Published: 03/10/2002 Volume II2, No.5825 Page 4 5

NHS chief executive Nigel Crisp has promised primary care trusts that they will be allowed 'local creativity' in deciding how to spend their share of the£150bn investment for the next three years.

Launching the priorities and planning guidance, Mr Crisp said the guidance - which largely pulls together existing targets - had been 'streamlined' to ensure PCTs enjoyed real freedoms during the three-year planning cycle.

He told HSJ: 'This is it.We are putting out 75 per cent of the money to PCTs. The only bids for money we will look at on a national basis would be for national things like education and training.

'This will mark a very significant reduction in central initiatives - if only for the reason that there will not be any money left for them.'

Mr Crisp said that of the money due to be allocated to primary care next month, only cash for cancer will be earmarked, in line with previous commitments to do so.

He said the decision to allocate cash without strings attached was 'absolutely' a response to concerns from the NHS and primary care community that PCTs should get proper freedoms to direct their own funds. Mr Crisp said the guidance aimed to provide 'national consistency' in standards while allowing 'local creativity'.

The document sets out nine priority areas, with associated targets, and spells out three key themes for the NHS in delivering improvements to the service.

As well as existing NHS priorities of access, cancer, coronary heart disease, mental health and older people, life chances for vulnerable people becomes a priority for health and social care (with lead responsibility held by social services), while patient experience, health inequalities and a cross-departmental priority to reduce the number of drug users join the list. The patient experience priority includes targets to improve the results of the annual patient survey year on year.

The three themes of the document are IT, workforce and physical capacity. On capacity, the paper promises at least 40 per cent of the total value of NHS estate should be less than 15-years-old by 2010. Strategic health authorities have been asked to produce capacity plans this month for the three-year period which will be incorporated into local delivery plans due in March. The document also promises a consultation paper on reforming NHS financial flows, to be published shortly.

The document instructs each organisation not only to make 1 per cent cost efficiency gains but also 'a minimum increase in quality equivalent to 1 per cent of its budget'. Further guidance on the methodology is due.Mr Crisp said the guidance was built on a recognition 'we can't do everything at once' and sets out a 'relatively small number of priorities and targets'.