In reply to sheffieldchris:
I have an interest in the area and did a lot of research for a proposed trip this year. I ended up going elsewhere and just got back home last night. We ended up going not to west Nepal really but first trying the western end of the Dhaulagiri range along the south via Gurjagaon (not good) then bailed and went to a peak at the far eastern end - Tasartse - but were hampered by the bad weather that hit Nepal mid-October for a week or more. Fellow UKCer radson was also in the region, nice pics will follow soon no doubt.
My original plan was for an unclimbed 6000er in the Api area and I discussed this with a lot of very experienced people - people with a lot more recent experience of exploratory Nepal trips than me. There is a widely known problem of roads and trails being washed out and/or abandoned south of the Api area, partly due to weather, partly due to no visitors, partly due to the Maoist years. Whatever.
The last team that I know much of, for sure, that went in the south side is the 1993 Slovenians that bagged three big new routes. Other teams, only a few, have been up the Seti to the east of here, toward the Raksha Urai peaks and the Urai Lagna, west of Saipal. Last year two Germans made the 2nd ascent of RU3. Find it on Facebook.
Porters and/or horses are hard, maybe impossible to get, and most recommend bringing your own porters from KTM. I have mixed feelings about this, as our small porter crew this year were not good at all and this is now a common comment from groups going in to odd and/or remote areas. In 93 the Slovenians walked from Gokuleshwar and a recent exploratory trek by Project Himalaya bussed to Dharchula then motored some way east before walking toward Saipal and Simikot.
For the area north of Api a few teams have been in recently, but don't think they climbed anything. I know some Japanese have been poking around the southern and eastern sides of the Api area, kinda south of the Raksha Urai range, but there are no published reports. Much older reports with some nice photos are available by wasting days at:
http://www.himalayanclub.org/the-himalayan-journal/search-the-journal/
Julian Freeman-Atwood and other Brits have done some good trips further north and east of here, out of Simikot etc, and those accounts are in the journals etc. More people are going to Simikot nowadays, but not so much further west. Lots of people (relatively speaking) are claiming to do the GHT but not really starting or finishing west of Simikot as the GHT is supposed to. I'm not sure how far north of Dharchula you can go without striking access/permit problems as you're on the Indian border and getting close to the Nepal-Tibet border (for Kailash pilgrims etc).
Go for it. Good luck.