Clinical commissioning groups (CCGs) may struggle to recruit hospital doctors as board members because the cost of their pay may be 'prohibitively high', the NHS Alliance has said.

A report from the NHS Alliance Specialists in Commissioning Network has warned that there is little clarity about levels of pay for specialist doctors on CCG boards.

It said the issue is likely to be 'complicated' because remunerating hospital trusts for specialist involvement on CCG boards could prove expensive.

CCGs are required to have a specialist on their board from outside their local area.

But the network warned that if specialists are offered the same rate of pay as nurses, lay members or GPs, trusts may not encourage senior specialists to take up the positions.

It also said early indications suggest specialists remain 'unconvinced' that their time would be best spent on CCG governance activity.

'Some specialists feel their knowledge and skills are better utilised by CCGs in discussions about commissioning for high quality local services, rather than trying to influence governance of CCGs outside their localities and clinical interactions,' the report said.

The network said the government must provide clarity on the purpose, role and responsibilities of specialists on CCG boards.

'If policy around inclusion of specialists in CCGs is not sensitively delivered or appears as unnecessary interference by GPs, it is unlikely to contribute to making the NHS reforms successful,' the report said.

GPC deputy chairman Dr Richard Vautrey agreed that clarity is needed on how specialists are to be paid. 'How specialists are remunerated depends on what we are asking them to do.

'If they are asked to take on lead responsibility or meet on a weekly basis, the costs could be more to be reckoned with.'