The NHS Commissioning Board is planning to redesigning its structure of local offices, and is considering having fewer branches than the 50 which had previously been expected.

The board had originally expected to have 50 “local area teams”, mirroring the current configuration of primary care trust clusters.

But a letter sent by chief operating officer Ian Dalton to PCT leaders this week said “things have moved on” since those plans were mooted. The board’s local divisions must avoid “crowding out” clinical commissioning groups, he said.

Mr Dalton wrote: “I do not expect to set a definitive rule on how many CCGs should relate to any local area team but will want to be convinced that the number is neither too high to enable strong relations to be built between senior leaders or so low as to create any sense that the board is ‘crowding out’ the legitimate role of the CCG.

“Current thinking is that each local area team should relate to a minimum of three CCGs.”

The letter, obtained by HSJ, says that over the past three months, “CCGs have continued to develop and we now expect to have fewer CCGs serving larger populations than we had anticipated”.

“It is important that we have a number of local area teams that gives CCGs real space and head room to take the local lead,” it adds.

The letter says that policy on the board’s responsibilities for direct commissioning “has also evolved”, and “given us better understanding of how these should be distributed across our geography”.

Mr Dalton appealed for PCT chiefs’ help in designing the local structures, which he described as an “important and urgent task”.

However, the board says there is no ideal model or geographical footprint for a local area team.

The letter also confirms that some of the board’s local area teams will carry out specialist commissioning and commissioning for public health services on behalf of others.

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