Clinical leaders are being excluded from strategic decision making in one in ten primary care trusts (PCTs), the national Professional Chair Conference has found.
Another one in five PCTs have no professional executive committee (PEC) in place, a month after the final guideline deadline.
The NHS Alliance survey has found that in 23% of PCTs, PECs have no real involvement in commissioning and in a quarter of PCTs, PEC members have no specific lead roles.
Nearly two thirds of PEC chairs say there are poor links with their Strategic Health Authorities (SHAs).
Peter Reader, NHS Alliance national lead for clinical leadership, said: "There is a massive variation across the country in how PCTs and SHAa are approaching clinical leadership.
"We are still too often seeing managerial/clinical tribalism along with worrying indications that clinical leaders are being sidelined undervalued and undermined.
"The best should show the rest how it should be done. Fast."
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