Public sector rebranding exercises are often seen as a costly and pointless distraction. But the proposal to rebrand primary care trusts - so Oldham PCT would become NHS Oldham, for example - makes a great deal of sense and does not need to cost money.

The PCT label has long been a barrier to local people understanding who is running their health services. The expression "primary care" is NHS jargon, while "trust" just adds a further layer of obscurity. Small wonder that PCTs have struggled to establish a profile. Some, such as Blackburn with Darwen, have already started using the new format in an effort to better explain what they do.

But the name change is, of course, just a small part of the long journey many PCTs still have to make to become the engine of service reform in their area, and to make clear who is wearing the commissioning trousers in the primary/acute relationship.

Improved public awareness of their role is just a springboard to greater understanding of their community's health needs, which is a vital counterbalance to the power of the providers.

Without these sound foundations, the commissioning model will never be secure.

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