News about the NHS’s new commissioning system is surfacing across the North East, Yorkshire and the Humber, reflecting discussions across England.

Readiness for commissioning consortia to take over varies significantly from area to area.

In Leeds, three separate commissioning groups - H3Plus, Leodis and Calibre - have been recognised as a single “pathfinder” consortium. Their situation reflects the huge uncertainty across England about the final size of consortia: will these three formally merge into a larger group, or form a looser partnership, or remain small and steadfastly independent?

The GPs that form the Leeds consortia are due to take responsibility for all non-elective commissioning from April. But they only cover 80 per cent of the Leeds population. As in all other parts of the country, some practices have yet to be drawn into emerging consortia, and some are resisting.

Over in North Lincolnshire there are apparently no confirmed consortia with members or leadership, but, according to the primary care trust, GPs are hoping to “move forward as a single unit”.

In neighbouring North East Lincolnshire, the PCT-wide group of GPs has already won pathfinder status.

Even as consortia tentatively develop, their leaders are being asked to involve themselves in enormous cost saving plans.

In Wakefield, consortium leads are involved in agreeing the main acute contract for Mid Yorkshire Hospitals Trust - including the ominous “whole system” change of “decommissioning/exclusion” and service redesign.