Pilots designed to drive the government's flagship policy of shifting services from hospitals into the community have made little difference, according to research.

An evaluation of projects chosen as the basis for the NHS Institute for Innovation and Improvement's Making the Shift programme found it had achieved only mixed success.

The programme followed 14 projects in five areas, across different types of NHS organisation.

Evaluation by Birmingham University's Health Services Management Centre found that projects had been harder to establish and slower to get going than had been anticipated.

Evaluation team leader and professor of health policy and management Chris Ham said: 'Some of the projects did really well, others made a little bit of progress but not a great deal and there were some that struggled to achieve anything in the tight timescale set.'

But the projects had highlighted the challenges in implementing the policy across the NHS. 'One key message from the pilot projects is that to bring about a shift in care, there's a real need to put in place some basic project management resources and skills which the NHS doesn't often have,' he said.

The most successful projects had GPs in leadership roles and practice staff working closely with hospital-based specialists, he added.

NHS Alliance chair Michael Dixon said GPs must be at the frontline of designing projects and it should not just be a matter of 'involving' them once schemes were under way.

He revealed his organisation will meet with the institute to look at improving partnerships with GPs.

Head of the institute's Care Outside Hospitals programme Martin Samuels said the aim was to identify what was needed make change work, and not best practice.

The institute is now developing a series of practical resources.