It's actually quite simple really - it's going to mean more of the same. More of the purchaser-provider split, more of the public pressure for access to services, more of the fiscal pressures.
Undoubtedly, CCG leaders will be breathing a sigh of relief. There will now be no subjugation by the Health and Wellbeing Board, and power will continue to reside in the hands of the CCG.
More pressure for the typical GP practice
And what does this mean for the typical general practice? Again, simply put, it means pressure.
We will be squeezed by those demands and, as far as I can see, federation is the only option to preserve the essence of general practice in the hands of general practitioners.
Some will say that as commissioners it is not our place to dictate or organise federations. That's true, but standing idly by will only act as a betrayal of the confidence placed in CCG boards by their membership, and that will not take five years to become apparent.
- Dr Chris Mimnagh is a GP and co-director of clincial strategy at Liverpool Health Partners.