Under the DoH's Transforming Community Services reforms, PCTs are expected to draw up plans to outsource the work by the end of March.

The plans have raised fears that general practice could be threatened by a drive towards 'vertical integration' of community and primary care services with hospitals (GP, 5 February).

David Stout, director of the NHS Confederation's PCT Network told a King's Fund conference in London last week that 25 per cent of PCTs were considering integrating their community services provider arms with an acute trust.

He said 15 per cent may transfer the service to a mental health trust, and 15 to 20 per cent could hand over services to local government or primary care. But he said no PCT had 'cracked what the organisational structure would be'.

Around 8 per cent of PCTs are looking to set up community foundation trusts, while a 'smattering' were looking to create social enterprises or retain their provider arm, he said.

NHS Alliance chairman Dr Michael Dixon said: 'This situation angers me because acute trusts are the wrong place to put community services.'

Dr Richard Vautrey, deputy chairman of the GPC, said: 'There are big risks of vertical integration of community services with acute trusts. Practices are concerned that services are becoming more remote.'

Community Services
Most popular options for changing community services 25 per cent of PCTs could integrate services with hospital trusts. 15 to 20 per cent may integrate services with local government or primary care. 15 per cent may transfer services to mental health trusts. Source: PCT Network