Councils in London are seeking to strengthen links with primary care trusts in response to the threat of more sector level commissioning.
PCTs have agreed to commission some services - primarily acute - jointly in five geographical groups, despite opposition from some boroughs.
But as councils take over commissioning some services formerly procured by PCTs, further sharing of functions between PCTs may become possible.
Former health secretary Alan Johnson and former NHS London provider agency chair Lord Warner are among those who have suggested full PCT mergers are needed.
Lobbying organisation London Councils leaders’ committee has approved a document which encourages all boroughs to develop proposals for borough level health commissioning.
Hammersmith and Fulham council and PCT have a joint chief executive, and merging functions. Authorities in Richmond were due to meet to decide this week between options, including full merger.
The London Councils document says some changes in the NHS have “caused concern” about centralisation and the time allowed to discuss the changes.
“It appears that local government could have had more influence if it had been in a position to offer its own proposals for the design of borough level commissioning, rather than responding to NHS plans.”
London Councils corporate director for policy and public affairs Dick Sorabji said boroughs needed to ensure “they are part of the solution, not pushed out”, as healthcare commissioning arrangements change.
Richmond council director of adult and community services Cathy Kerr said: “If the community commissioning functions of the PCT were to go into sector commissioning arrangements, this would be a real missed opportunity for local people and is something I suspect the council could not support.”