By Tash Shifrin
8 April 2010
NHS leaders have warned that the reorganisation of community health services could ‘unravel’ – and have to be reshaped again – because plans have been rushed to meet tight government deadlines.
Primary care trusts have faced uncertainty over their community services, with the government sending mixed signals and alternately urging faster and slower change.
Unions feared that last year’s division of PCTs into commissioning and provider wings was the precursor to privatising services – a move seemingly at odds with Health Secretary Andy Burnham’s declaration that the NHS was the ‘preferred provider’.
The NHS Operating Framework, published in December, told PCTs to draw up plans for the services’ future and have them signed off by strategic health authorities by the end of March. The framework offered a series of options, including keeping provision within PCTs, hiving it off to the private sector, merging with other NHS bodies, setting up social enterprises or becoming a ‘community foundation trust’.
Both Unison and the NHS Confederation have told Public Finance that as far as they are aware, no PCTs have opted to transfer community services to the private sector.
But confederation policy director Nigel Edwards warned of ‘significant risks’ to many PCTs’ plans. The confederation’s own straw poll figures suggest that more than a quarter of community services across the country will be merged into local acute hospital trusts, with more than a third going either into mental health trusts or being integrated into local authority provision. Around 10% are set to become social enterprises.
The Department of Health has confirmed that eight potential CFTs have been approved, while six PCTs have been given clearance to retain provision in-house.
Edwards said PCTs had gone for a variety of approaches, while SHAs had also varied in their responses, with some taking a more directive line than others.
‘The concern is that in some places a very careful process has been gone through to define business units and plan their future. But in other places... staff have been led in one direction and have now reversed into a different one. There are some hasty solutions that may not be sustainable.’
Some of these proposals might unravel, he said. In these cases, or if another government announces new proposals for the sector, community services could face a further shake-up.
The changing policy towards the services over the past few years was ‘not one of the most glorious episodes in the history of change management’, Edwards added.
8 April 2010
NHS leaders have warned that the reorganisation of community health services could ‘unravel’ – and have to be reshaped again – because plans have been rushed to meet tight government deadlines.
Primary care trusts have faced uncertainty over their community services, with the government sending mixed signals and alternately urging faster and slower change.
Unions feared that last year’s division of PCTs into commissioning and provider wings was the precursor to privatising services – a move seemingly at odds with Health Secretary Andy Burnham’s declaration that the NHS was the ‘preferred provider’.
The NHS Operating Framework, published in December, told PCTs to draw up plans for the services’ future and have them signed off by strategic health authorities by the end of March. The framework offered a series of options, including keeping provision within PCTs, hiving it off to the private sector, merging with other NHS bodies, setting up social enterprises or becoming a ‘community foundation trust’.
Both Unison and the NHS Confederation have told Public Finance that as far as they are aware, no PCTs have opted to transfer community services to the private sector.
But confederation policy director Nigel Edwards warned of ‘significant risks’ to many PCTs’ plans. The confederation’s own straw poll figures suggest that more than a quarter of community services across the country will be merged into local acute hospital trusts, with more than a third going either into mental health trusts or being integrated into local authority provision. Around 10% are set to become social enterprises.
The Department of Health has confirmed that eight potential CFTs have been approved, while six PCTs have been given clearance to retain provision in-house.
Edwards said PCTs had gone for a variety of approaches, while SHAs had also varied in their responses, with some taking a more directive line than others.
‘The concern is that in some places a very careful process has been gone through to define business units and plan their future. But in other places... staff have been led in one direction and have now reversed into a different one. There are some hasty solutions that may not be sustainable.’
Some of these proposals might unravel, he said. In these cases, or if another government announces new proposals for the sector, community services could face a further shake-up.
The changing policy towards the services over the past few years was ‘not one of the most glorious episodes in the history of change management’, Edwards added.
