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CCGs must have non-primary care nurse

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Clinical commissioning groups will be required to have a nurse from outside primary care on their governing body, it has been announced.

CCGs will take over the majority of NHS budgets from primary care trusts next April.

The government said last year that each of the groups must have at least one nurse on its board. It followed Nursing Times’ Seat on the Board campaign and similar calls from the Royal College of Nursing and MPs on the Commons health select committee.

At the time ministers said the mandatory nurse on CCG boards could be from any nursing background but must not work for any of the main hospitals or other service providers to the CCG. This was in order to avoid a conflict of interest between the organisation commissioning the service and that responsible for providing it.

However, concerns have been raised that some CCGs would appoint nurses who worked at GP practices that were members of the commissioning group. The RCN and others have warned that these nurses may not have the required management skills or experience, and represent a “token” nursing appointment by the CCG.

But Dame Barbara Hakin, who is the national director of commissioning development, said last week that a rule would be introduced requiring the mandatory nurse on the board to be a non-primary care nurse.

Governance requirements for CCGs are due to be set out formally in legal regulations in coming weeks.

Speaking at the NHS Confederation conference in Manchester, Dame Barbara said: “The nurse on the governing body should not be a primary care nurse. It seemed important that the prescribed nurse bring a different perspective [to the CCG].”

Dame Barbara pointed out that CCG member practices could choose to “have as many people on the board as they want”, so the rule would not prevent additional nurses – potentially from local practices – from sitting on the board as well.

Andrea Gupta, a practice nurse lead and chair of St Helens Health CCG, said she recognised the need for the “different perspective” provided by having a non-primary care nurse on the board.

But she said: “You can’t just have that, as that person might not have credibility with the practice nurses.”

Her CCG is planning to have a part-time executive nurse from outside primary care, and two practice nurses, as well as Ms Gupta herself.

Nursing Times understands the regulations will also confirm that the nurse – and the acute care medic who will also be required to sit on the board – must not be employed by major local service providers to the CCG.

This had been proposed by the government previously, but many of those involved in developing CCGs had hoped it would be changed in the final regulations.

Nursing times understands some are having difficulty finding clinicians from outside their area who want to sit on take up the posts.

It is also understood that the new regulations will specify that councillors may not sit on CCG boards. It is unclear how many CCGs had planned to appoint councillors.

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Readers' comments (1)

  • michael stone

    'concerns have been raised that some CCGs would appoint nurses who worked at GP practices that were members of the commissioning group'

    Yes - similarly, it would be helpful if the statutory lay members were not patients of any of the GPs, or commercially connected to any of them.

    This aspect would have been easier to achieve, if the CCGs had been more numerous and smaller, with overlap between CCGs within areas - in fact it seems most towns and cities are only going to have one CCG, making this much harder to achieve.

    With smaller CCGs, you could appoint a practice nurse who didn't work for any of the GP practices represented by that CCG, and who was therefore much less prone to 'undue influence from the GPs', while at the same time incorporating the perspective of a practice nurse.

    These were the details, which were 'very fudged' when the NT claimed victory in its Seat on the Board campaign. At least it seems, judging from the above, pressure is leading to a sensible tightening up of the requirements - somewhat to my surprise !

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