The NHS Alliance has branded government plans to transfer billions of pounds of community services from PCTs to newly emergent organisations as the equivalent of “selling off the family silver.”
The Department of Health announced on Friday that from April next year, PCTs should have transferred all community services staff and provision to a range of new organisations, such as community foundation trusts and social enterprises, who will be expected to take on 26% and 10% of services currently provided by PCTs.
The move is intended to deliver more personalised care closer to home and strengthen local accountability under the auspices of the Transforming Community Services programme.
Community services employ around 200,000 staff and represent around £10bn of NHS spend.
But the Alliance says that community foundation trusts may never be authorised as financially viable by foundation trust regulator Monitor. Of the eight aspiring community foundation trust applicants currently declared, none has been authorised, it claims
It fears that the Department of Health may be following a timetable set by the last government for PCTs, which will handle local NHS finances until April 2013, to divest themselves of community provision.
"Transforming Community Services — a juggernaut launched by the last government — is now crashing into the reforms of the new government,” suggests NHS Alliance chair Dr Michael Dixon.
"It has put PCTs, their local clinicians and local people in an impossible situation. Instead of integrating community services with general practice and other local services (which is what our members clearly told our annual conference they prefer), most will become part of large, distant provider organizations,” he says.
“Like unwilling parents, PCTs have been told to sell off the family silver before GP commissioning consortia inherit their role. This is cart before horse; form before function - the sort of unthinking policy that we have seen all too often before: the last gasps of a centralist system run from Whitehall, which has never really sympathised with or understood primary care,” he fumes.
“This isn't about improving patient care; it is about organisation of convenience and change for change’s sake. Surely it would be more sensible to allow time for local clinicians and local people to make plans that keep all community, general practice and other services together, rather than fling them apart? How else can we get the properly integrated and co-ordinated services that our patients want and need?”
GP commissioning consortia should be allowed to develop and have a greater say on the configuration of local community services to maximise the benefits of local clinician led commissioning, he suggests.
Department of Health figures show that of £8.5 billion worth of NHS community services being transferred, only one third are going into social enterprises and community foundation trusts. More than half will go to provider hospital trusts and mental health trusts, including many foundation trusts, says the Alliance.