Confused messages from the Department of Health over the future of community services configuration are “not helping the NHS”, the Primary Care Trust Network has warned.

Last month at the DH medical directors’ conference, NHS chief executive David Nicholson appeared to withdraw support from the idea of PCT provider arms becoming community foundation trusts and social enterprises, and instead backed the idea of vertical integration with acute trusts.  

Has the rug been pulled from under them or hasn’t it?

Speaking to HSJ on the issue, PCT Network director David Stout said the DH was “struggling with their messaging” over the future of community services.

He said there appeared to be a debate going on within the DH attached to the need to make savings and how this fitted in with current policies.

“It’s difficult to explain how you’re reducing management costs on the one hand and potentially increasing the number of organisations on the other. It’s just politically difficult,” he told HSJ.

He added: “What we don’t want is 152 community foundation trusts being set up. That much is clear and I don’t think anyone is arguing that we should, so I don’t think there’s any problem with clarity on that point.”

But he said: “I think there are confused messages out in the service at the moment about the first wave of community foundation trusts and any of these social enterprises like Hull – has the rug been pulled from under them or hasn’t it?”

Mr Stout said he thought that the first wave would go ahead but doubted whether there would be a second wave.

“I suspect we’ll see those early adopters happen,” he said.

“Where the jury is seriously out is whether that’s the end of that story and we’re now in a new era, where we’re looking at less about the number of separate organisations we have and more about how do you find a way of integrating the things they offer,” Mr Stout added.

“I don’t think they’ll announce no more anything, but they’ll probably find ways of discouraging proliferation of organisations,” he said.

He said he expected the forthcoming NHS operating framework to answer most of the outstanding questions over the government’s intended direction.

“In the meantime you are just going to get this slight confusion with messaging, which I don’t think anyone’s really going to be able to do anything about and it doesn’t help the NHS,” he warned.

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