It said although GP consortia will be responsible for £60bn of public money their governance arrangements are weak, with only limited requirements for how they should be made accountable to the public.
The report said the lack of governance arrangements for consortia could mean the NHS Commissioning intervenes to drive up performance, which will undermine the government’s aim of reducing top-down management.
It raised concerns that consortia are not required to have non-executive directors represented at board level or to hold their meetings in public.
It also said it is not clear whether the health and wellbeing boards will be ‘sufficiently empowered’ to hold consortia to account, and warned that local authorities' scrutiny role could be undermined by financial pressures on council budgets.
Anna Dixon, director of policy at the King’s Fund said the report highlights the weaknesses in the accountability arrangements in the reformed NHS.
She said: ‘The pause in the legislative process provides an opportunity to look again at these issues and strengthen accountability in the health system to drive improvements in performance and ensure that public money is well spent.’