treated by a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and be treated by that consultant’s team. But this does not necessarily mean you’ll be seen by the consultant themselves. This choice is a legal right. If you’re not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options.”
NHS GM does not hold recorded information specifically relating to the availability of NHS Right to Choose for adults with suspected developmental coordination disorder. The eligibility for NHS Right to Choose on this matter is determined in accordance with national NHS guidance and the circumstances of the individual referral, as explained within the answers to the other questions provided as part of this FOI response.
If responsibility for commissioning any aspect of adult assessment or support for developmental coordination disorder lies with another NHS organisation, please identify that organisation and specify which aspects fall outside the ICB’s commissioning responsibilities.
no dedicated adult assessment pathway exists within the ICB area, please provide any recorded information held by the ICB regarding alternative referral options. This should include any guidance, policies, or procedures relating to:
Referrals to providers outside the ICB area where clinically appropriate; and whether the NHS Right to Choose may be available for adults with suspected developmental coordination disorder, and if so, under what circumstances.
The absence of a dedicated adult diagnostic service should not be interpreted as meaning that there are no NHS assessments of symptoms, functional difficulties, or support needs being available within the ICB area. As detailed in the alternative answers provided above, NHS GM commissions various community and mental health services, which may be a clinically appropriate referral option, depending on the individual’s presentation and clinical need.
In conjunction with the answers provided above, NHS GM does have a Specialist Team who oversee any individual funding requests, which can be used by clinicians, such as GPs, to request funding for patients, which goes above and beyond what routine health and care services are able to offer. However, it is imperative to manage expectations in regard to this, and clarify, that specific criteria must be met by a patient, such as in exceptional healthcare needs. A GP would be able to discuss this with a patient in more detail. In the meantime, I have provided the appropriate website link as follows: Greater Manchester Individual Funding Request Service | Greater Manchester Integrated Care Partnership
Please note that the Individual Funding Request process is not a routine assessment pathway and applications are considered based on exceptional clinical circumstances.
If responsibility for commissioning any aspect of adult assessment or support for developmental coordination disorder lies with another NHS organisation, please identify that organisation and specify which aspects fall outside the ICB’s commissioning responsibilities.
The absence of a dedicated adult diagnostic service should not be interpreted as meaning that there are no NHS assessment of symptoms, functional difficulties, or support needs being available within the ICB area. NHS GM are the identified NHS organisation who are responsible for commissioning community and mental health services, which encompasses adults with developmental coordination disorder. Support can be accessed for assessment and ongoing management, if deemed clinically appropriate, as detailed within the answers provided to the alternative questions.
There are two key documents which have been considered to answer this question. Firstly, the model ICB Blueprint, published by NHS England in May 2025. This explained that ICBs have a positive vital future, undertaking the same role as strategic commissioners in every integrated care system (ICS). The following link has been provided to the NHS England website for further details on the model ICB Blueprint guidance: https://www.england.nhs.uk/long-read/update-on-the-draft-model-icb-blueprint-and-progress-on-the-future-nhs-operating-model/
The second document being the Strategic Commissioning Framework, published in November 2025. In short, both of these documents explain the current and long-term ambitions for the role of ICBs. The role of ICBs is to commission local health and care services. As explained within the Strategic Commissioning Framework, with ICBs continuing to develop a clear set of skills and capabilities to carry out strategic commissioning. They will focus on identifying, developing and deploying their diverse workforce and growing the data, analytical and transformation capabilities required to drive change. The following link has been provided to the NHS England website for further details on the Strategic Commissioning Framework: https://www.england.nhs.uk/long-read/strategic-commissioning-framework/
As detailed within the answer to question 4, in the spirit of living our value of collaboration, you may wish to reach out to the NHS trusts within NHS GM’s footprint for a similar FOI request. However, to manage your expectations, there may be a variability in information available from the NHS trusts, based upon the sophistication to extract data from within their respective clinical systems. NHS GM has provided the FOI Teams for each of the NHS trusts in GM below.
GM Providers
Bolton NHS Foundation Trust – Freedom of information – Bolton NHS FT (boltonft.nhs.uk)
Northern Care Alliance NHS Foundation Trust – Freedom of Information Requests :: Northern Care Alliance
Manchester University NHS Foundation Trust – Freedom of Information – Manchester University NHS Foundation Trust (mft.nhs.uk)
Stockport NHS Foundation Trust – Freedom of information – Stockport NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust – Freedom of Information Requests :: Tameside and Glossop Integrated Care (tamesideandglossopicft.nhs.uk)
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust – WWL Teaching Hospitals NHS Foundation Trust | FOI Disclosure Log
The Christie NHS Foundation Trust – Freedom of information disclosure logs (christie.nhs.uk)
Pennine Care NHS Foundation Trust – Freedom of Information :: Pennine Care NHS Foundation Trust
Greater Manchester Mental Health NHS Foundation Trust – Freedom of Information | Greater Manchester Mental Health NHS FT (gmmh.nhs.uk)
