The carve-up of primary care trust provider arms has seen mental health and acute trusts pick up the greatest amount of work while the private sector will secure the least.

The Department of Health announced last week that it had approved all but three of the transactions of the transfers and that 28 per cent of PCT provider arms were being merged with mental health trusts.

The community provider market is worth £8.5bn. Of that, £2.5bn has gone to mental health trusts. Vertical integrations with the acute sector account for 27 per cent of the transfers, and aspirant community foundation trusts 26 per cent.

This largely confirms the proportional split set out in HSJ in October.

The rest of the transfers constitute social enterprises and integration with care trusts, leaving just 4 per cent of services to be tendered to any willing provider.

David Worskett, director of the NHS Partners Network, which represents private providers, told HSJ his members were “unpleasantly surprised” by that news.

He said it was now looking for a test case of a “rather too cosy” inter-NHS transfer to refer to the NHS cooperation and competition panel.

He said the fact only 4 per cent of community services would now be put out to tender was particularly surprising. The network had been told informally in April that some 20 per cent of PCT proposals were unlikely to pass criteria set out in the Transforming Community Services programme and could therefore be put to the market.

In a letter to DH director of system management and new enterprise Bob Ricketts this week Mr Worskett queried “whether the principle of any willing provider is being applied to reconfiguring community services so that the taxpayer gets the best value”.

However, DH managing director of provider development Ian Dalton said it was important to distinguish between Transforming Community Services and the any willing provider principle, which only applies from April 2011.

He told HSJ the Transforming Community Services process was “to ensure provider organisations were established that could stand on their own two feet and compete in the marketplace”.

He said: “That’s separate from the opening up of the market. All organisations offer services to local commissioners; [the choice of service provider] is really going to be up to consortia.”

Mr Dalton said the outcome of the programme had produced “quite a varied landscape” of different organisations.

“We have got to a place I am very comfortable with,” he said. “It’s fantastic we have the range of organisations we do but the hard work starts here. Whether it’s becoming a community foundation trust or looking to integrate, there’s a major leadership task. We are not looking for rebadging.”

Ten per cent of the community services budget is set to go to social enterprises, ranging from provider arms to small nursing teams. Mr Dalton said the health social enterprise sector that had been created was “vibrant” and was “the largest Europe has ever seen”.

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