Sweeping changes to the NHS were due to be announced today – with the practice-led clinical commissioning groups being abolished.

Doctors’ leaders, who welcome many aspects of the changes, called for caution as exhausted health workers come to terms with the legacy of the pandemic. The government is to seek to take back control over the NHS as part of its promised reforms of the service, it was reported today.

Health secretary Matt Hancock is expected to set out a programme largely developed by NHS England and involving the abolition of the clinical commissioning groups established less than a decade ago. Mr Hancock said he would be freeing the service from “burdensome bureaucracy” but, according to several reports, the proposals will give ministers increased control over much of the NHS, especially the Care Quality Commission, Health Education England and NHS England.

The 2012 reforms created NHS England as an arm’s length organisation, ostensibly to help protect the service from political interference. The plans to abolish clinical commissioning groups and replace them with the developing integrated care systems have won widespread support – as have promises to remove privatisation incentives that have led to many services being taken over by private companies. Mr Hancock said the service would be “accountable to taxpayers that use it, while maintaining its clinical and day-to-day operational independence.”

The British Medical Association questioned the timing of the announcement, calling for tired clinicians to be given time to consider them. Chair Dr Chaand Nagpaul said: “On the back of a year in which doctors have gone above and beyond in responding to the greatest health crisis in a generation, they are now both physically and emotionally exhausted. Proposals for sweeping reorganisation on such a scale will need greater time for consideration and must not be rushed through while doctors are still tackling the winter surge in infections, hospitalisations and tragically, deaths.

“The immediate and forthcoming challenge for the NHS will be addressing the greatest backlog of care our health service has ever faced, alongside the continued pressures of COVID-19. This requires significant new resources and an immediate action plan, rather than risk being diverted by a reorganisation of the health service in the midst of the pandemic.”

Nuffield Trust chief executive Nigel Edwards said: “We must be careful that in trying to boost cooperation, we don’t fall into the age old traps of distracting, confusing reorganisation, or trying to run Europe’s biggest public service from Whitehall. The NHS has seen so many restructures that it can shift easily into reorganisation mode, where attention is taken away from patient care to focus on who is on which committee and which lines are on the organogram. Ministers may come to regret all the new powers they are set to be granted over hospital closures and downgrades, directions to NHS England, and the responsibility to collaborate.”

Professor Andrew Goddard, president of the Royal College of Physicians said: “The shift from ‘competition’ to a focus on ‘collaboration’ in law will be welcomed by NHS clinicians. The recognition of the importance of workforce planning is also crucial – no long-term problem our health and care system faces will be solved until we tackle our workforce shortages. The implications of these proposals will be far reaching, so ongoing consultation with the health and care sector is key. It is essential that policymakers consider carefully how changes are communicated to NHS staff, many of whom are exhausted after the last 12 months and understandably wary of a major reorganisation.”