Start with the decision, not the bank line
NHS-funded nursing care is a payment towards nursing care by a registered nurse in a care home with nursing. The national framework collection explains the two funding routes. The resident is considered for NHS Continuing Healthcare first; if they do not qualify for that whole-package funding, the ICB can decide whether they qualify for FNC. The NHS explanation of FNC sets out that sequence and the standard rate. The national practice guidance says the ICB normally pays the nursing home directly, unless another route, such as payment through a local authority, has been agreed.
Keep the decision notice, resident reference, effective date, funding band and ICB together. The public information leaflet describes the assessment and direct payment. The home should not create an entitlement simply because a resident has nursing needs or a bed is occupied. Equally, a delayed remittance does not by itself cancel a confirmed decision. If the decision date or funding route is unclear, ask the ICB to confirm it before posting a precise debtor or pursuing a shortfall.
Build a register that can be checked line by line
Give each resident one row for each uninterrupted funding period. Record the ICB, decision reference, decision and effective dates, care-home admission and departure dates, standard or legacy higher band, weekly rate period, payer route, invoice or claim reference, remittance period and bank date. Put changes on a new row so the old decision is not overwritten. Keep a restricted resident identifier in the working papers; a public-facing report needs totals, not personal details.
The Department of Health and Social Care announcement confirms that from 1 April 2026 the standard rate in England is £267.68 a week and the closed higher band is £368.24. For an earlier period, use the rate that applied then. Check the local ICB arrangement for part weeks, rounding, invoices and remittance references rather than imposing a daily calculation of your own. LOYALS supports London and UK nursing-home operators with management accounts and income checks, where those period boundaries need to be visible each month.
Work through one four-week remittance
This illustrative schedule assumes three residents have written standard-band decisions covering respectively four, two and one whole weeks in a four-week period after 1 April 2026. At the published £267.68 weekly rate, seven supported resident-weeks total £1,873.76. Suppose the ICB remittance lists four weeks for A and two for B, totalling £1,606.08, and no line for C. The £267.68 difference is a query, not an automatic invoice: check C's effective date, ICB and payment route, then ask for the missing remittance line or a reason for exclusion.
| Resident reference | Decision-backed weeks | Remitted weeks |
|---|---|---|
| A | 4, £1,070.72 | 4, £1,070.72 |
| B | 2, £535.36 | 2, £535.36 |
| C | 1, £267.68 | 0, £0 |
| Total | 7, £1,873.76 | 6, £1,606.08 |
Keep changes out of the ordinary FNC line
A hospital admission, death, departure, change of ICB or move to NHS Continuing Healthcare can alter the schedule. The practice guidance says nursing-care payments should not be duplicated during hospital stays and should resume on return. It also describes a possible separate retainer under local agreements and says post-death payments depend on agreements with providers. Record any agreed retainer or final payment in its own line; neither should be invented from the standard weekly rate.
When the ICB changes a decision, keep the old and new notices and their effective dates. A retrospective adjustment should point to the resident and period it corrects. For a disputed line, note the ICB contact, evidence sent, amount, next action and date. A broad credit in next month's remittance is not enough until it can be allocated to the right resident and period. The NHS contract accounting guide covers the wider question of when income belongs in the accounts; this register deals with whether each FNC line was actually supported and paid.
Close the control account and chase a named difference
At month end, total the decision-backed schedule for the period, compare it with ICB remittance lines and match the remittance to the bank. Carry any confirmed earned but unpaid amount as an open item for accounting review, with the decision and dates attached. The Financial Reporting Council's FRS 102 standard governs revenue in company accounts; your accountant should decide how a disputed or uncertain amount is recognised under the applicable contract and accounting period. A bank shortfall alone is not proof of a recoverable debt.
Give the home manager and finance lead a short exception list: resident reference, covered weeks, expected amount, remitted amount, difference, reason, owner and follow-up date. Resolve timing and coding differences before asking the ICB to correct a payment. LOYALS can set up that schedule alongside monthly management accounts for a London or UK nursing home, with the resident detail kept in its private records and the owner seeing the totals and unresolved items.