A primary care group keen to move swiftly to primary care trust status has appointed a lay chair instead of a GP.
Doctors in Fenland PCG in Cambridgeshire decided not to form a majority on the board or take the chair in order to be ready for PCT status. The new organisations go live in April next year.
GPs in at least three other areas have rejected the opportunity to lead PCGs in favour of lay people.
But in most cases concern about 'drowning in paperwork' has been blamed for their reluctance.
Dr Rod Smith, president of the National Association of Primary Care, said many GPs would regret taking up chairs and places on the board. 'We will see many resignations, particularly if PCGs don't start delivering.'
In Cambridgeshire, only four out of seven PCGs are chaired by GPs, with two lay chairs and one nurse. North West Anglia HA was split between Cambridgeshire and Norfolk HAs on 1 April. Fenland PCG chair David Burall said: 'The HA, anticipating its disappearance, set up its four PCGs to go to PCT status early.'
He said the local community trust was also keen for PCGs to 'get ahead of the game' because an anticpated move to PCT status would be less disruptive and protect jobs. GPs were 'apprehensive' that forming a majority on the board or taking the chair would delay the move. Fenland PCG has only five GP members.
Mr Burall was previously a non-executive director of North West Anglia HA.
South Somerset PCG chair Keith Pearson said his members wanted 'an experienced manager' because 'the next couple of years are about managing change and taking us forward to PCT status'.
South Somerset still has two vacant GP places on the board, although members hope to recruit more GPs. The shadow PCG was chaired by a GP, but he stepped down and is retiring from practice.
In East Cambridgeshire, PCG chair Brian Ashton blamed GP reluctance to take the chair on 'a degree of scepticism' about the latest set of reforms and the bureaucracy that goes with them.
NHS Primary Care Group Alliance executive member Dr Ron Singer said lay chairs could 'stop GPs fighting among themselves for resources'. But he said lay chairs risked being 'ground down by lack of influence in the wider NHS'.
The fourth PCG to be chaired by a lay member is Breckland PCG in Norfolk, headed by Gillian Hickling.