Exclusive: The number of clinical commissioning groups is reducing rapidly as managers step in to prepare them for authorisation.
A Pulse investigation reveals the number of CCGs has fallen by at least 40 in the past six months. There are now 227 groups after a spate of recent mergers, which included the CCG of one of the Government's most senior commissioning advisers.
The NHS Operating Framework for 2012/13 instructed SHA clusters to resolve ‘outstanding configuration issues' by the end of this month, but GPs on the ground have claimed their freedom to decide locally is being sidelined.
SHAs contacted by Pulse revealed a number of recent CCG mergers, particularly in the North West, London and the West Midlands. There are at least 40 fewer CCGs than in the last wave of pathfinders in October, and SHAs are continuing to broker mergers in other parts of the country.
Dr James Kingsland, national lead for the NHS Clinical Commissioning Community and president of the National Association of Primary Care, said his own CCG had been forced to rethink its opposition to an SHA instruction to merge with two other CCGs on the Wirral: ‘If we hadn't agreed we wouldn't have been authorised, so what can you do? ‘In a battle there would only have been casualties.'
The smallest CCG in England is still waiting to hear its fate after refusing an SHA demand to merge with a neighbouring CCG. Dr Mike Ingram, chair of the Red House Group CCG, which covers three branch surgeries in south Hertfordshire, said: ‘This contradicts the rationale behind these reforms, to devolve decisions locally'.
Current numbers of CCGs
North East 13
North west 34
Yorks and Humber 24
East of England 26
East Midlands 20
West Midlands 27
South central 18
South east coast 19
South west 14
London 32
Source: Strategic Health Authorities
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