A second wave of 67 clinical commissioning groups (CCGs), serving 18 million people, has received approval to take control of National Health Service budgets, though the majority have been authorised with conditions.

Just nineteen of the 67 CCGs - which have been through a five-month vetting process - met all 110 authorisation criteria, leaving 45 deemed in need of "formal support" to help them achieve the needed level, the NHS Commissioning Board (NHSCB) said.

Three CCGs – NHS Nene CCG, NHS Herts Valleys CCG, and NHS Medway CCG - were found in need of level four support, which means that they have been authorised to take control of their commissioning budgets but with more intensive help, to be provided by the NHSCB or neighbouring CCGs and will be underpinned by legally binding instructions.

Still, Dame Barbara Hakin insists that CCGs have "made fantastic progress in a very short time", and that "the vast majority of these 67 new organisations have demonstrated excellence and a very high level of achievement and are clearly ready for the challenge of leading their local health communities in partnership with the public and with local partner organisations". 

"It has always been clear that some of the new organisations would be at different stages to others, often dependent on their previous commissioning activities," and the NHSCB "has the mechanisms in place to give them all the support they need and we can assure the communities in these areas that health commissioning will be done to the same high standard as elsewhere", she said.

The first group of 34 CCGs was approved for operation in December, and the remaining 110 to be authorised are expected to be given the green light in waves three and four over the next two months, so that, by April, a total of 211 local groups will take control of £65 billion of the NHS' £95 billion commissioning budget. 

The Board is keen to stress that the development and improvement of all CCGs will continue past April. "Authorisation is just the beginning: these new organisations will continue to develop, and I am confident patients will start to see real benefits in their local areas as CCGs begin to realise their potential," Dame Hakin said.