A lack of strategic health planning will follow the demise of strategic health authorities and primary care trusts, senior NHS figures have warned.

Speaking at the Wellards conference at the Royal College of Physicians, chief executive of the NHS Confederation Nigel Edwards questioned how facilities such as new trauma centres would get built without any authorities to plan them and force the different specialities to locate in the same place.

He said: “It’s very clear that Andrew Lansley has a prejudice about planning and management.”

Similar concerns were raised at a Westminster Health Forum on stroke care, where London-wide improvements in stroke care were celebrated.

Stroke clinical director of NHS London stroke and cardiac networks Tony Rudd said that he was worried that the end of PCTs and SHAs would mean a return to a “local free market” where only “popular” diseases with strong advocates got attention.

“Where there is little strategic management it will come down to pressure groups or specialist consultants in hospitals lobbying for their particular area, I worry that proper strategic planjning will follow SHAs into oblivion,” Dr Rudd warned.

South London cardiac and stroke network director Lucy Grothier told HSJ at the health forum event that it might be possible networks like hers could take over some of the strategic regional roles once SHAs had gone.

“Networks could be used to overcome the commissioner/provider split and provide strategic planning across regions like London, providing they got the funding and muscle that would require,” Ms Grothier said.