NORFOLK'S community healthcare services from school nurses to physiotherapy could be provided by one of the first foundation trusts of its kind in the country.

NORFOLK'S community healthcare services from school nurses to physiotherapy could be provided by one of the first foundation trusts of its kind in the country.

The idea of Community Foundation Trusts (CFTs) was once described by former health secretary Frank Dobson as “crackers” but has been enthusiastically backed by NHS Norfolk's board and staff. The Norfolk and Norwich University Hospital and James Paget University Hospital in Gorleston are already foundation trusts, which means they have more involvement from local members, more independence and the ability to borrow money from the private sector. But the first CFTs in the country are only just getting off the ground as six pilot schemes, and Norfolk could be in the next wave of four to join them.

The move comes because primary care trusts have to separate the commissioning or paying for services from the provision of services. So NHS Norfolk has set up Norfolk Community Healthcare, which provides everything from school nurses and health visitors to district nurses, physiotherapy, speech therapy and sexual health. But they have to decide what kind of organisation it is, and yesterday's board meeting chose a CFT.

But there were warnings that the process could be a long one, as local hospitals have discovered. The earliest date a CFT could be set up is April 2011, and if it should fail in its bid its future shape is left uncertain.

Ian Mack, a GP and clinical executive member, said: “It is very disconcerting for patients to know there is another reorganisation going on. Most GPs want reassurance that services will be continue to be delivered.”

Chairman Sheila Childerhouse said: “I think it will mean that we continue to raise the standards and quality of the services we have got. It is not about the process, it is about continually driving standards up. It is not going to be a major reorganisation like patients and staff have had to deal with in the past.”

Yesterday's meeting also approved integrated working with social services, which was also approved by Norfolk County Council's cabinet on Monday. The local teams will work together to focus on people most at risk and try to keep them out of hospital or care homes. The pilots are due to run in six areas of Norfolk, not including Yarmouth, but no date has been set. There are hopes that the scheme will be chosen in March as part of a national programme on integrated care, which would give Norfolk the chance to set an example for other areas as well as learn from others.

County councillor Tony Moore said: “The problem with integrated care is that the doctor is free, but social services are not free.”