Dr Michael Dixon, chairman of the NHS Alliance, said the recommendation has been made in a bid to save money and could result in redundancies across community services.

Dr Dixon said he had received reports from many clinicians and managers in PCTs that suggests they are being instructed to see the vertical integration of community services in acute hospitals as the ‘preferred option'.

'PCTs are being told they cannot delay in making decisions, and will have to put plans in place by the end of March,' he said.

'The explicit reason for the move is that the NHS is going to have to save an enormous amount of money over the next couple of years, and this is a quick financial fix,' Dr Dixon added.

A DoH spokeswoman said the goal of making these changes is to achieve services that are ‘increasingly integrated' in an attempt to ‘improve quality and productivity'.  

She added: 'The format which most effectively delivers this outcome is best shaped locally in discussion with local partners.'