A National Association of Primary Care (NAPC) and NHS Alliance survey of 67 CCGs found PCT clusters and SHAs are dictating the size and shape of CCGs.
It comes just days after the NHS Midlands and East SHA wrote to one of the smallest CCGs in England urging the group to merge as it is 'very unlikely to be authorised’.
Dr Charles Alessi, an executive member of the NAPC, said he is ‘deeply concerned’ about the ‘top-down directives’.
He called on NHS chief executive Sir David Nicholson to demand a ‘completely different tone’ from PCTs and SHAs clusters.
NHS Alliance chairman Dr Michael Dixon, a Devon GP, said PCTs should be supporting CCG development.
He said: ‘We’ve heard too many reports that CCGs are being told by the current system managers that they must be created in specific ways.
‘In a significant number of cases, this seems to cross the line into unacceptable pressure in the form of bullying or coercion.’
