As promised in the Operating Framework 2010/11, the Department of Health has published further guidance on the options available to PCTs’ provider services, Transforming Community Services: The assurance and approvals process for PCT-provided community services, which can be accessed here.

Whilst the language used is not as categorical as some statements attributed to Sir David Nicholson previously, there are some clear hints. For example, whilst community foundation trust may still be an option for more than the six initial pilots, they are “not expected to be the norm” and SHAs were required to give the department their shortlist of community foundation trust candidates by 12 February, only one week after the guidance was published.

This fits with some commentators’ observations that the imposition of a 31 March 2009 deadline for PCTs to agree their plans with their SHAs, coupled with the disadvantages and risks associated with moving to a social enterprise, means that for most PCTs’ provider arms the only realistic option is to be acquired by an acute or mental health trust. There is also a sense that whereas the initial guidance stressed that the primary goal was to achieve better services for patients, the current guidance is as much about driving change in organisational form, to allow PCTs to focus on improving their skills as world class commissioners.