STRUCTURE: The smallest pathfinder clinical commissioning group in England has been given less than two days’ notice to merge with its neighbours.

The Red House Group CCG, which covers a group of three Hertfordshire surgeries and a population of just 18,900, received an ultimatum from the Midlands and East strategic health authority cluster, on 28 February.

The SHA cluster said: “The SHA cannot support the Red House Surgery in its ambition to become a CCG in its current configuration.

“As you are very aware your current configuration does not meet the requirements of the Health and Social Care Bill and therefore authorisation will be very unlikely… the SHA do not feel assured that the practice has taken the actions required to resolve the configuration issues despite both the PCT and the SHA providing recommended actions and offers of facilitation.

“We will therefore make the recommendation to the Department of Health that you are deemed to be an unaffiliated practice as of 1st March 2012.”

Under the GP contract for 2012-13 agreed late last year, all GP practices must be affiliated with a CCG.

The letter, sent as an attachment to an email, continued: “If the practice decides in the meantime to start discussions with the Herts Valleys CCG and reaches an agreement to join them, please inform both the PCT and the SHA immediately.”

Although the letter was dated 17 February, the file was created on 28 February. The Red House Group said it received it for the first time yesterday, and had not been sent a paper copy earlier.

An SHA spokeswoman said it was a “simple admin error” and the date should have read 28 February.

Red House chair Mike Ingram told HSJ: “We are robust, developing new services and we have an enormous amount of co-operation with our local population – we have a strong record of innovation and delivering under budget.”

He added that he would walk away from commissioning altogether unless the group was allowed to remain an autonomous sub-group of the Herts Valleys CCG.

“If we’re going to be stopped from succeeding, we have better things to do with our lives,” Dr Ingram said.

“The only saving grace of the NHS reforms was that local GPs will be able to streamline and improve healthcare. But an example is being made of a small CCG which has been successful… that’s the one being scuppered.”