FOI2026/2074

For NHS Greater Manchester Integrated Care Board: This request concerns ICB-commissioned pathways for people with type 1 diabetes and an eating disorder, including disordered eating involving insulin restriction, during 1 April 2025 to 31 March 2026.

1. Please provide the relevant service specification, eligibility criteria and joint diabetes/eating-disorder referral pathway, including arrangements when a person does not meet one service’s threshold.
2. Please provide the latest existing commissioner-held activity or quality report showing accepted, declined and redirected referrals, reasons for refusal and waiting times, to the extent these are already recorded for this pathway.
3. Please provide the latest completed evaluation or safety review of gaps between the services, with its action plan or current risk-register extract. Please state if no joint service is commissioned and supply the existing alternative pathway document.

Please reply electronically, supplying tables in their existing spreadsheet/CSV format where held. I am requesting existing records, not a new investigation or identifiable personal information. Please distinguish information not held from a recorded zero. A direct link is fine for published information. If part would exceed the applicable cost limit or require an unreasonable search, please advise how to narrow it, prioritising the first two items. Please disclose the remaining material with any necessary redactions.

NHS Greater Manchester does not commission a dedicated joint diabetes and eating disorder service and does not hold a separate joint diabetes and eating disorder pathway document. Children and young people with co-existing diabetes and eating disorders would ordinarily be supported through the relevant specialist eating disorder service working alongside the individual’s GP, diabetes team and other physical health services to ensure their physical and mental health needs are appropriately considered and managed.

NHS GM does not routinely collect or hold information specifically relating to children and young people with co-existing diabetes and eating disorders, including referral, activity, waiting time, evaluation or pathway-specific performance information. Provider organisations may hold local standard operating procedures (SOPs) or clinical pathway documents that set out how services work together to support individuals with co-existing clinical needs. Any bespoke reporting relating specifically to this cohort is not routinely collected or held by the ICB and may be held by the relevant provider organisations.