The clues are all there: the cluster is only temporary; the CCGs are the way forward; the NHS is not cash rich. I know all these things because the secretary of state has told me, and a few million others, that it is so.

So this month our old PCT websites are being merged into one NHS Cluster website. Three local CCGs are being forced to merge to meet stage one authorisation, and we’re all getting a bung to keep us interested in CCGs.

I’m not entirely sure, but this sounds like the Cluster is planning on staying put, the CCGs are still poodles of the system and the old Silver Fox is keen to try and generate some passing interest in CCGs from more than the handful of GPs who decided they wanted to ‘Liberate the NHS’ and subsequently found that putting your hand up got you fitted with two bracelets and matching connecting chain.

All in all, the last week or two has been like an episode of Sherlock, without the benefit of a scriptwriter to keep things on plot.

The amiable doctor, fraught with angst, bumbles along next to the genius who runs the Cluster, one step ahead in every way. Except at the centre of the web, the Silver Fox pulls the threads, perhaps not quite as dark as Moriarty, but just as brilliant or barking.