PCTs are NHS organisations that work at a local level to commission and provide healthcare for people living and working within their boundaries. NHS Ealing has a budget of roughly £509 million and is responsible for the NHS healthcare of the 315,000 people in Ealing. Commissioned HealthcareHospital Trusts provide the better known NHS services, such as Accident & Emergency, and operations such as heart by-pass or cancer removal. Mental Health Trusts also provide specialist care, either in hospitals or in the community.The PCT's commissioning role means it must identify the treatment local people are likely to need and provide money to the trusts to help pay for the care they offer. Primary CareThe primary and community health services which people have most regular contact with come under these headings. GPs (family doctors) Therapy and rehabilitation Community nursing (district nurses, health visitors, school health advisers, specialist nursing) Counselling services Children's services Palliative care Learning disabilities Hospital treatment Dentists Pharmacies (chemist shops) Opticians The Government created Primary Care Trusts to give more of the decision-making power to local NHS staff and the communities they serve.Different parts of the country have different health needs. Primary Care Trusts, with their own budgets, are in a better position than previous NHS organisations to direct money where it is most needed.