As part of the English NHS programme of separating the provision of services from commissioning known as Transforming<unk>  Services a number of<unk> s were established when these services were separated from primary care trusts. This was one of a number of options taken. In some places<unk>  services were transferred to an existing mental<unk>  trust or hospital trust. In South West England there was considerable pressure for staff to establish social enterprises such as Peninsula<unk><unk>  to take on these services. Campaigners in Gloucestershire successfully challenged the decision to establish a social enterprise to provide<unk><unk>  services there in 2012. Contracts to run NHS<unk>  services are subject to competitive tendering processes under the<unk>  and Social Care Act 2012, so it is not clear whether these organisations will survive. The NHS<unk><unk>  services sector, not including mental<unk>  services is said to be worth £9.7 billion - about 10% of the entire NHS budget. This is the sector in which competition from private providers such as Virgin<unk> care and Serco is most intense. There is a great deal of pressure to move NHS services out of hospitals and into the<unk> , but up to now most of these services have been funded by block contracts. There are measures of activity but no outcome measures and no NHS tariff, so there is no financial incentive for providers to ensure services are effective. It remains to be seen what impact the instigation of Any Qualified Provider contracts will have on this sector.<unk>  services have been repeatedly reorganised since the abolition of district<unk>  authorities in 1996. Established as NHS trusts they were under the same imperative to become NHS foundation trusts as existing trusts, but it seems unlikely that many of them will be able to pass the tests in their present form.<unk><unk> care trusts may provide services including: *District nursing, including out of hours nursing<unk>  visiting *School nursing<unk>  physiotherapy *Speech and language therapy<unk>  podiatry
Community health trust
NHS trust
Public security
Nursing ethics
Good tissue practice
Mental health trust
Good clinical practice
Pharmacy management system