Primary care trusts provide a range of community services and contributeto the healthy schools programme, the teenage pregnancy programme andsupport GPs to improve immunisation rates.
Now they are to change in two ways. Trusts are to become fewer in numberbut bigger, and so reduce their running costs, and are to focus more oncommissioning than service provision.
The boundary changes will happen as soon as possible. A key principle isto achieve coterminosity, or matching boundaries, with the localauthority providing children's and social services. Yet in some areaswhere primary care trusts are already coterminous, they may still bemerged with others to reduce costs.
A loss of coterminosity with children's trusts in areas where it alreadyexists would threaten effective partnership working. Policy-making andstrategic planning would be less sensitive to local need and it would bemore difficult to share budgets.
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