Primary care trusts must centrally coordinate the transition to GP consortia, but not dictate, according to the NHS Alliance.

The Alliance has published its official response to the Liberating the NHS white paper, setting out six key themes that need addressing, including the transition period.

It defines the “key” to successful implementation of the proposed reforms as “local empowerment, local decision making and flexibility in both detail and timescale that reflects local circumstances”.

In particular it warned it was “absolutely necessary” to manage the transition in an orderly way, which would need good working relationships between PCTs and fledging consortia.

It says: “The smoothness of transition will depend upon positive relationships between PCTs and their nascent GP commissioning consortia and, in the spirit of the reforms these, should be centrally coordinated but not directed.

“This calls for concerted work to create productive transitional plans between GP commissioning consortia and PCTs and for them to learn from the experiences and outcomes of others.”

On the government’s timescale, which has been criticised by other organisations for being too fast, the Alliance called for “sufficient flexibility within the proposed timetable to accommodate both the fast movers and those who require a more considered timescale”.

It says: “Some will say that the transition is too fast, others that it is too slow. That is an oversimplification of the reality that in some parts of the country putative GP commissioning consortia will be ready to assume responsibility for commissioning now and in the very near future, and in others, will require more development support and time to be in that position.”

The Alliance notes however that the “considerable skills of those currently working in PCTs must not be lost to the NHS”.

The response says: “Their skills and experience should be valued and their contribution to the future ensured where this is appropriate. For instance, their ability to morph into independent businesses, perhaps of social enterprises should be supported and invested in.”

The Alliance added that it considers current PEC chairs – reflecting both clinical and organisational knowledge – having an especially important role in the transition period.

“In many ways, they represent both the commissioners of now and the future and their contribution must be recognised and valued,” the response says.

NHS Alliance chief executive Michael Sobanja said: “The direction of travel is right.

“There are many opportunities to improve the NHS and, as expected, there are also risks. Concerns around the details of implementation and timescale need to be carefully considered. The pace of change may be daunting but we must ensure we get it right. For that to happen, flexibility and a focus on culture, behaviour and outcomes, at all levels in the system, will be paramount. ”

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