Health managers are calling for clarity on how primary care trusts should manage their assets when separating commissioner and provider functions.
Delegates at an HSJ conference on transforming PCT provider services questioned what would happen to assets such as buildings, and suggested that in some cases commissioners did not want to take on the risks associated with them.
The conference heard that in some trusts, commissioners were convinced they had to keep assets but in other areas, neither commissioners nor providers wanted them.
Delegates were also concerned that some provider arms would not be large enough to function autonomously and might have to merge, making it more difficult to tackle local health issues.
Speaking after the conference, NHS North West chief executive Mike Farrar said he was encouraged that PCTs were asking questions that showed they were engaging with the task. "It's important that solutions are localised so that we don't have one size fits all, because one size won't fit all," he said. "Collective thinking" involving national bodies such as the Department of Health and Monitor was needed over the future of assets, he added.
Helen Fentiman, adviser to the new forms of care team at the DH, said that foundation regulator Monitor had been "testing out the issues that might arise with an asset-light foundation trust".