GPs are already working on delivering reformed health services for more than half of England, Prime Minister David Cameron has said.More than 140 pathfinder consortia had stepped forward to test the coalition government’s commissioning plans, Mr Cameron said in his speech to the Royal Society for the Encouragement of Arts, Manufactures and Commerce in London.The plans will see consortia take over responsibility for commissioning health services locally, and pathfinder groups are "dry running" the plans."Far from fearing new commissioning arrangements, over 140 GP-led consortia have now come forward, covering over half the country," Mr Cameron said.His announcement was welcomed by health secretary Andrew Lansley who said early progress was beyond expectations."This second group of selected pathfinders is welcome evidence of widespread enthusiasm for taking these ideas forward," Mr Lansley said.But despite the announced progress Patients Association chief executive Katherine Murphy warned: "There are very big unanswered questions about these reforms."She  raised concerns over the number of consortia involved in the government’s trials."We would feel more comfortable with smaller numbers of pilots using the consortia model, and perhaps other pilots using some of the suggested alternative models like PCTs reformed to be led by clinicians instead of wholesale abandonment," she said.Mr Lansley pointed out some of the successes of the scheme so far and said that in Somerset the need for improved management of long-term conditions had been identified."As a result of successful local commissioning, specific initiatives have been rolled out to improve the prescribing for patients living in nursing and residential homes and provide patients with a greater choice in end of life care," the Department of Health said.This had reduced hospital admissions by 46 per cent, according to the Department of Health.