Moving to another area does not produce one universal answer about which integrated care board pays for NHS Continuing Healthcare. For an out-of-area residential continuing-care placement arranged by an ICB, the placing ICB can retain responsibility for the accommodation and planned services connected with it, even after the person registers with a local GP. A CHC package delivered in the person’s own home generally follows the ordinary commissioner rule and can transfer when the person moves and changes GP. The family should obtain an agreed responsibility statement before changing address or placement.
Describe the current arrangement precisely
Record where the person lives, which GP they are registered with, which ICB completed or received the CHC referral, which body signed the placement or provider contract, and whether care is residential or delivered in the person’s own home. Include any joint council arrangement, section 117 aftercare, rehabilitation placement or pending CHC assessment, because special rules may apply.
Do not use “funding follows the patient” as a rule. Commissioner responsibility depends on the legal category and sequence of events. The care home’s postcode or new GP can matter for some services without transferring the entire CHC placement. Ask the current ICB to identify the exact rule it is applying.
Understand the placing-ICB exception
When the responsible ICB arranges a residential continuing-care placement outside its own area in a care home or independent hospital and commissions planned healthcare connected with that accommodation, it generally retains responsibility for those placement services. That can continue through a later move to another residential location while the person still requires a continuing-care package.
The retaining ICB does not necessarily commission every unrelated NHS service. Ordinary GP, hospital or community services may follow other responsibility rules. Ask the handover plan to name the commissioner for the CHC placement, primary care, prescriptions, equipment and any specialist pathway rather than assuming one ICB pays for everything.
Map the arrangement as two concentric rings. The inner ring contains accommodation and planned healthcare connected with the residential continuing-care placement; the placing ICB can remain responsible for that ring. The outer ring contains unrelated NHS treatment, whose commissioner may follow GP registration or another exception. Writing named services into each ring exposes omissions such as tissue-viability review, wheelchair maintenance, mental-health follow-up or elective surgery before invoices begin to circulate.
Distinguish a home-care package from a placement
The residential exception does not apply in the same way to a continuing-care package delivered in the person’s own home, including supported living. If the person voluntarily moves house to another ICB area and registers with a new GP, responsibility for the package can transfer under the general rule from the relevant date. Timing and GP registration therefore need active coordination.
A private family move into a care home while assessment is pending may also require the referral-date rules to be examined. Do not sign a new agreement on the assumption that either ICB will reimburse it. Request confirmation of assessment responsibility, interim payment and the consequences of moving before the decision.
Keep NHS responsibility separate from council residence
“Who Pays?” guidance determines NHS commissioner and payment responsibility. Council social-care responsibility uses ordinary-residence rules under the Care Act. The same move can therefore leave one ICB responsible for a CHC element while a different analysis identifies the council. Use this guide to ordinary residence after an out-of-area care move to keep the systems separate.
Cross-border moves between England, Wales, Scotland and Northern Ireland add different legislation, commissioners and regulators. The UK cross-border care-home placement guide outlines those handovers. This article’s ICB rules concern moves within England.
Get an agreement before the moving date
Ask both ICBs for a written statement that names the responsible commissioner, effective date, provider, agreed rate, planned services and dispute contact. The NHS should not delay assessment or treatment while organisations resolve a payment disagreement. Families should not be asked to bridge an institutional dispute with an open-ended private payment.
- Confirm who issues the new care plan and contract.
- Identify who supplies medicines, equipment and continence products.
- Arrange record transfer and the first GP review.
- Set an escalation route if invoices or authorisations fail.
If the ICBs disagree, ask them to use their commissioner dispute process and give the family one operational lead.
Include invoice routing in the agreement. The new provider should know the purchase-order or contract reference, remittance contact and process for authorised variations. Clarify whether the retaining ICB pays only accommodation-linked planned services while the receiving ICB commissions unrelated community or hospital care. A single named lead can coordinate the interfaces without pretending that one budget legally covers them all.
For a move during an unresolved CHC assessment, preserve the referral date and identify which ICB held responsibility then. Ask what happens if the eventual decision awards residential CHC, home-based CHC or no CHC, because those outcomes can engage different rules. A family-selected address should never be treated as an informal commissioner agreement.
Verify that the new home can deliver the package
Funding responsibility does not force a provider to accept the resident. The proposed home must review clinical information, staffing, registration, equipment, behaviours and room availability. Ask whether the ICB’s assessed package and rate are sufficient for the identified needs and what happens if needs change after admission.
Use the UK care-home directory and planning hub to build a shortlist, then verify regulator registration and current capability. Do not end the existing placement until the receiving home, responsible ICB and relevant clinicians confirm the admission plan, funding start and safe transfer arrangements.
Does the new local ICB always take over CHC?
No. A placing ICB can retain responsibility for an out-of-area residential continuing-care placement and connected planned services. A package delivered in the person’s own home can follow the general GP-based rule when the person moves and re-registers. Other NHS services may be commissioned locally even while the placing ICB retains the CHC placement.
Can an ICB reassess eligibility because someone moves?
A move may justify reviewing whether the care plan and provider remain appropriate, but changing address does not by itself prove that the person has lost the primary health need. Any eligibility change should follow the proper review and reassessment process with continuity arrangements. Ask the ICB to distinguish a commissioner-responsibility decision from a clinical eligibility decision.
Who gives the final funding and admission answer?
The relevant ICBs must issue and, if necessary, dispute-resolve the commissioner allocation without interrupting necessary treatment. Council ordinary residence is a different legal determination. For the residential move itself, the decisive operational documents are the responsible ICB’s contract or authorisation and the receiving home’s confirmed placement. A new GP registration may redirect unrelated NHS services, but it cannot by itself rewrite an existing out-of-area CHC commission.
