Speaking at the Commissioning Primary Care 2015 conference, organised by GP's sister site Inside Commissioning, NHS England's head of commissioning development Dr Julia Simon said some LMCs had been 'very supportive' of plans to hand CCGs the new powers, while others had opposed them.
In Surrey and Sussex five CCGs decided not to apply for the new powers, which come into effect in April, because of a 'very strong anti feeling from their LMC', said Dr Simon.
It was, she said, 'disappointing if we cannot resolve it in a more constructive way'.
Ms Simon said NHS England encourages CCGs to work with LMC and members practices. Nationally, she added, after meetings, there was now a 'positive sense' from the GPC about co-commissioning.
CCG engagement with practices a big issue
GPC commissioning lead Dr Beth McCarron-Nash said CCG engagement with member practices was a big issue.
She was 'very, very concerned' that systems of engagement with practices 'are not as robust as we thought they were'.
'There is a swell of opinion that CCGs now feel very much like PCTs', which, she added NHS England should prevent as it hands CCGs contract management powers and tries to prevent conflicts of interest.
Engagement between the governing body and its members is key
Dr Simon said NHS England was looking what it could do to help CCGs with membership engagement, but had to consider whether that would be 'meddling'.
She told the conference that if CCGs did not get relationships with practices and other partners right, co-commissioning was 'dead in the water'.
'Foremost for a CCG is the member practices', she said. 'A CCG is the member practices'.
'But we have seen since authorisation since the lead up to April 1 2013 when there was a very, very strong set of engagements between the governing body and its members, and we know that it has been hard to sustain that. We know many CCGs report finding this more difficult now. That is key, and without it you wont be able to drive change.'
She said it was important for CCGs to have practices signed up and excited about co-commissioning.
Dr Simon revealed that 77 CCGs across the country have applied for the 'most extreme', delegated model, which hands full commissioning powers to CCGs.
NHS England had a 'very permissive' intention, she said, and wanted as many CCGs as possible to take the powers.
On Tuesday, she said, the final decision will be made on what powers CCGs will receive. 'We are hopeful the very great majority of those who have said they want it will get it.'
NHS England was currently going through CCG applications for the joint commissioning model.
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