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At the heart of general practice since 1960

Acute trusts to compete with GPs

GPs warn that 'predatory' behaviour by hospitals could put practice-based commissioning at risk

Acute trusts will be allowed to bid to take over community services as part of the next tranche of Government NHS reforms.

Community foundation trusts will also be established and may take over PCT-provided services, a Department of Health official has revealed.

Speaking at a practice-based commissioning seminar held by Avon LMC, Andrew Sanderson, a member of the department's policy and strategy directorate, said acute and ambulance trusts could take a greater role in primary care.

But he added that this would not stretch to taking over 'list-based general practice'.

Despite the reassurance,

GPs warned that 'predatory'

behaviour by hospitals could put practice-based commissioning at risk.

Dr Richard Vautrey, GPC

negotiator, said the outcome could be a more centralised

service as acute trusts aimed to shore up their own services. He said: 'The department needs to be very cautious.'

Mr Sanderson said the department was already working with some PCTs on establishing community foundation trusts.

The policy was a way to 'change the pattern' of service provision and help shift services out of hospitals and into the community, he added.

Mr Sanderson said: 'A foundation trust is just a generic way of running an NHS organisation. It might look like the current PCT provider function or might be a way of redrawing the boundaries.'

Community foundation trusts would be 'firmly within the NHS' and would not force people to transfer out of NHS pensions, he added.

Monitor, the regulator for hospital foundation trusts, would also cover community trusts and ensure only 'high performing applicants' were

selected, Mr Sanderson said.

Dr Mike Dixon, NHS Alliance chair and a GP in Cullompton, Devon, said there was a clear agenda for PCTs to devolve

provision of services. Where GP practices did not tender for them, others, including foundation trusts, were bound to

apply, he said.

He said: 'It depends a bit on the GPs themselves, it depends a bit on the facilities and it

depends on the backers they can get.'

Steve Mercer, chief executive of Avon LMC, said community foundation trusts and others must not expect to be delivering services in 'sacrosanct, ring-fenced, guaranteed ways'.

hcrump@cmpmedica.com

• For practice-based commissioning advice, go to searchmedica.co.uk

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