Primary care trusts

PCTs sit at the heart of plans to devolve health care delivery and the development of services to local communities and to unify primary health and social care provision, commission, planning and development. They are freestanding, statutory bodies accountable to their health authority. They have the same overall functions as primary care groups (qv), which allows continuity of strategic plans developed for them. Since April 2004, PCTs have had responsibility for at least 75 per cent of the NHS budget.

The DoH consultation document, Shifting the Balance of Power Within the NHS, said: “[PCTs] will lead the NHS reorganisation for partnership working with local authorities and other partners.”

They are charged to work closely with other public agencies – much stress is currently placed on their close working with social services departments- to offer better health and better care. PCTs work to ensure co-ordination of planning and community engagement, integrated services, better support to practices and individual clinicians, better access, action to improve public health and bringing decision making closer to patients and local communities. However, PCTs are also involved with delivering the wider objectives for social and economic regeneration, and with Quality Protects, Sure Start (qv), community safety, and youth offending teams (qv).

PCTs have two “levels” – level 3 commissions services but does not deliver them but they do this with greater flexibility than level 2 PCGs. Level 4 PCTs bring together commissioning and primary care development with the provision of community health services. At this level the PCT can commission and provide services, run community hospitals and community health services, employ necessary staff (level 3 PCTs can only employ limited numbers of staff) and own property.

Other UK equivalents: Independent local health boards by April 2003 (Wales)