This slide deck presents the fourth and final year of results from an annual survey of GPs and practice managers in six CCGs across the country. The survey explores how GP attitudes towards clinical commissioning have evolved since their launch in 2013. The results show that over the past three years, CCGs have matured as organisations and clinical leaders are increasingly confident in their commissioning roles. However, only one fifth of GPs without a formal role in the CCG felt they could influence decisions - a substantial decrease in the last two years.