The three CCGs in the Surrey Heartlands integrated care system could potentially be joined by East Surrey CCG to create a new CCG from April next year.

East Surrey CCG has been part of Sussex and East Surrey sustainability and transformation partnership – sharing an accountable officer with the seven Sussex CCGs – but is now aligning with the Surrey Heartlands CCG, as its main providers Surrey and Sussex Healthcare Trust and the local community provider First Community Health are expected to do as well.

A paper which will be considered by the three Surrey Heartlands CCGs tomorrow says: “After 18 months of working closely together across the ICS, the question of a merger seems to be the logical next step.”

East Surrey CCG joining the three – Surrey Downs, North West Surrey, and Guildford and Waverley – in a merged organisation would also be “logical,” it says. East Surrey CCG’s governing body is expected to discuss the potential merger on Thursday.

The three existing Surrey Heartlands CCGs already work closely together, including holding governing body meetings in common and sharing a joint accountable officer, Matthew Tait.

The paper lists the benefits of a merger as closer alignment with the county council’s structure around scrutiny and health and wellbeing, and potentially economies of scale for the larger organisation – mainly through reduced management costs, compared with multiple organisations with their own governance structures.

All CCGs are expected to reduce management costs by 20 per cent by April 2020, making mergers a popular option.

However, risks include a loss of local autonomy and clinical leadership, and dilution of membership engagement, the paper adds – but it points out the role that primary care networks and integrated care partnerships will play at locality level in the future.

East Surrey CCG is expected to transfer to the Surrey Heartlands ICS on 1 October this year – but any application to merge CCGs would need to be with NHS England by the end of September if it was to take effect in the next financial year. GPs are expected to vote on any proposals during September.