The government has announced the identity of the first nine care
trust pilots sites and confirmed that a further 29 areas are still
under consideration, writes Lauren

At an initial meeting of representatives from the nine selected
areas, health minister Jacqui Smith said she was encouraged by the
level of interest – far higher than early reports had suggested –
and confirmed that care trusts were here to stay.

“Where we need the extra organisational links that care trusts
bring, this is clearly the system to develop,” Smith said.

She added that care trusts would be key in the development of
the kinds of integrated services outlined in the national service
frameworks for older people and for mental health.

However, she acknowledged that the voluntary care trusts,
brought in under the Health and Social Care Act 2001, would not be
suitable in all areas of the country or for all types of

As expected, the nine pilot sites focus predominantly on mental
health services and services for older people. Partners involved
represent the range of different local authority and NHS

Smith acknowledged that closer working between health and social
services would raise issues around different staff terms and
conditions which the pilot care trust boards would need to resolve
before going live from April next year, but ruled out the need for
a “common employment framework”.

“Clearly there will be issues in terms of human resource
management that the boards will have to consider when they are
thinking of staffing,” she said. “But this does not mean that the
logical step is that we have to do away with different terms and

Following recent references by prime minister Tony Blair and
health secretary Alan Milburn about potential private sector
involvement in NHS management, Smith said she “would not see care
trust boards as areas for private management”.

Andrew Butters, chief executive of Manchester Mental Health
Partnership – on which one of the pilot care trusts will be based –
said that care trusts would be a way of managing integration after
the demise of health authorities in April 2002.

“Care trusts are designed to accommodate all the parties that we
need to actually make this sort of service work,” he said. “They
will allow users and carers to sit at the highest level and that is
very, very important in the field of mental health and learning

Pilot care trust sites:

Bexley (older people)

Manchester (adult mental health)

Essex (Housing, focusing on older people)

Camden and Islington (mental health)

Sandwell (mental health)

Bradford (mental health)

Brighton & Hove (vulnerable client

North Somerset (wide number of client

North West Surrey (mental health and learning

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