Warning over status of nurses involved in NHS commissioning

Involving Nurses in Commissioning: How To Get in Right was due to be published by the NHS Alliance Nurses in Commissioning Network today at a conference in Manchester. It was commissioned by the Department of Health to inform commissioning reforms.

The work was led by NCN lead Ursula Gallagher, the former NHS Ealing chief nurse, and is based on evidence from senior nurses, mainly in commissioning, primary and community services, across the country.

The report says a series of problems risk the position of nurse involvement on a CCG being “seen as ‘tokenistic’ without real power and influence”. It says: “The NCN believes this would be a missed opportunity and that CCGs need to have a senior nurse, who is fully aware of the whole health system locally – someone who has the credibility and leadership skills to influence, challenge and network across the heath and social care community, and hold to account the local system.”

It notes that nurses with roles in emerging CCGs “felt that they had been given only minimal time to do this, had no proper role/job description, and didn’t feel that the training and development package or formal support and supervision that was being offered to GP colleagues was equally available for them”.

The report calls for nurses to be given “access to tailored development programmes”. Another recommendation is that: “[CCG nurses’] remuneration should reflect their role, time commitment and remit on parity with their colleagues on the CCG”. Nursing Times has previously reported evidence nurses are being paid less for the time they spend on commissioning.

The report also calls for the current PCT cluster nurse directors in “influencing and promoting nursing input into [CCGs], helping them to design roles if required”.

It suggests PCT clusters or, when they are abolished, the NHS Commissioning Board, could have a role in appointing senior nurses to CCGs.

The report says: “Since PCTs and now [strategic health authorities] have now clustered, it is not apparent that anyone at a strategic level is responsible for overseeing the development of the new tranche of nurses in commissioning roles, and support can feel very distant.

“It was agreed that many CCGs will need help to clarify the role and responsibilities of their nurse leads, and select and recruit accordingly.”

It adds: “SHA chief nurses traditionally sat as external assessor on the interview panels of all nursing directors on their patch, but it was not clear if this standardised approach to the role would exist in future.

“Whilst some may see this as unnecessary bureaucracy, there is a danger that nurses will be appointed on their clinical performance rather than benchmarked against the requirements of a strategic role, and there is a risk that they will be set up to fail.

“CCGs and ultimately patients may never experience the very real impact nurses can have on their commissioning activities if they don’t harness the skills of their nurses and other clinicians, and welcome them to the table as full and equal members.”