Over the next two years, The Practice group, a GP-led firm, will create a federated network of regional consortia, each consisting of 20-25,000 patients. This was possible after practices run by Chilvers McCrea, another GP-led firm, merged last week into The Practice, to form the biggest private GP practice provider in England and Wales, with a total of 50 practices.
This vision of GPs leading commissioning consortia is at the heart of health secretary Andrew Lansley's health White Paper.
At the time of writing, the DoH's response to the White Paper consultation appeared imminent and the NHS Operating Framework detail, when consortia will discover how they won't be saddled with PCT debt and also what management allowances will be, is expected on 15 December.
This detail couldn't come soon enough for the GPs and managers involved with commissioning at the NHS Alliance annual conference in Bournemouth last month.
Many asked, quite reasonably, how they were expected to start planning for consortia when they didn't know the operating budgets?
The merger of Chilvers McCrea into The Practice lends credence to the theory that consortia will consolidate and England could potentially ape what happened in the Netherlands where 60 health funds shrank to a dozen insurance companies of whom four hold almost 90 per cent of the market.
It also increases the likelihood that consortia will make back office savings, despite denials by health minister Lord Howe, and raises the question of how sustainable the partnership model of general practice is in an NHS where firms are increasingly influential?
The strong links The Practice has with secondary care and its emphasis on GP training will stand it in good stead.
It's a firm that is clearly leading the way on White Paper reform and should be applauded for having GPs at its helm.