FOI2026/2025

I am requesting information under the Freedom of Information Act 2000 concerning the governance and oversight of NHS-funded healthcare delivered by independent/private providers commissioned by NHS Greater Manchester.

I am particularly interested in the arrangements by which NHS Greater Manchester assures the quality and safety of care that it commissions from independent providers.

Please provide the following information, covering the period 1 January 2023 to the date of this request, unless otherwise stated.

1. Commissioning and clinical governance
2. The policies, procedures, protocols or guidance governing the clinical governance and patient-safety oversight of NHS-funded care delivered by independent/private providers.
3. The governance structure showing which team, department or role within NHS Greater Manchester is responsible for:

o        monitoring clinical quality;

o        monitoring patient safety;

o        monitoring complaints;

o        monitoring provider performance; and

o        escalating concerns relating to NHS-funded care delivered by independent providers.

3. The policies, procedures or guidance setting out the respective responsibilities of:

o        NHS Greater Manchester;

o        the independent/private provider;

o        NHS England;

o        CQC; and

o        other relevant bodies

when a patient raises a concern about the safety or quality of NHS-funded care delivered by an independent provider.

2. Patient complaints and escalation
3. The policy, procedure or guidance governing how NHS Greater Manchester handles a complaint concerning clinical care delivered by an independent/private provider under an NHS contract.
4. Please provide any flowchart, pathway, standard operating procedure or guidance showing how such a complaint should be escalated where it raises concerns about both:

o        the clinical care provided; and

o        the NHS commissioning or referral pathway.

6. Please provide the policy or procedure governing circumstances in which a complaint received by an independent provider should also be notified to NHS Greater Manchester.
7. Please provide the policy or procedure governing circumstances in which NHS Greater Manchester would itself investigate, rather than simply refer a complaint back to the independent provider.
8. Patient-safety incidents and individual clinicians
9. Please provide the policy, procedure or contractual requirements governing what patient-safety incidents independent providers are required to notify to NHS Greater Manchester.
10. Please provide the policy or procedure governing the notification to NHS Greater Manchester of significant concerns regarding the clinical competence, conduct or performance of an individual clinician working for an independent provider delivering NHS-funded care.
11. Please provide the policy or procedure governing the sharing of such concerns with other NHS organisations or providers where the clinician may also practise.
12. Please provide the policy or procedure governing notification to the GMC or CQC where concerns relating to an individual clinician or provider meet the relevant threshold.
13. Identifying patterns
14. Please provide the policy, procedure or guidance describing how NHS Greater Manchester identifies recurring or thematic patterns of complaints, patient-safety incidents or concerns relating to:

• a particular independent provider;
• a particular specialty; or
• an individual clinician.

13. Please confirm whether NHS Greater Manchester maintains any central database, register, risk register or equivalent system for recording concerns about independent providers or clinicians delivering NHS-funded care.
14. If such a system exists, please provide the policy or guidance governing its operation.
15. Please provide the policy or procedure describing how NHS Greater Manchester determines whether multiple individual complaints should trigger:

• enhanced provider monitoring;
• a clinical governance review;
• a thematic review;
• contractual action;
• referral to a regulator; or
• other escalation.

5. Provider performance
6. Please provide the standard quality and patient-safety indicators/KPIs used by NHS Greater Manchester to monitor independent providers delivering NHS-funded elective surgical care.
7. Please provide the relevant service specification, quality schedule or equivalent document setting out the clinical and patient-safety requirements applicable to independent providers delivering NHS-funded elective surgical care.

If any requested information is considered commercially confidential, please provide the remainder of the document/information with only the genuinely exempt information redacted, rather than withholding the entire document.

If any information is not held by NHS Greater Manchester, please state this explicitly and identify, where possible, which organisation is responsible for holding or providing that information.

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.

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.

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

In accordance with our duty under Section 16 of the Freedom of Information Act 2000 to provide reasonable advice and assistance, if you are able to narrow the scope of your request, we may be able to respond to it within the appropriate cost limit.