Only three formal recommendations have been made by clinical senates since their formation, and only two of these have related to clinical matters HSJ has learned.

Twelve of the organisations were set up in April last year under the government’s Health Act reforms, with the intention they would use clinical expertise to advise commissioners on service change.

However, by the end of the year, two had not met at all, three had met only once, and three met twice. Two clinical senates had met three times by the end of 2013.

The senates for London and London and West Midlands met on four occasions.

NHS England’s national lead for clinical senates David Levy said in these two areas there were “senate-like structures” in place before these were introduced meaning “it was possible to move to a formal senate structure more quickly”.

No meetings have been held in public.

Dr Levy said clinical senates were “an important part of the new health landscape”. He added: “However, in much of the country they are new and novel structures and it has taken time to engage the new bodies.”

NHS England said running senates and strategic clinical networks, which they are linked with, cost more than £42.6m in 2013.

Information released to HSJ shows senates have made only three recommendations so far, and one related to administrative issues.

In one of them, West Midlands clinical senate made a recommendation about acute hospitals in Worcestershire in January. It advocated creating a “networked emergency centre” at the Alexandra Hospital and a “major emergency centre” at Worcestershire Royal Hospital.

Wessex Clinical Senate last year reviewed specialised vascular services in Hampshire, recommending the centralisation of surgery in Southampton.

No formal recommendations have been made in London, but the clinical senate is currently reviewing proposals for specialist cancer and cardiovascular services in north and east London and west Essex.

Labour peer and former health minister Lord Hunt said he was “very disappointed” with the lack of progress so far.

He said in Parliamentary debates over the Health Bill, which led to the introduction of senates, “the presumption was they would play a key role in overseeing the configuration of services” and would be a “counterbalance to the introduction of a more marketised [service]”.

Lord Hunt said it was “extraordinary” no clinical senates met in public as “these are public bodies… the people who serve on them are public servants”.

Academy of Medical Royal Colleges chair Terence Stephenson said senates were needed as the “regional geographical tier [between] the national body NHS England and CCGs”, but that “no one’s clear what they’re doing or the added value they provide”. He said: “I’m someone who lives and breathes this stuff and I’m not sure.”

The academy has discussed with NHS England the possibility of it co-ordinating clinical advice nationally for around £1m per year, but this has not yet been agreed.