As your article on the NHS Confederation report on aspirant community foundation trusts acknowledges, the move towards this status is challenging, writes David Stout

But many people involved in delivering community services believe they offer locally sensitive solutions to moving care out of hospital, and increased separation for provider services that will help increase the focus on improved business planning and providing quality services.

The model hopes to build on this success. While not the only solution, it has potential benefits. Under the model staff remain employed in the NHS and the opportunities for public engagement are strong. It is flexible enough to allow local changes.

The model will require changes in governance, working cultures, IT and incentives. There are lessons to be learned, and that is why the primary care trusts involved came together to explore the issues - many similar to those all PCTs will face as they separate commissioning from service provision.

The process may not be easy but many involved in the pilot feel this has strengthened their organisation, and will bring great benefits for patients.

David Stout, director, Primary Care Trust Network

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