The NHS is set to be transformed, with some fearing a major shake-up in the way the organisation is run will lead to more privatisation.

Currently, the NHS is organised into Clinical Commissioning Groups (CCGs), which plan and buy healthcare services for their local areas.

In Cheshire and Merseyside there are nine CCGs, one for each borough, but they are set to be scrapped in favour of just one ICS (Integrated Care System) which will commission NHS services across the entire region of more than 2.5m people.

The move is going through parliament currently, but should be in place by April next year.

It is hoped that consolidating the different commissioning groups into one will help to share ideas across the region, tackle health inequalities and improve the lives of the poorest fastest.

Although a spokesperson for the department for health and social care said "the NHS is not and never will be for sale", some believe the way Integrated Care Boards (ICBs), which will take on some of the current functions of CCGs, will work allows for far greater private sector involvement in the running of the NHS.

The board of each ICB would include a chair, a chief executive and representatives from NHS providers, general practice and local authorities as a minimum.

But beyond that, they have flexibility to create committees, with the potential for sub-committees below these, which some fear will mean ICBs delegating budgets to provider collaboratives, which may include the private sector, giving them a greater role in the functioning of the NHS.

Although NHS England will agree ICB's constitutions and hold them to account, campaigners have argued that corporations could gain a far bigger role in NHS decision making through ICBs.

In recent months, a number of Wirral councillors have expressed concerns in public meetings about the impact the move to an Integrated Care System could have on care in the borough.

Cllr Jo Bird, who represents Bromborough, was worried that the move to an ICS was more about balancing the books than the rights of patients.

The Labour councillor asked Simon Banks, Wirral CCG's chief officer, what assurances he could give that the new system will say yes to patient demands on healthcare services rather than no.

Mr Banks said the ICS was about improving care and not simply a book balancing move, but he said the new system would have to live within its means.

Liberal Democrat councillor Dave Mitchell asked Graham Hodkinson, Wirral Council's director of health and strategic commissioning: "Who is going to make the decision to spend money on behalf of our constituents?"

Seeking to reassure him, Mr Hodkinson replied that while a number of decisions will be made at a Cheshire and Merseyside level, Wirral Council and the ICB would also have a role in commissioning Wirral's health services.

Cllr Phil Gilchrist, who leads the Lib Dem group on Wirral Council, was also concerned about what influence Wirral would have over decisions impacting on care in the borough given the creation of a new body covering the whole of Cheshire and Merseyside.

Mr Hodkinson said many decisions on how Wirral's health inequality will be tackled will be taken locally, while the borough's health resources will still be used locally under the new structure.