An "incremental approach" is needed to abolishing primary care trusts, a think tank has warned.
Civitas said scrapping the trusts in one go could damage patient care, causing delays to treatment.
A study entitled A Risky Business said plans laid out in a government white paper could undermine hopes of making efficiency savings in the NHS, worth up to £20bn by 2015.
It follows suggestions that PCTs are currently in "meltdown" over the policy, which will see most of the NHS budget transfer into the hands of GPs, who will be responsible for commissioning health services for patients.
Written by James Gubb, director of the Civitas health unit, the document poses 12 questions for Cabinet Office minister Oliver Letwin, who is to scrutinise the new health policy.
It says it is "very uncertain" that the wholesale abolition of PCTs by 2013 in favour of groups of GPs will bring about significantly improved commissioning in the short, medium or long term.
Patients are likely to suffer delays in getting treatment while the reforms are carried out and will not necessarily get improved care in the future, it says.
While the NHS has been guaranteed a small real terms increase in funding, campaigners say demand for services is putting pressure on the NHS.
To meet this demand, the NHS will have to improve productivity by around 4% per year, the report said.
However, it argues that GP consortia are more likely to be more focused on administration and structural tasks, such as merging organisations and getting the right people in place as they establish themselves.
Mr Gubb said: "The coalition government needs to stop repeating the mistakes of the past by mandating wholesale structural change."
Copyright © Press Association 2010
Your comments (terms and conditions apply):
"I feel the NHS is in danger of collapse with such drastic changes. GPs do not have the time to manage services, I acknowledge some do employ IT specialist but what do they understand about clinical decisions?" - Mary Swinney, Tyneside
"Change for the better? Not from experience of 40 years. As a foreign nurse who started my career in the sixties I have seen the NHS built, things improved slowly but steadily with difficult working conditions. I would be very hurt and sad to see this service go under. I feel that this government including the opposition should invite nurses from above with their input
to join in this discussion also go to your local MP and give written or discuss this subject because it is our NHS like myself we help to build and I would not like it to go under" - Violet Weerasinghe, Birmingham
"I am a district nurse and I think that in a majority of cases patient care will deteriorate. Based on my experiences working with GPs, district nurses struggles to get appropriate support from some GPs who are not "patient focused", reluctant to do home visit for house bound patients and refusal to prescribe appropriate treatment because it will increase their
prescribing budget. The future for the service looks dismal because nurses will not have a voice in the future of the service they provides" - Bernice Woode, West Midlands
"What worries me is the fact that the time taken out by GPs with commissioning/meetings etc means less time spent with actual patients. Instead of spending money on yet more changes, would it not be better to employ more British trained, English-speaking doctors and nurses and have such lost goals as teamwork, dependability, work contracts and quality of
patient care. We do not need to import nurses from abroad. There are plenty of well-qualified nurses and midwives in the UK who are having their jobs undermined with less qualified cheaper foreign imports" - LD, Hampshire
"The whole scheme is a total mess, has the government done any research to see if other country have done this before? And they should scrap single-handed GPs from this skim or marry them together. Has anyone thought about how this will affect nurses' pay, with the PCT and the union in play nurses are always fighting for their rightful pay/pay scale. Who will monitor the skim and who will pay for the monitoring? Is this not robbing Paul to pay Peter? When the Tories live government in 4 yrs' time what will happen, the next gov will want to bring about changes again, why don't this gov hand off NHS" - Comfort Renner, London
"I have have concerns about the changes in the NHS. I have worked full time for 32 years and have never seen change on this unprecedented scale. As a designated nurse for safeguarding children we are now required to justify
our role to the Secretary of State. These changes are affecting the most vulnerable. Children, the vulnerable elderly and adults with learning difficulties seem the easy target for a government who is driven by saving money and quickly. As someone who works with vulnerable people and advocates on their behalf I am very concerned that posts are seen as
unnecessary beaurocratic layers and will be cut. With a pay freeze and proposals to stop incremental rises which are part of agreed terms and conditions highly experienced and motivated staff will leave the NHS as they are being driven out. It seems we have no protection. I have spent all my 32 year nursing career, covering shifts, staying late, working in
my own time with no pay and no time back to keep services going. This government would be ill advised to lose all that good will. For nurses it isn't about money but commitment to patients" - Pam Jones, Bolton
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