GP commissioners feel a "lack of engagement" with the development of the new urgent care NHS 111 scheme.
An NHS Alliance survey found only 11% of clinical leaders have experienced "good engagement" and felt their view was taken into account in the development of the new urgent care services.
Over 30% said there has been "some" GP engagement but that they had "no real ability" to affect decision-making.
Three-quarters of respondents also feared NHS 111 is in danger of becoming "lost in translation" as they said there is "little scope for local clinicians to shape the service to meet local needs."
"We remain supportive of the [NHS 111 scheme] and want to work in partnership with the Department of Health and other national partners to ensure that local commissioners are actively involved in its development," said Rick Stern, Urgent Care Lead at the NHS Alliance.
"However, our members currently feel disengaged and believe there is little room for local flexibility. We need to take steps to address this now, otherwise both the 111 programme and the credibility of local clinical commissioning will suffer."
The NHS Alliance has called upon the DH to make more of an effort to encourage local CCGs to take more active leadership of the process for introducing NHS 111.
The representative body has also prompted CCG leaders to stand up against being forced to support a regionally-determined urgent care solution that doesn't meet their local needs.