The requirements for CCG 'authorisation' are outlined in a draft DoH document, Developing clinical commissioning groups: Towards authorisation.
By April 2013, the whole of England will need to be covered by established CCGs, the document said. By this date CCGs will either be fully authorised and commissioning or operating as 'shadow' CCGs with commissioning responsibilities taken on by the NHS Commissioning Board (NCB).
The first official 'phase' of authorisation will be a risk assessment of all CCGs, to be completed by December 2011.
Four key areas of CCG activity will be assessed to help CCGs establish whether they will meet the criteria of authorisation.
The document lists key requirements on which CCGs would be assessed before authorisation. These include a strong clinical and professional focus, engagement with patients and clear plans to deliver the quality, innovation, productivity and prevention challenge.
GPC deputy chairman Dr Richard Vautrey says CCGs may need to merge in order to fulfil these criteria.
'This has significant implications for whether a CCG needs to review their structure, size and affordability as part of the process,' Dr Vautrey said.
'To imagine that you can become a statutory CCG in line with the expectations that the NCB will have and remain a small organisation I think is increasingly in doubt.'
Dr Vautrey said small CCGs may have to merge or work in federations in order to meet the requirements for accreditation.
The DoH has invited CCGs to have an initial risk assessment as soon as possible, starting from October 2011, allowing them to become authorised more quickly.