The White Paper put emphasis on joint budgets and joint commissioning and said the government would like to see trusts and councils elect joint directors.
The NHS Confederation, which represents PCTs, warned against more restructuring. Last month PCT numbers were cut from 303 to 152.
‘We are concerned about the scope to change the boundaries for local authorities,’ said Jo Webber, NHS Confederation deputy director of policy. ‘Recent experience of PCT restructuring has been painful and has hindered rather than helped trusts improve patient care. This was reflected in the recent annual health check. In any reorganisation, we must be certain that the benefits outweigh the costs.’
The White Paper, called Strong and Prosperous Communities, says: ‘The legislation will propose a new duty to cooperate for PCTs and local authorities, in order to enable local partners to achieve a truly integrated approach.
‘We would envisage responsibilities including the agreement of shared outcomes, a common assessment framework, single budgets (where appropriate), joint commissioning and planning and the delivery of joint targets.’
Ms Webber also warned that commissioning changes would have to involve GPs and must be jointly devised by councils and PCTs.
‘We must ensure that closer working relationships between local authorities and PCTs include clinicians,’ she said.
‘Practice-based commissioners need to be part of the equation. A recent Confederation poll of NHS PCT chief executives showed that only 25 per cent of respondents had processes that linked their practice-based commissioners into the joint commissioning process.’
The DoH will shortly begin a consultation on ‘the effective implementation of these partnerships’, the report says.
Local government White Paper