Tackling organisational change in the new NHS

This is the first in a series of five articles The organisational centrepiece of the Labour government's reforms of the NHS was the establishment of 481 primary care groups in England in April 1999 and their anticipated progression to trust status. 1 2 For the first time since the founding of the NHS in 1948, primary and community health services have come together in a single organisation that controls a unified budget for delivering health care to and improving the health of communities of about 100 000 people.3 Although they will initially operate as subcommittees of health authorities, they will become freestanding primary care trusts as they show that they can manage budgets and services. As trusts they will have full control of their budgets and be responsible for providing and managing a wide range of community based services as well as for commissioning hospital services on behalf of their patients. Seventeen trusts were established in April 2000, a further 23 in October 2000, and 124 in April 2001. It is anticipated that all groups will become fully fledged trusts within the next two years.4 #### Key points of the NHS plan #### Summary points The establishment of primary care groups and trusts in England …