Senior hospital clinicians have criticised the white paper for overlooking the role of the acute sector in the commissioning of services for patients.

Jonathan Waxman, professor of oncology at Hammersmith Hospital, said commissioning services should not be left to GP consortia alone, as they “do not represent the whole of the health service”.

He said: “The NHS is a joined up health service and there should be input from hospital consultants and all the people involved in [the commissioning] of healthcare.”

Professor Waxman also warned that not all GP consortia would possess the skills necessary to effectively commission services for patients.

He said: “It is not within their abilities to know everything and I cannot understand how a GP would be able to know all the minutiae around oncology, for example.”

Royal College of Physicians president Sir Ian Gilmore agreed. He told HSJ it was vital that GP commissioners worked very closely with specialists.

“The success of GP commissioning will depend critically on how the consortia work through clinical engagement in the commissioning process, and the way they can work constructively with specialists in secondary care,” he said.

Sir Ian summed up the white paper proposals as “very radical plans with remarkably short timelines”.

Royal College of Surgeons president John Black said: “It could be that consultants in secondary care are not quite the commissioners, but they select where the super specialist, and regional and national specialties go.”