The NHS Commissioning Board (NHS CB) appears to have given CCGs permission to broker money between each other to fund transformative care.

John Appleby, Chief Economist, Health Policy at the King's Fund, said how a CCG funds individual service redesign "is up to them".

A spokesperson at the NHS CB seems to agree.

When asked whether its view on CCG brokering arrangements, they said: "CCGs will be statutory bodies who will receive resources via the NHS Commissioning Board. We expect them to have appropriate collaborative arrangements in place to help them commission the best services for patients."

Appleby said the message from the NHS CB is that CCGs will be free to "get on with the job" free from too much red tape.

"I don't think anyone wants any bureaucratic arrangements to get in the way of patients benefiting from new or enhanced services," he said.

"Whether funding arrangements are official or ad hoc, in the end it doesn't matter."

He, however, notes a hint of caution to those CCGs planning to pool the majority, if not all, their funds. He claims such CCGs will have to reconstitute themselves as a single organisation.

Former Labour MP for Dartford, Bexley CCG Chair Dr Howard Stoate hopes for a fluidity of funds between neighbouring CCGs to cover end of year positions and 'overlaps' in services.