Only four care trust pilots to go live

Only four of the 16 care trust demonstrator sites announced by
the government last year are actually expected to go live in April
this year, writes Lauren Revans.

Manchester, Bradford, and Camden and Islington – the only
demonstrator site to cover two local authorities – are all in
the process of submitting formal applications to create mental
health care trusts from April, based on existing mental health

Northumberland, meanwhile, has submitted a formal application
proposing the creation of a care trust which would be responsible
for “providing or commissioning most health services and all social
services for adults for the people of Northumberland”.

Lucy O’Leary, Northumberland care trust project team
member, said there had been a history of partnership working in the
area, and plans for moving to a care trust had been developed
throughout 2001.

“With the changes in the NHS organisations coming in, clearly we
were going to have to do something,” O’Leary added. “We were
going to move from four primary care groups to four primary care
trusts. But we had been talking about a care trust for some time,
and when the guidance started emerging in October then the
timescales became clear.”

However, the same NHS re-organisations – which include
primary care groups moving towards primary care trust status, the
replacement of 95 health authorities with 28 strategic health
authorities, and the replacement of department of health regional
offices with new regional directors of health and social care
– have caused other demonstration sites to put on the

In North Somerset, where a care trust covering “a wide number of
client groups” had been under consideration, the primary care group
and council have now decided to withdraw from the process “for the
time being”.

“We are concerned about the lack of DoH guidance and the other
changes going on in health,” said Graham Pearson, assistant
director of adult services at North Somerset social services
department. “We didn’t feel it was sufficiently clear how the
care trust we were proposing would fit into the new

Meanwhile Birmingham, where two potential care trusts –
one covering mental health and one covering learning difficulties
– had been included on the department of health’s list
of demonstration sites, have insisted that no decision has been
taken. A spokesperson for Bexley council, which was proposing a
care trust for older people’s services, said no decision had
been made there yet either.

South-west Hampshire partnership manager Pauline Owen said the
New Forest partnership was still committed to looking at a care
trust model, but that if the improved outcomes desired by service
users could be achieved using health act flexibilities without the
upheaval and cost of introducing a care trust then that option
would be followed instead.

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