Published: 16/06/2005, Volume II5, No. 5960 Page 41

Primary care is a huge growth area for managers in terms of actual posts and new kinds of roles.

Some experts are predicting that primary care may need an extra 500 managers to cope with the changes ahead - two to three new managers per primary care trust, for example, to handle practice-based commissioning.

NHS Alliance chair Dr Mike Dixon says: 'Primary care is the place to be for ambitious managers. There are some wonderful opportunities there now.

'Primary care trusts may be diminishing in number but there will be lots of work to do, particularly in new roles. With practice-based commissioning, trusts will need highly skilled managers with a knowledge of commissioning. PCTs will need directors of modernisation and commissioning managers. I think the profile of finance directors and chief executives of PCTs will go up.

'They will need some innovative young managers who can think the unthinkable in terms of new commissioning processes in both primary and secondary care. I think there will be an increase in the numbers of managers on the front line - we are talking about two to three extra managers per PCT. I hope we will see a deployment of staff from strategic health authorities.' Elaine Cohen, head of primary care contracting for NHS Employers, says these are exciting times for managers in primary care.

But who employs them could change: 'There is an issue of the changing shape of employment practices for primary care to respond to new policy, ' she says.

'There could be an increasing use of alternative employers, not necessarily the private sector but also the voluntary sector. There will be a wider range of players in the market, and the idea of the NHS being a job for life may need to shift. As you get new providers and new managers of services coming in to the market, you might find yourself not being employed by a member of the NHS family.' With practice-based commissioning, she is uncertain if it will mean an increase in management posts or just a refocusing, but she is sure jobs will change: 'It is reshaping people's skills and more commissioning expertise may be needed.'