A series of NHS "super-trusts" are to take over social care of the elderly from local councils as part of plans to free hospital beds for patients who really need them.

A series of NHS "super-trusts" are to take over social care of the elderly from local councils as part of plans to free hospital beds for patients who really need them.

Alan Milburn, Secretary of State for Health, will announce on Thursday that the national plan for the NHS will dismantle the barriers between the health service and local authority controlled social services. A key element of the plan will be "super trusts" in which social and health service budgets are pooled to produce an integrated programme for the care of mainly elderly people.

Although wary of upsetting council leaders, Mr Milburn is determined that the NHS will take the lead on the issue to ensure the smooth transfer of patients from hospitals to the community. He will warn that unless better co-ordination can be achieved, the social services may in the long term have to be taken over completely by the health service.

Mr Milburn has been alarmed by figures showing that up to 5,500 hospital beds are filled by patients who are ready to be discharged but cannot leave because care outside is not available. So-called "bed-blocking", which is thought to cost the NHS up to £250m a year, means that waiting lists and times for operations are kept artificially high.

Research by the Department of Health has found that more than 75 per cent of such patients are left in hospital because of poor liaison between trusts and local social services. Ministers have concluded that councils are often at fault for failing to assess elderly patients' needs for residential care.

Mr Milburn confirmed yesterday that the national plan, which will include schemes to recruit 40,000 more doctors and nurses as well as give a £400m boost to GPs' surgeries, would make the NHS a more "patient-centred" service.

"We have got to do away with the divisions between health services and social services, because that means that elderly people don't get out of hospital quickly enough when they are ready to leave," he told the BBC Television's Breakfast with Frost programme

The Commission for Health Improvement, which hasbeen set up to monitor the performance of hospitals, will be ordered by Mr Milburn to assess the discharge rates from each hospital. GPs will be offered financial incentives to develop intermediary care, as well as rapid response and rehabilitation teams for patients leaving hospital.

Mr Milburn will confirm that all social workers will have to undergo re-registration every few years to prove they are up to the job. The move, which echoes new schemes to re-register doctors to improve performance, will be accompanied by an overhaul of training for social workers.

To break down the barriers between health and social care, new "multi-skilled care workers" will act as personal carers for people in the community. A new type of "specialist older people's nurse", able to work across the health and social care boundary, is also envisaged.