STRUCTURE: The current configuration of clinical commissioning groups in Birmingham and Solihull, Black Country and Arden present a significant challenge on the basis of their “size and geographical coherence”, according to NHS West Midlands.

Discussions have commenced with those considered to be high risk, the strategic health authority’s handover document states.

The SHA is actively working with PCT clusters to ensure emerging CCGs are best placed to be fully authorised without conditions by April 2013 if they wish.

The SHA is also supporting emerging CCGs to consider future financial requirements of a statutory organisation to enable them to factor this into configuration plans.

There remains a risk, however, that emerging CCGs in areas with significant service reconfiguration or issues of quality are unable to deliver the strategic change programme required. This risk is being mitigated.