NHS England is considering giving clinical commissioning groups two year allocations from 2014-15, to enable them to transform services and plan efficiency gains over a period of more than a single year, HSJ has learned.

A letter sent from NHS England to CCGs on the day of the spending review says: “It is NHS England’s intention to explore the scope to give CCGs two year allocations for 2014-15 and 2015-16 to support commissioners to deliver the changes required in the NHS to realise the necessary efficiencies.”

It is not yet clear whether the second year’s allocation will be a definite figure, or if it will be an indication for the sake of planning, which could be subject to change.

Johnny Marshall, director of policy at the NHS Confederation, said that when flat budgets were predicted for the foreseeable future, two year allocations could allow CCGs to make investments in the first year without needing to declare a deficit, as long as that investment paid off during year two.

Dr Marshall added: “My question would be, if every CCG in the country made an investment in the first year, where is the extra money coming from in year one?”

The letter also says the creation of the £3.8bn integration fund will mean the average CCG loses £10m of its allocated funding to the pooled budget, on top of reablement and carers’ breaks funding that is currently within its allocation.

This amounts to around 3 per cent of CCGs’ total allocations.