The Government insisted today it had listened to concerns about the scale and speed of its radical shake-up of the NHS.
Unions, thinktanks and health campaigners have expressed doubts about the reforms, which will see primary care trusts (PCTs) and strategic health authorities (SHAs) abolished.
GPs will take hold of the purse strings from 2013, planning hospital care and services for patients.
Some 52 "GP consortia" have already signed up to manage their local NHS budgets, covering a quarter of the population.
But opponents have insisted the reforms are too speedy and could damage patient care.
Unite said today Health Secretary Andrew Lansley was driving the NHS into "the buffers" by moving too fast and without proper consultation.
The union, which has 100,000 members in the health service, said the plans were heading "in the wrong direction" and had been "cobbled together".
Later today, the Government will outline its priorities for the NHS in the coming year as part of the NHS operating framework.
Mr Lansley announced that part of it would include hospitals being "held to account" and fined if they fail to get rid of mixed sex wards.
In its response to the consultation on its white paper, the Government said it had listened to concerns about the structural overhaul of the NHS.
It has made some amendments, including placing commissioning of maternity services with GPs instead of with a National Commissioning Board.
It has also pledged to "allow a longer and more phased transition period" for completing some of the reforms, such as keeping the regulator Monitor on board for some control of foundation trusts.
It has also promised to "create a clearer, more phased approach to the introduction of GP commissioning" through the pathfinder pilots.
"This will allow those groups of GP practices that are ready, to start exploring the issues and will enable learning to be spread more rapidly," it said.
The document said the Government will "increase transparency in commissioning by requiring all GP consortia to have a published constitution."
Ministers have also recognised "that our original proposal to merge local authorities' scrutiny functions into the health and wellbeing board was flawed.
"Instead we will extend councils' formal scrutiny powers to cover all NHS-funded services, and will give local authorities greater freedom in how these are exercised."
The document said the Government had listened but "disagrees" with concerns from groups including the think tank the King's Fund, the Royal College of Nursing and Arthritis Care that the scale of the reforms are too big, untested or are occurring at the wrong time.
Also today, PCTs were told they will receive a total of £89 billion next year to fund services.Reuse content