"Bigger isn't always better" was the reaction of the councillor in charge of adults' health care when members of Swindon's health and wellbeing board were told of the merger of three Clinical Commissioning Groups.

Gill May, head of nursing and transformation, told the board that the governing bodies of three CCGs - Swindon, Wiltshire and Bath and North East Somerset had now all agreed to become one body.

She said: "We don't have any choice in the matter - the integrated care system is mandated centrally.

"This won't change the relationships locally- the health and wellbeing board and health oversight and scrutiny committee will still be very locally focussed. In fact it will help that the focus and concentration will be on place-based integrated care work."

Ms May said now the boards of the CCGs had agreed to merge, they were working with medical practices and other members of the groups to get approval and they hoped to be able to apply to NHS England to merge and have it running by April 2020.

Brian Ford, the council's cabinet member for adults services including health said: "I do have some concerns. Bigger isn't always better. We have a fantastic relationship with Swindon CCG and we need to fight to make sure than continues after this merger."