PERFORMANCE: The primary care trust’s latest board assurance framework identifies the potential impact of the NHS reforms as one of the two most serious risks it faces.

The document states that the PCT is “directly affected by the [Liberating the NHS] white paper with commissioning responsibilities moving to consortia”.

This, it says, “along with the impact of the clustering of PCTs and reduction in management costs has the potential to impact upon delivery of business as usual, lower staff morale, [and cause] lack of confidence of the public and adverse media coverage”.

It gives this risk a rating of 20 out of 25 – a score reserved for “major” risks which would either have “catastrophic” consequences and are “likely” to happen, or which would have “major” consequences and are “almost certain” to happen.

The framework identifies seven strategic risks, of which three are graded as “major”.

The only other risk with a rating of 20 is the risk that the PCT might “fail to meet our statutory financial duties and are overspent, limiting our ability to deliver our strategic plan”.