Of the 16 care trust demonstrator sites
announced by the government last year, only four are expected to go
live in April 2002.
Three of the sites – Manchester, Bradford, and
the joint Camden and Islington site – are all in the process of
submitting formal applications to create mental health care trusts
from April, based on existing mental health partnerships.
Meanwhile, the fourth, Northumberland, has
submitted a formal application proposing a care trust responsible
for providing or commissioning most health services and all adult
Northumberland care trust project team member
Lucy O’Leary said: “With the changes in the NHS organisations
coming in, clearly we were going to have to do something. 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 time
scales became clear.”
However, the same NHS re-organisation – which
includes primary care groups moving towards primary care trust
status, replacing the 95 health authorities with 28 strategic
health authorities, and substituting NHS regional offices with
regional directors of health and social care – have caused other
demonstrator sites to put on the brakes.
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”.
The council’s assistant director of adult
services, Graham Pearson, cited the lack of Department of Health
guidance and insufficient clarity over how the care trust would
work within a restructured NHS as reasons for the withdrawal.
Meanwhile, Birmingham, whose two potential
care trusts – one covering mental health and one covering learning
difficulties – had been included on the DoH’s list of demonstrator
sites, has insisted that no decision has been taken.
And Bexley Council, which was proposing a care
trust for older people’s services, also said no decision had been
South West Hampshire partnership manager
Pauline Owen said the New Forest partnership was committed to
looking at a care trust model, but that if the improved outcomes
desired by service users could be achieved using Health Act 1999
flexibilities without the upheaval of introducing a care trust then
that road would be followed instead.