Key changes to the NHS reforms to widen clinical involvement in commissioning will not be written into legislation.

The government’s full response to the NHS Future Forum’s report last week said the requirement for commissioners to have a nurse and a hospital doctor on their governing bodies would “allow flexibility”.

The original wording of the bill would have left it up to clinical commissioning groups to decide their own governance arrangements.

The response said the government would seek amendments to the Health and Social Care Bill “to allow regulations to be made specifying certain core requirements for governing bodies”.

It said: “We propose to require, through such regulations, that, in addition to GPs, there must be at least two other clinicians on every governing body: at least one registered nurse and a doctor who is a secondary care specialist.”

This would mean the requirements on CCGs could be removed at a later date. The document said: “Including the detail of core governance requirements in regulations will allow flexibility for the approach to evolve over time in the light of experience.”

A Department of Health spokesman said: “There is no loophole and we will not go back on our pledge. Our full response to the Future Forum is absolutely clear that we will introduce regulations requiring at least one registered nurse and one doctor who is a secondary care specialist on everygoverning body. Regulations are legally binding.”

The document stressed that the “non-GP members” must not have conflicts of interest and do not necessarily need knowledge of local health services. “It is more important that the nurse and doctor on the governing body bring an understanding of nursing and of specialist care,” it said.

It also said since clinical senates and clinical networks will be “hosted” by the NHS commissioning board “they will not need to be provided for by amendments to the bill”.