Six primary care trusts have been given approval in principle by the government to continue as direct provider organisations.

The PCTs in question are: Tower Hamlets, Cumbria, Knowsley, Wirral, Isle of Wight and Stoke on Trent.

We would not anticipate further successful applications due to the high challenge

But the Department of Health said it did not expect any further PCTs to be given the opportunity to retain their current commissioner and provider arms.

It said: “These PCTs had to undergo a rigorous assurance process and meet the national tests. We would therefore not anticipate further successful applications due to the high challenge involved in meeting the commissioning and provision tests for continued direct provision.”

NHS Stoke on Trent chief executive Graham Urwin said: “I am delighted with the announcement that we are one of six PCTs nationally that have been allowed to continue to directly provide services.

“I believe there are clear reasons for this decision,” he said. “One of those is that we have made significant progress to separate out the commissioning function from our provider services.”

The Department of Health’s deadline for all PCTs to gain provisional approval from strategic health authorities for the future model of their community services is 31 March, with implementation to be completed by April 2011.

While the DH guidance on transforming community services offers several alternatives, at least four SHAs have told PCTs that vertical integration with an acute or mental health trust is the preferred option.