PCT and SHA clusters will remain in place post April 2013 under a different name to retain financial control over GP commissioning, it is claimed.
Chris Calkin, Chair of the Policy Committee at the Healthcare Financial Management Association, said PCT and SHA clusters have to remain to ensure financial control of commissioning.
"The risk of putting all that money into the hands of GPs is not something that will be tolerated," he said.
"PCT and SHA clusters will need to perform checks and balances to ensure financial control is maintained."
Calkin argued that if the clusters do not remain and clinical commissioning groups (CCGs) underperform, it could lead to "stupid short-term decisions" being made, ie, further slashes to budgets.
"The clusters are needed to ensure the commissioning reforms are sustainable," he said.
A spokesperson from the Department of Health told MiP: "SHA and PCT clusters are a transitional arrangement and will be abolished in 2013, subject to the passage of the Health and Social Care Bill, when clinical commissioning groups (CCGs) will take over."
The DH claims the only situation in which the NHS Commissioning Board (NCB) – or its outposts – would retain financial control over CCGs would be if they failed the authorisation process or were authorised with conditions.
PCT and SHA clusters have been committed to the initial organisation of the NCB "being based on the same geographical areas as the four SHA clusters and 50 PCT clusters".
The same spokesperson told MiP: "This would not be a statutory tier, just a layer of the single organisation that is the NCB, which could change its arrangements over time."
Speaking at the Wellards Annual Conference held in the Royal College of Physicians yesterday (9 November) Calkin, who also serves as Finance Director for the University Hospital of North Staffordshire, expressed his concern that GPs are failing to see "the bigger picture" on how some of the larger hospitals in the UK are funded.
"It isn't the changes that are being made that I'm struggling with but the pace of change. We need time to reorganise," he said.
"We are not going to be able to complete this reorganisation in time for the CCG handover and that is what I'm worried about."