The National Health Service (Integrated Care Boards: Responsibilities) Regulations 2022

Regulations 3 and 4

SCHEDULE Additional persons for whom an ICB has responsibility for the purposes of sections 3 and 3A of the NHS Act 2006

1.  In this Schedule—

“adult” means a person aged 18 or older;

“care home”—

(a)

in England, has the same meaning as in the Care Standards Act 2000(1) (see section 3 of that Act); and

(b)

in Wales, means a place at which a care home service, within the meaning of Part 1 of the Regulation and Inspection of Social Care (Wales) Act 2016(2), is provided wholly or mainly to adults;

“CCG” means Clinical Commissioning Group(3);

“child” means a person under the age of 18;

“children’s home”—

(a)

in England, has the same meaning as in the Care Standards Act 2000; and

(b)

in Wales, means a care home service, within the meaning of Part 1 of the Regulation and Inspection of Social Care (Wales) Act 2016, which is provided wholly or mainly to children;

“commissioning functions” means the functions of the ICB or NHS England in arranging for the provision of services as part of the health service but it does not include, in relation to NHS England, its functions in relation to services provided under a primary care contract;

“continuing care” means care provided over an extended period of time to a person to meet physical or mental health needs which have arisen as the result of illness;

“EHC plan” has the same meaning as in the Children and Families Act 2014(4) (see section 37 of that Act);

“independent hospital” means a hospital, as defined in section 275(1) of the NHS Act 2006, that is not a health service hospital, as defined there;

“planned service” means any service whose provision is planned and arranged by an ICB as part of the health service in response to the results of an assessment of a person’s physical or mental health needs and which is intended to bring about or promote a specific outcome in relation to those needs;

“predecessor CCG”, in relation to an ICB, means—

(a)

a CCG whose area, as it was immediately before the commencement of paragraph 100 of Schedule 4 to the Health and Care Act 2022, is wholly contained within the area of the ICB; or

(b)

in any other case, a CCG from which rights and liabilities relating to arrangements for the provision of accommodation or services under relevant legislation are transferred to the ICB under section 14Z28(1) of the NHS Act 2006(5);

“relevant legislation” means the following provisions of the CCG Regulations 2012—

(a)

in relation to paragraph 8 of this Schedule, regulation 4 and paragraph 8 of Schedule 1;

(b)

in relation to paragraph 9 of this Schedule, regulation 4 and paragraph 3 of Schedule 1;

(c)

in relation to paragraph 10 of this Schedule, regulation 4 and paragraph 4 of Schedule 1;

(d)

in relation to paragraph 11 of this Schedule, regulation 4 and paragraph 5 of Schedule 1;

“secure children’s home” means a children’s home used for the purpose of restricting liberty and approved for that purpose in respect of which a person is registered under Part 2 of the Care Standards Act 2000, or premises in respect of which a person is registered under Part 1 of the Regulation and Inspection of Social Care (Wales) Act 2016 to provide a secure accommodation service within the meaning of Part 1 of, and Schedule 1 to, that Act.

2.  The list of persons referred to in regulation 3(1) is as follows—

(a) every person present in the ICB’s area who is not a person for whom the ICB has core responsibility, in relation to the provision of emergency ambulance services or accident and emergency services, whether provided at a hospital accident and emergency department, an urgent treatment centre or elsewhere (but excluding any services provided after the person has been accepted as an in-patient, or at an out-patient appointment);

(b) every person aged 18 or over who falls within paragraph 3, in relation to the provision of the accommodation and services referred to in paragraph 3(b);

(c) every child who falls within paragraph 4;

(d) every person who falls within paragraph 5, in relation to the provision of the accommodation and services referred to in paragraph 5(b);

(e) every person who falls within paragraph 6, in relation to the provision of the accommodation and services referred to in paragraph 6(c);

(f) every child who falls within paragraph 7, in relation to the provision of the accommodation and services referred to in paragraph 7(c);

(g) every child who falls within paragraph 8;

(h) every person who falls within paragraph 9, in relation to the provision of accommodation and services referred to in paragraph 9(c);

(i) every child who falls within paragraph 10;

(j) every person who falls within paragraph 11, in relation to the provision of accommodation and services referred to in paragraph 11(c);

(k) every person resident in Northern Ireland, Scotland or Wales and present in the ICB’s area who is a qualifying patient within the meaning of section 130C of the Mental Health Act 1983, and not being provided with NHS primary medical services.

3.  A person falls within this paragraph if—

(a) the ICB has made an arrangement in the exercise of its commissioning functions (by itself or jointly with a local authority) by virtue of which the person is to be provided with services to meet the person’s continuing care needs;

(b) those services consist of or include the provision of the following accommodation and services to meet the person’s continuing care needs—

(i) accommodation in a care home or independent hospital situated in the area of another ICB or of a Local Health Board; and

(ii) at least one planned service (other than a service consisting only of NHS-funded nursing care) which is connected to the provision of such accommodation (whether or not the accommodation is arranged by the ICB referred to in sub-paragraph (a));

(c) the person is resident in that accommodation and continues to need that planned service (or those planned services); and

(d) the person would not be a person for whom the ICB has core responsibility.

4.—(1) A child falls within this paragraph if both of sub-paragraphs (2) and (3) apply to the child.

(2) This sub-paragraph applies to a child if any of the following is the case—

(a) the child is looked after by a local authority, within the meaning of section 22 of the Children Act 1989(6) (general duty of local authority in relation to children looked after by them), other than by way of being accommodated in a secure children’s home in respect of which NHS England must arrange for the provision of services to children accommodated there;

(b) the child is a relevant child within the meaning of section 23A of that Act(7) (the responsible authority and relevant children);

(c) the child is a person to whom section 24(1A) or (1B) of that Act(8) (persons qualifying for advice and assistance) applies;

(d) the child is provided with accommodation at a school, institution within the further education sector or 16 to 19 Academy (within the meaning of section 1B of the Academies Act 2010(9)) to which the person is admitted in accordance with an EHC plan; or

(e) the child requires accommodation in a care home, a children’s home or an independent hospital to meet the child’s continuing care needs.

(3) This sub-paragraph applies to a child if—

(a) the child is provided with—

(i) services which consist of or include the provision of accommodation situated in the area of another ICB or of a Local Health Board, under arrangements made by the ICB in the exercise of its commissioning functions (by itself or jointly with a local authority); or

(ii) such services under arrangements made by the local authority and immediately before those arrangements were made the child was a person for whom the ICB had core responsibility; and

(b) the child—

(i) is resident in that accommodation; and

(ii) would not be a person for whom the ICB has core responsibility.

5.  A person falls within this paragraph if—

(a) the ICB has made an arrangement in the exercise of its commissioning functions (by itself or jointly with a local authority) by virtue of which immediately before attaining the age of 18 the person was provided with services to meet the person’s continuing care needs;

(b) those services consist of or include the provision of the following accommodation and services to meet the person’s continuing care needs—

(i) accommodation in a care home, a children’s home or an independent hospital situated in the area of another ICB or Local Health Board, or a school, institution within the further education sector or 16 to 19 Academy (within the meaning of section 1B of the Academies Act 2010) to which the person is admitted in accordance with an EHC plan; and

(ii) nursing and another service which is a planned service, as part of the health service to meet the person’s continuing care needs;

(c) the person is resident in that accommodation and continues to need that planned service (or those planned services); and

(d) the person would not be a person for whom the ICB has core responsibility.

6.  A person falls within this paragraph if—

(a) immediately before the coming into force of these Regulations, a CCG was responsible for providing services to the person by virtue of regulation 4 of, and paragraph 6 of Schedule 1 to, the CCG Regulations 2012;

(b) the rights and liabilities relating to arrangements for the provision of those services are transferred to the ICB by virtue of a scheme made under section 14Z28(1) of the NHS Act 2006;

(c) the person continues to need services consisting of or including the provision of the following accommodation and services to meet their continuing care needs—

(i) accommodation in a care home or independent hospital situated in the area of another ICB; and

(ii) at least one planned service (other than a service consisting only of NHS-funded nursing care) which is connected to the provision of such accommodation (whether or not the accommodation is arranged by the ICB); and

(d) the person would not be a person for whom the ICB has core responsibility.

7.  A child falls within this paragraph if—

(a) immediately before the coming into force of these Regulations, a CCG was responsible for providing services to the child by virtue of regulation 4 of, and paragraph 7 of Schedule 1 to, the CCG Regulations 2012;

(b) the rights and liabilities relating to arrangements for the provision of those services are transferred to the ICB by virtue of a scheme made under section 14Z28(1) of the NHS Act 2006;

(c) the child continues to need services consisting of or including the provision of the following accommodation and services to meet their continuing care needs—

(i) accommodation in a care home, a children’s home or an independent hospital situated in the area of another ICB; and

(ii) nursing and another service which is a planned service as part of the health service; and

(d) the child would not be a person for whom the ICB has core responsibility.

8.  A child falls within this paragraph if—

(a) immediately before the coming into force of these Regulations, the child fell within paragraph 8 of Schedule 1 to the CCG Regulations 2012;

(b) the CCG who, immediately before the coming into force of these Regulations, had responsibility for the child is a predecessor CCG in relation to the ICB;

(c) the child continues to need accommodation at a school in the area of another ICB or Local Health Board, to which the child is admitted in accordance with an EHC plan; and

(d) the child would not be a person for whom the ICB has core responsibility.

9.  A person falls within this paragraph if—

(a) immediately before the coming into force of these Regulations the person fell within paragraph 3 of Schedule 1 to the CCG Regulations 2012;

(b) the CCG who, immediately before the coming into force of these Regulations, had responsibility for the person is a predecessor CCG in relation to the ICB;

(c) the person continues to need services which consist of or include the provision of the following accommodation and services to meet their continuing care needs—

(i) accommodation in a care home or independent hospital situated in the area of another ICB or of a Local Health Board; and

(ii) at least one planned service (other than a service consisting only of NHS-funded nursing care) which is connected to the provision of such accommodation;

(d) the person is resident in the accommodation referred to in sub-paragraph (c)(i); and

(e) the person would not be a person for whom the ICB has core responsibility.

10.  A child falls within this paragraph if—

(a) immediately before the coming into force of these Regulations, the child fell within paragraph 4 of Schedule 1 to the CCG Regulations 2012;

(b) the CCG who, immediately before the coming into force of these Regulations, had responsibility for the child is a predecessor CCG in relation to the ICB;

(c) the child—

(i) continues to need services which consist of or include the provision of accommodation situated in the area of another ICB or of a Local Health Board; and

(ii) is resident in that accommodation; and

(d) the child would not be a person for whom the ICB has core responsibility.

11.  A person falls within this paragraph if—

(a) immediately before the coming into force of these Regulations the person fell within paragraph 5 of Schedule 1 to the CCG Regulations 2012;

(b) the CCG who immediately before the coming into force of these Regulations had responsibility for the child is a predecessor CCG in relation to the ICB;

(c) the person continues to need the following accommodation and services to meet their continuing care needs—

(i) accommodation in a care home, a children’s home or independent hospital situated in the area of another ICB or of a Local Health Board; and

(ii) nursing and another service which is a planned service, as part of the health service to meet the person’s continuing care needs;

(d) the person is resident in the accommodation referred to in sub-paragraph (c)(i); and

(e) the person would not be a person for whom the ICB has core responsibility.

(1)

2000 c. 14.

(2)

2016 anaw 2.

(3)

Clinical commissioning groups were established under section 14D of the National Health Service Act 2006. Section 14D was repealed by paragraph 100 of Schedule 4 to the Health and Care Act 2022.

(4)

2014 c. 6; section 37 was amended by paragraph 97 of Schedule 1 to the Care Act 2014 and Children and Families Act 2014 (Consequential Amendments) Order 2015 (S.I. 2015/914).

(5)

Section 14Z28 was added by section 19(2) of the Health and Care Act 2022.

(6)

1989 c. 41.

(7)

Section 23A was inserted into the Children Act 1989 by section 2(1) and (4) of the Children (Leaving Care) Act 2000 (c. 35) and amended by paragraph 8 of Schedule 3 to the Children and Young Persons Act 2008 (c. 23) and S.I. 2016/413.

(8)

Section 24(1A) and (1B) were inserted into the Children Act 1989 paragraph 60(a) and 60(b) of Schedule 3 to the Adoption and Children Act 2002 (c. 38).

(9)

2010 c. 32; section 1B was inserted by section 53 of the Education Act 2011 (c. 21).