The role of England’s most senior nurse has been downgraded in plans for a new Department of Health structure, sparking concern about loss of influence.
Currently the chief nursing officer has an independent directorate and reports to the chief civil servant - the permanent secretary. But the department is being reorganised by permanent secretary Una O’Brien, who was appointed in October.
A document showing the top level of the proposed new structure does not include the chief nursing officer role at all. It is understood the DH has proposed that a senior DH nurse will report to one of five director-generals, who in turn will report to the permanent secretary.
In contrast the structure shows the chief medical officer as reporting directly to the permanent secretary.
The document also suggests any senior nurse role will have to work across social care and public health – as well as the NHS – making it both broader and less senior than the existing chief nursing officer role. The document says: “This is still under development and does not include all details.”
The current chief nursing officer Dame Christine Beasley is expected to retire in the autumn. It was expected a new senior nurse would be appointed in the DH, and a separate nursing director would sit on the new NHS Commissioning Board.
Royal College of Nursing policy director Howard Catton, commenting on the structure, said it suggested the senior nurse role was being “doubly downgraded”, because it is now two rungs of seniority below the chief medical officer – Dame Sally Davies.
He said: “If this is what is being proposed there is a clear disparity with the CMO’s role. Given what we know about future healthcare needs and demands – and the crucial role nursing will play in meeting those needs – there should be parity between the nurse role and CMO role.
“The chief nurse role should report directly to the permanent secretary.”
A DH spokeswoman told Nursing Times: “Details will be announced shortly.”