At a recent meeting of the South Reading CCG Council of GP Practices the member practices failed to support the proposed merger of all four Berkshire West CCGs with a sufficient majority to allow the necessary change of constitution. South Reading NHS CCG has issued the following statement: "The 4 CCGs have decided to withdraw from the process to apply to create a single CCG by April 2015. They will continue to explore the optimal way of working to maximise focus on the considerable challenge that the Berkshire West health and social care system faces." The 4 CCGs in Berkshire West are South Reading, North and West Reading, Newbury and Wokingham CCGs. The other three CCGs are believed to have been in favour of the merger. The Berkshire West CCGs carry out much of their work through a federated common staff but are still 4 separate legal entities with their local governing bodies and small local establishments. Like the United Kingdom itself the Berkshire West CCGs are struggling to find the right balance between, on the one hand, local engagement, accountability and freedom to address local problems and, on the other hand, efficiency and common standards.