GPC contracts and regulations subcommittee chairman Dr John Canning told GP: ‘Pathfinder consortia need very clear agreements about what they are responsible for, how they arrange it and how they protect themselves.’

He said consortia would be forming potential unofficial partnerships with PCTs, and need written confirmation that individual GPs would not be at risk if patients claimed they had been denied treatment because of consortia commissioning decisions.

‘You need a clear set of principles about how PCTs share powers, devolve budgets and what the arrangements are,’ Dr Canning said. ‘These have to be written down in case of disputes – if you are being delegated powers there has to be a formal accountability agreement.’

He added that as PCTs were wound up, the NHS faced a period of ‘unmanaged change’. ‘That is potentially dangerous,’ he said.

He urged consortia to watch out for short-term PCT decision making. ‘All sorts of things could appear through the slots in the system that could leave nasty messes,’ Dr Canning warned.

The DoH is expected to set out its vision for consortia in more detail on Wednesday in the NHS operating framework and its formal response to the consultation on the NHS White Paper Liberating the NHS.