Primary care trusts (PCTs) provide a broad and complex range of community-based services. However, the commissioning and management of these services have been a challenge for the NHS and in particular for PCTs. As PCTs provide community health services, there is a potential conflict of interest for their role as commissioners. The government is clear that PCTs need to separate their provider and commissioning functions. This report examines the issues surrounding the placement of community health services, the options proposed for their reorganisation, and the steps that must be taken to deliver the desired transformation in community health services.