Clinical commissioning groups (CCGs) are in danger of becoming the bottom tier of the commissioning hierarchy, warns the NHS Alliance.
The representative organisation has called upon the government to ensure CCGs are fully involved in authorisation processes and modernisation plans.
The NHS Alliance recommends the authorisation process become a dialogue rather than an "arms length assessment" and that there should also be a dialogue in relation to the roles and responsibilities of the NHS Commissioning Board (NCB).
Bodies – such as the NCB/PCT cluster – are also reminded they should work with and support CCGs who are not ready, rather than taking over their commissioning responsibilities, said the NHS Alliance.
Dr Michael Dixon, Chairman of the NHS Alliance, said managing CCGs through PCT clusters "puts CCGs at arms' length" from the NCB, placing them in the periphery and at the bottom tier of the commissioning hierarchy.
"CCGs will play a crucial role in the new NHS and there needs to be a lot more dialogue between them and the centre regarding their authorisation and implementation," said Dr Dixon.
"At the moment, it seems that they will be put in a position where other bodies will be telling them what to do, which goes against the government's commitment to put 'CCGs at the heart of modernisation plans'."
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"The standalone professional culture of working in the NHS has to change if the proposed changes are to work. All health interest groups should be involved in the consultation and all aspects of the commissioning process. No one body should dominate as health itself is complex and should be seen and treated holistically if outcomes are to be achieved and changes made to work for the benefit of all of us" – V Henry, London