NHS chief executive Sir Alan Langlands hinted strongly that local authorities would win significant funds for care of elderly people in the comprehensive spending review, due later this month.

Sir Alan, speaking at his final major management event before leaving the NHS this summer, said that while he was 'still negotiating' on the government's response to the Royal Commission on Long-Term Care, he was positive about the outcome. 'A good settlement will take some of the pressure off general and acute hospitals and ensure more appropriate care for older people. Anything less will leave us with some very tough choices to make at the boundary between health and social care.'

NHS Confederation chief executive Stephen Thornton told HSJ: 'He sounded as if he was speaking with some authority. I would interpret that as a positive settlement for local authorities.'

Mr Thornton welcomed fresh money for councils to spend on personal care, as it would reduce the need for the NHS to draw on its own four year spending package, announced in the March Budget.

Sir Alan also told delegates that capital investment in the NHS would be strengthened. The government was already committed to spending£8bn between 1999 and 2004, 'and there is more to come on that point'.

Sir Alan, who leaves later this month to become vice-chancellor of Dundee University, reassured managers there would be little reorganisation of trusts, health authorities, primary care groups and primary care trusts.

'You will notice that at no point have I mentioned structural change. It is no more, in my view, than a drain on resources and a distraction from the main job.'

The government's policy was to transform the NHS through clear national standards of care, expanding primary care, improving access to health services and modernising hospital care.

Managers had to focus on 'transition strategies' for moving the service towards networks of care based around the patient, Sir Alan said.

Information technology, human resources and capital investment policies had to link to key service priorities such as increasing staff numbers.

The strategies had to be linked - putting clinical governance in place depended on good information and investments in team building and training.

Sir Alan went on to warn against 'eroding the professionalism of NHS staff ', which won him a round of applause from delegates.