The Government's reforms of the NHS "continue to cause chaos" on the ground, doctors leaders have said.
The British Medical Association (BMA), which opposes the Health and Social Care Bill in its entirety, said changes taking place now before legislation has even been passed are "chaotic and poorly co-ordinated".
Groups of GPs have been told they must form groups to determine how the NHS budget is spent but, according to the BMA, they are being told they are too small.
Dr Hamish Meldrum, chairman of the BMA, said: "There has been a growing level of unease about how the reforms are panning out - we hear repeated concerns from doctors about mounting chaos on the ground.
"For example, clinical commissioning groups (CCGs), that had initially been told they'd have freedom to form to suit their local communities, are now being told they're too small and have to re-form.
"People are still unclear how primary care will be managed as we don't yet know where staff currently working in primary care trust 'clusters' will eventually be based or if they'll have jobs at all.
"Even at this stage, there are still unanswered questions about what statutory functions some bodies will have, making planning very difficult.
"Guidance is being issued that is overly restrictive and more and more bureaucracy is being created to try to deal with issues which should have been dealt with at the beginning.
"A huge amount of time, energy, money and commitment has been wasted because of a lack of a clear plan from the outset."