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Having read the documents, they are bureaucratic to the extreme. BUT with many £100s millions of public money flowing through these groups it would be naive to expect less. The quality and experience of CCG leadership will be critical. Moving from the current 50ish commissioning PCTs to nearly 250 CCGs will mean that there is insufficient of either. When we moved to 300 PCTs from 100 Health Authorities we failed to find sufficient talent and ruined many careers. The same debacle is about to happen again. It's a pity none of the NCB Directors have actually Commissioned with a significant budget, but I guess they know best!