Commissioning chiefs in south west London are proposing to share an accountable officer in a bid to streamline decision-making and cut costs.

Leaders in Kingston, Merton, Richmond, Sutton and Wandsworth clinical commissioning groups are drawing up proposals to work collectively under a single leader. However they are not proposing a full merger.

Neighbouring Croydon CCG will retain separate management accountability and local delivery arrangements.

A spokesman for the six CCGs said they would need to work more closely together to realise their “ambitious plan” for south west London.

He said: “There are significant benefits from working collaboratively at scale across south west London, particularly in relation to acute service strategic commissioning and contract arrangements”.

However Croydon would remain separate to focus on its challenges in becoming a “sustainable health economy in the future”.

All six CCGs will keep their chairs.

From April 2017 a single accountable officer will cover four CCGs: Kingston, Merton, Richmond and Wandsworth. By April 2018 the accountable officer will also cover Sutton CCG.

Documents seen by HSJ show a major concern for all six CCGs is “returning the system to financial balance”.

Sustainability and transformation plan documents from June say that under a “do minimum” scenario, the combined, underlying deficit in South West London and Surrey Downs could rise to approximately £600m per year by 2020-21.

Under that scenario, growth in demand would require an estimated 454 additional beds in the local system by 2020-21.