Clinical Commissioning Groups have been placed under scrutiny as it was revealed that 40 per cent are operating below standards in England.

Wiltshire CCG has been rated good by the Care Quality Commission and is not one of 24 deemed to be failing or at risk of failing.

A report revealed that in September the CCG hit targets for the number of people being helped by community teams to die in their place of choice and South West Ambulance Service achieved all ambulance targets.

However all three acute trust hospital in Salisbury, Swindon and Bath missed A&E waiting time targets. A&E departments are expected to see 95 per cent of patients within four hours, but in Salisbury just 83.9 per cent were seen within the limit in September.

September statistics showed that there were 1205 extra people on waiting lists to receive treatment following a referral, compared to in March across Wiltshire CCG. There were 11 people who had to wait over 52 weeks for treatment after being referred by their GP.

Wiltshire CCG said that addressing waiting list sizes would remain a focus and is set to introduce specific recovery plans and said preparations to meet increased winter demands had been made.

GP Dr Ian Orpen, a GP based in Bathand chair of B&NES, Swindon and Wiltshire Sustainability and Transformation Partnership’s Clinical Board, said: “As winter gets well and truly underway, health and care services in B&NES, Swindon and Wiltshire will begin to experience an increase in demand, so the more our residents can do to stay well this winter and help reduce that pressure, the better. It’s also important that everyone uses the service that is right for their health and care needs. During the winter, hospitals and A&E departments can get very busy – so calling 111 or visiting your pharmacist or GP can make all the difference.” Wiltshire CCG covers BaNES, Swindon, Wiltshire and Gloucestershire. CCGs were introduced in 2012 to replace primary care trusts. England CCGs are set to lose 20 per cent of its £1.21bn funding by 2020/2021."

Amyas Morse, the head of the National audit Office, said: “We have seen almost three decades of change to NHS commissioning.

"It would be a huge waste if in five years’ time NHS commissioning is undergoing yet another cycle of reorganisation resulting in significant upheaval. The current restructuring of CCGs must deliver balanced and effective organisations that can support the long-term aims of the NHS and deliver a much-needed prolonged period of stability.

and hospitals are more easily able to treat those with serious conditions or injuries.”