this week

Ministers are expecting fewer than a dozen flagship primary care trusts to be created to spearhead their primary care reforms, HSJ has learned.

Department of Health officials have briefed GP and primary care representatives to expect about 10 PCTs to go live in the first wave next April. Despite receiving up to 170 expressions of interest in PCT status last spring, sources said officials are planning for just 30-40 more to go live in the second wave in October 1999.

Treasury officials are believed to be keen to rein in the overall costs of PCTs, which are entitled to up to£275,000 start-up funds.

The DoH will not confirm how many firm proposals for PCT status have been made ahead of the 30 September deadline. A spokesperson said applications to NHS Executive regional offices 'are not being tracked nationally'.

But at least eight primary care groups have told HSJ that they are drawing up proposals to become level-four PCTs, providing community and primary care and commissioning acute services.

PCG boards in East Anglia, Lincolnshire, Northamptonshire, Hampshire and South Manchester are due to start official consultation within weeks. The plans would create smaller PCTs than many commentators expected, covering populations from 100,000 up to 170,000.

All four PCGs surrounding North West Anglia Healthcare trust are planning separate bids. South Peterborough, North Peterborough, Fenland and West Norfolk PCGs are seeking to take over community services such as district nursing, paediatrics and health visiting.

The PCGs, which cover populations of up to around 130,000, will leave the community trust as a residual organisation with a budget of only£20m.

Trust chief executive Barbara Kennedy, who has led the programme to create PCTs, said: 'We are a key partner in the process. Being in at the start will mean we can influence the way they develop.'

North East Lincolnshire PCG is meeting the Trent regional office next week to refine its proposals in the light of the most recent government guidance on staff transfers and the timetable for consultation.

Chief executive Roz Gower said it would seek approval for an alternative governing body to that outlined in central guidance.

'We wanted to ensure we kept a grass-roots-driven model with a professional college that brings nurses, professions allied to medicine, dentists, opticians and pharmacists together.'

Daventry and South Northamptonshire PCG chief executive Julia Squire said it was 'considering a phased approach' to taking over community services to avoid destabilising Northampton Community Healthcare trust.

The board is also awaiting the outcome of a larger consultation on reorganising services across Northamptonshire.

PCG chair Dr Kevin Herbert said the trust would redevelop Danetre Community Hospital as a 'genuine GP hospital where primary care is co-ordinated for the community'.

Dr David Paynton, Southampton East PCG chair, said the shape of the PCT was still under discussion. 'At a management level it will be fairly slim - a flat structure with people with comprehensive generic skills. We don't want to repeat the hierarchy of NHS trusts which stymies development.'