Published: 21/03/2002, Volume II2, No. 5797 Page 4

Primary care trusts have little independence, commissioning power is almost non-existent and morale among their staff is poor, a stark document from the NHS Alliance will warn next week.

Vision in Practice is the third in a series published by the alliance which began in 1998 with the publication of Restoring the Vision, the strategy behind primary care groups. The latest report will take a critical look at the government's success in implementing policies designed to give power to the frontline.

The document, due to be published next Tuesday, provides a chance for the frontline to examine how far government rhetoric has translated into reality. In particular, it looks at how PCTs will cope with new powers for public involvement among a raft of new responsibilities. It also looks at how healthcare should be structured to be patientcentred, and examines issues of quality and safety.