Primary care trusts will be allowed to “park” their provider arms with other NHS organisations in order to meet the deadlines for transforming community services, under the revised operating framework.
The framework, published earlier this week, states that separating PCT commissioning arms from provider arms remains a priority. But it suggests PCTs will be able to use pass community services to acute trusts as an interim measure while they develop more ambitious future models.
It says: “This [separation] must be achieved by April 2011, even if this means transferring services to other organisations while sustainable medium term arrangements are identified and secured.”
When deciding these longer term arrangements, it says PCTs must ensure “they consider a wide range of options, including the development and early delivery of community foundation trusts and social enterprises, providing employee leadership and ownership”.
The framework also says that the white paper, due later this summer, may introduce an “additional option of a staff membership foundation trust model for community services” – the so called mutual model.
Although permanent vertical integration is not explicitly ruled out, it says future models must “consider the implications for choice and competition” – which HSJ has been told will be tantamount to barring integration with an acute provider in some areas.
NHS Alliance chair Mike Dixon said he thought the government was “rightly concerned” that most proposals had been for vertical integration and “unlikely to transform services sufficiently”.
He said: “Generally the timescale has not allowed for a proper consultation of frontline clinicians or patients. It takes time…. to develop imaginative horizontal models, let alone get the funding, create the organisational form and get buy in from local clinicians.”
PCT Network community services forum chair Matthew Winn agreed. He said: “It is a welcome opportunity which gives PCTs a slightly wider number of options.”