The Department of Health has released delayed guidance on new 'vital signs' performance indicators which aim to give trusts more freedom to set local goals with less interference from the top.
Under the new operating framework, trusts will be judged on three tiers of 'vital signs' - and can set local priorities for the first time.
Targets will be agreed with strategic health authorities after consulting with local people and partners such as councils.
Progress against all vital signs - including mandatory targets for national priorities such as teenage pregnancy - will be published by the DH annually. PCTs will be expected to draw up annual "operational plans" and publish progress reports locally.
"This will allow a local population to understand how well or poorly their local PCT is performing across a range of commissioner responsibilities and will be part of a local conversation between PCTs and their populations," says the guidance.
The DH has said it will take a hands-off approach to setting and monitoring local priorities.
However, it expects PCTs to focus on areas where they are lagging behind. "If they are not doing well in a certain area and decide not to focus on that they will need to have a good reason," said a DH spokeswoman.
Trusts will also be expected to deliver on all existing commitments such as waiting times for treatment and appointments.
NHS organisations have been sceptical about how much freedom they will actually gain.
The DH will step in if trusts' combined plans fall short of overarching public sector targets or officials fear local area agreements fail to address local needs, reveals the guidance.
Nonetheless PCT Network director David Stout gave the document a cautious welcome. "It could work but we do need to be careful that it is not just a whole new set of targets for PCTs," he said.
"It is important the rhetoric surrounding these new indicators is followed through."