News

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 social services.

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 made yet.

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.