STRUCTURE: The chief executive of the NHS has said the formation of clinical commissioning groups in south Essex could lead to “fragmentation”.

Following an assurance meeting with NHS East of England, Sir David Nicholson wrote to the strategic health authority. He said a department of health panel “heard about some boundary challenges which had occurred as a result of the formation of consortia”.

The letter said: “This seemed particularly pronounced in south Essex where consortia crossed local authority boundaries which has the potential for the fragmentation of delivery. Further work will be needed to ensure that the quality of services are maintained in this new environment.”

The government’s response to a review of the NHS reforms by the NHS Future Forum said consortia, now called clinical commissioning groups, should not normally cross local authority boundaries.