New government must give rapid clarity on community service plans

NHS chief executives told HSJ they see the transforming community services programme as particularly vulnerable to the vagaries of a coalition government, due to the challenging deadlines for its implementation in the operating framework.

PCTs had to submit their proposals by 1 May. Most are now being assessed by strategic health authorities.

One PCT chief executive told HSJ political clarity on the issue was needed in “weeks not months”. “Transforming community services is the acutest decision that we have,” he said.

Foundation trust chief executives – potentially hoping to take over community services – are also concerned about the effects of a weak government. One said:  “I would hope it isn’t out on hold by all of this. It’s gaining momentum.”

PCT Network director David Stout said clarity on the implementation plans – and whether the programme would even remain policy – was needed quickly. Progress would stall if no one in government was “pushing the go button”.

“If uncertainty continues for three or four months, the original deadlines become impossible to meet. At best, there will be a slow down. At worst, they will have to go back to discussions.”

But PCTs that were unhappy about the original timescale may not mind, he conceded.

NHS Alliance chair Michael Dixon is due to criticise the transforming community service programme tomorrow in a speech to the annual conference of community hospitals. He will warn the programme risks “dismantling community services” due to the speed with which it is due to be implemented.

Dr Dixon will tell delegates: “PCTs are being bulldozed into devolving their community services far too fast. The result, as we are seeing, is that most community services will, under current plans, be vertically integrated with acute trusts.” 

“We are in danger of creating even larger hospital monopolies, reducing productivity and fragmenting those community services away from general practice and social services, where they really belong. This is not the time to be pursuing organisational change for the sake of organisational change; it will put the NHS back 30 years,” he will say.