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Commissioning

This form confirms the funding and commissioning arrangement for a Wild Mane placement. As a commissioned provision, we require a named paying organisation, a confirmed funding route, and clear payment arrangements before a placement can be allocated.

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Wild Mane operates as a not-for-profit organisation, with programme costs directly supporting delivery, staffing, and resources. The information requested ensures that funding, invoicing, and any procurement requirements are agreed in advance, allowing the placement to move forward without delay.

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If you are referring on behalf of another organisation, or where a placement is privately funded by a parent/carer or participant, the relevant details and authorisation must be included.

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This form is completed alongside baseline measures (SDQ, GBO, WEMWBS, and Starling) as part of one submission process. Once this has been received and commissioning confirmed, placement allocation and start date will be confirmed.

Referrer Details

Paying Organisation

Who is funding this placement?

Relationship to Referrer

Is the referring organisation the same as the paying organisation?
Yes
No
If “No” is selected, please confirm your position:
I have confirmed funding with the paying organisation
I am awaiting confirmation (The placement will not be confirmed with the participant or allocated a start date until commissioning has been confirmed)

Funding Route

Please select the funding pathway:
NHS Personal Health Budget (PHB)
NHS Continuing Care (Children’s Continuing Care)
NHS Social Prescribing (via Primary Care Network)
NHS Service Commissioning (e.g. CAMHS-linked funding agreed)
School Funding (SEN / Pastoral / Alternative Provision budget)
Local Authority Funding (SEND / Inclusion / Early Help)
EHCP Funding (allocated provision)
Direct Payments (Local Authority managed budget)
Personal Budget (Education / Health combined funding)
Parent / Carer Private (This can be arranged by installments)
Employer Funding, Workplace well-being or supported placement)
Sponsored Placement (charity / organisation funded)
Other

Payment Method

How will payment be made?
Purchase Order provided
Purchase Order to follow
Invoice required (no PO)
Other

Placement Cost

£645 per participant per 6-week programme.

Finance / Accounts Contact

Who should invoices be sent to?

I confirm that:

  • I confirm that the organisation named above has agreed to fund this placement.

  • I confirm that the programme cost has been reviewed and agreed by the paying organisation.

  • I confirm that the funding route and payment method provided are accurate.

  • I confirm that any purchase order, invoicing, or procurement requirements have been outlined in advance.

  • I confirm that I am authorised to submit this request or have obtained approval from the appropriate budget holder.

  • I confirm that payment will be made in line with agreed terms between The Wild Mane Ltd. and the paying organisation or person.

  • I understand that placement confirmation and start date will follow once commissioning has been confirmed.

Authorisation

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