Frenetic pace to attain PCT status will leave those who resist vulnerable

Have primary care groups had their day? That seems an extraordinary question just a mere 15 months after the 481 PCGs spearheading the new NHS reforms went live. But already some of that number have gone - subsumed into 17 primary care trusts. And the word is that the momentum behind seeking PCT status is gathering irresistible force.

Up to another 30 PCTs are about to be announced, with a further 101 expressions of interest currently under consideration. In London alone, 24 PCGs are working on proposals to form 19 PCTs. Soon any PCG not plotting its progress to PCT status will look dangerously like a dinosaur stranded in a backwater.

This frenetic pace may please ministers, but it will bring problems. Major questions of governance and accountability remain to be answered in many places - the issue of coterminosity with local authorities is only one of them. On the front line, complaints about mixed messages and moving goalposts abound. If managers feel confused, what will the public make of it all? Time to sit back and take stock.