THE workforces providing community and elderly health care throughout Staffordshire will be merged by spring if a historic proposal by their bosses is given the go-ahead.

Under the plan, the 2,000-plus staff employed by the county's three primary care trusts (PCT) would be switched to the body currently running mental health in North Staffordshire.

But the move, bringing countywide NHS services together for the first time, is opposed by doctors who dubbed it "absolutely crazy" and said there is too little in common between North and South Staffordshire.

A shake-up is needed because the PCTs, Stoke-on-Trent, North Staffordshire (covering Newcastle and the Moorlands) and South Staffordshire, must offload their directly managed services such as community hospitals, district and school nursing and therapies in health centres and people's homes.

Instead the bodies will focus on purchasing mainly hospital-based care for their populations until their proposed abolition in two years' time.

Now all three PCTs have said they want to transfer the services to Combined Healthcare mental health trust based at the Harplands psychiatric hospital, in Hartshill.

Combined ran the same community services when it was created in the 1990s, but handed them over to the PCTs.

Combined's chief executive Fiona Myers told her 2,000 staff of the proposals yesterday.

She said: "I can confirm the proposed integration of the three Staffordshire PCT provider organisations with us to form a Community Foundation Trust, subject to approval.

"We are working with the PCTs to ensure we can continue to meet their future commissioning intentions.

"The pace of the proposed changes is unprecedented and I appreciate it will be an anxious time for everyone."

GP leaders fear the changes are being made so quickly they will end up as "a mess",

Dr Paul Golik, secretary of North Staffordshire's 280-strong Local Medical Committee, said: "Even though the PCTs will be replaced by GP consortia, we have had no input in this and by the time they appear deals will have been stitched up and it will be difficult to unpick them. It is doubtful whether it will bring benefits to patients and it will cause anxiety for staff."

George Wiskin, NHS North Staffordshire chairman, said he was comfortable with the south of the county joining the move so long as it retained a separate operating unit.

He added: "This would require a complete reorganisation of Combined, but it has a long tradition of running community services."

But Lorien Barber, director of North Staffordshire mental health users' group, said: "We would be concerned if there was any dilution of mental health services at Combined if it takes over all these extra community services."

Officials from Stoke-on-Trent PCT stressed distinct North and South County structures would be retained.

Chief Executive Graham Urwin added: "We recognise the importance of keeping a northern county health footprint in any proposals."

And South Staffordshire chief executive Stuart Poynor said his area would have a dedicated division within the countywide organisation.