PCTs told to merge to prepare for change

The government has set out its plans for pushing ahead with a massive shake-up of the NHS in England.

The Department of Health today published its response to the three month consultation on its white paper, ‘Equity and Excellence: Liberating the NHS’.

In doing so, it confirmed plans to scrap strategic health authorities and primary care trusts and pass about 80% of the NHS budget to GP consortia.

A Health and Social Care Bill will be put before Parliament in January to legislate for the changes.

The DH has also announced that PCTs will be streamlined into clusters as part of the transition.

It said would reduce running costs and enable clusters to work with GP practices and emerging consortia on commissioning. More details are to be published in the Operating Framework due out later today.

Although the programme of reform remains largely unchanged from the white paper in July, the government has made some modifications as a result of the consultation.

These including passing commissioning of maternity services to GP consortia and giving councils formal scrutiny powers over all NHS-funded services.

GP consortia are also to have a statutory duty to support the NHS Commissioning Board in improving the quality of primary care services.

The consultation on the white paper attracted 6,000 responses. The government said these had strength its belief in the reforms and its resolve to see them introduced.

It rejected criticism that major structural reforms were unnecessary or disruptive and said it was building on principles established over 20 years, through GP fundholding and practice-based commissioning.

The DH also argued that the policy changes would not be a distraction from the need to save £20 billion in the health service over the next four years but essential to plans to do so.

Health secretary Andrew Lansley said: “Today is a launch-pad for the NHS we all aspire to. One that is focused increasingly on what matters: better results for patients.”

The DH said concerns about the pace of change had led it to set up 52 pathfinder consortia covering around 25% of the population.

Its latest response outlines plans to see a growing number of shadow consortia become pathfinders.

It says that during 2011-12, consortia should work with PCTs to identify staff posts that can be transferred to consortia from 2012.

It says they should also agree a process for transferring any IT or information systems associated with commissioning and work with PCTs and SHAs to identify where external commissioning support may be needed.

The document says that the NHS Commissioning Board will establish consortia from April 2012 and that once they are confirmed as statutory bodies they will be able to take on NHS staff.

The document says the aim is to ensure that “the great majority of consortia” are able to be set up in April 2012 or shortly afterwards.

The document adds: “We want to strike a balance between retaining essential talents and capabilities of SHA and PCT staff and giving GP consortia the freedom to innovate and access the support they need through the transition to the new system.

“Whilst it will be for consortia to make these decisions, bearing in mind the associated costs, we anticipate that a number of PCT staff across all grades will be essential in providing consortia with the skills and knowledge required to take on their new commissioning role."

The DH response says the consultation showed strong support for the government’s vision of an information revolution but the government said it would give its formal response on those proposals following the end of the consultation on its Information Revolution document on 14 January.