Our map reveals the new shape of the clinical commissioning group landscape following a wave of 74 mergers confirmed for April this year.

NHS England has approved the merger of 74 existing CCGs to establish 18 new ones.

It means the total number of CCGs is due to fall from 191 to 135 — a 29 per cent drop.

There is substantial variation in the number of existing CCGs merging to form a single new group. Kent and Medway Sustainability and Transformation Partnership is merging all eight of its commissioning bodies into one.

At the other end of the scale, the new Northamptonshire CCG will be formed by merging just two CCGs, as will County Durham CCG.

Three CCGs combining into one is the most common, with six new CCGs each being formed from three predecessors.

NHSE has given all the merging groups conditions which must be met before they can go ahead, but these are widely expected to be met.

All CCG mergers are subject to two conditions: approval of the new CCG’s constitution by NHSE and filling legally required leadership roles within the new CCG.

Other conditions vary according to individual mergers, but typically include having a chief officer in place which NHSE approves of and having robust financial and operational plans.

Last week’s planning guidance reiterated NHSE’s intention that it wants all developing integrated care systems to be actively “streamlining commissioning arrangements, including typically one CCG per system”.

It added: “Formal written applications should be made at the latest by 30 September 2020 for a merger which is proposed for 1 April 2021.”

Outgoing NHS Clinical Commissioners chief executive Julie Wood said in an interview with HSJ last month she expected the final CCG tally to “fall between 60 to 80 CCGs” — and warned that NHSE’s ambition of one CCG per ICS “will not work for all systems”. There are currently 42 ICS and STPs.

NHSE has confirmed to HSJ no further mergers were under consideration for this April.