Who Pays?

Determining which NHS commissioner is responsible for commissioning healthcare services and making payments to providers.

Who Pays? sets out the framework for establishing which NHS commissioner will be responsible for commissioning and paying for an individual’s NHS care.

Who Pays? – June 2022

The June 2022 version of Who Pays? and accompanying Appendix 3 come into effect from 1 July 2022 and replace the previous version published in August 2020.

It reflects a number of changes brought about by the Health and Care Act 2022 and associated regulations:

  • it sets rules for determining the group of people for whom each integrated care board (ICB) has core responsibility
  • it introduces a change in the rules around detention and aftercare under the Mental Health Act
  • it introduces a change in relation to transition to adult continuing care

A webinar has been made available on the FutureNHS collaboration platform setting out what has changed from the August 2020 version of Who Pays? The webinar is located in the NHS Planning workspace at Library and Resources > Finance Guidance > Finance Webinar Series.

Who Pays? – legacy documents

Previous versions of Who Pays? can be accessed below:

Who Pays? August 2020: This version of the Who Pays? guidance came into effect from 1 September 2020. The structure of this version of Who Pays? guidance was broadly similar to the 2013 version and the core rule remained that the commissioner responsible for payment will be the clinical commissioning group of which the patient’s GP practice is a member, with some exceptions to this core rule which are described.

There were important changes in paragraph 13 on stays in hospital, in paragraph 14 on discharge from hospital and continuing care and in paragraph 18 on detention and Section 117 aftercare under the Mental Health Act.

There were also new, mandatory arrangements for dispute resolution described in Appendix 1 and in Appendix 4, which was published separately.

Who Pays? August 2013: The 2013 version of Who Pays? guidance was amended in 2016 through the publication of an addendum on the ADASS website which made changes to paragraphs 33 and 34.