THE overhaul of health commissioning across the country is widely regarded as the biggest change to the NHS since its creation in 1948.

It will mean that clinicians are now at the heart of commissioning, rather than managers taking the lead for primary care trusts.

Clinicians know exactly what patients need and which aspects of the NHS requires more focus and funding.

But there are still many areas of the new Clinical Commissioning Groups (CCG) that are causing concern.

Perhaps the biggest question is exactly how clinicians, many of whom will continue as GPs, will manage their increased workload without becoming swamped.

Oxfordshire is significantly under-funded compared with other areas and the county’s CCG needs to make eye-watering savings this year.

Much of these will come from treating more patients at home, rather than in the county’s John Radcliffe and Horton hospitals.

How this will work, especially as Oxfordshire is already one of the best performing in this area nationwide, remains to be seen.

There is also the question of whether the changes will bring ‘privatisation through the back door’ as they open commissioning to private providers.

The changes could bring radical improvements to Oxfordshire’s health service as clinicians put patients first in their commissioning.

But on the day the new system goes live, serious concerns remain.