After the Francis Inquiry, the gagging clause were not at all acceptable in the health services and despite this, several GP practices are unable to talk about the NHS care in their area under their CCG constitutions.

Over 20 practices were covered by legal agreements from 1 April and this includes clauses that do not allow GP members to voice their concerns about the CCG's work without prior approval from the board.

According to the GPC, the legal duty of candor was something that was not right for health professionals and especially after the publication of the Francis Inquiry into failures of care at Mid Staffordshire NHS Foundation Trust.

Last year there was gagging of GP practices in two CCGs. This led to a step that manifested a shift in the independent status of GP practices.

Ever since then, constitutions of NHS Newbury and District, NHS Sutton, NHS Dorset, NHS Thurrock and NHS Windsor, Ascot and Maiden head CCGs, have retained a clause that does not allow member practices to voice their concern on CCG matters without any prior approvals from leaders of the CCG.

Clauses are being followed by a further five CCGs and this does not allow the governing body to be verbal on issues.