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Chief nurse role downgraded in DH structure plan


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.”


Readers' comments (67)

  • michael stone

    I can guess the comments for this one !

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  • Ignoring the comment above, is this a slight against the nursing profession, or dissatisfaction with the previous post holder, and what is being given as the reason? It seems that revision of salaries might have been more important than downgrading the post.

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  • Anonymous | 8-Aug-2011 3:44 pm I think it is a little of both.

    I personally do not know one Nurse who had a single good thing to say about Christine Beasley, if they knew anything about her at all (and I include myself in that negative assessment of her). She was not a figure head or a leader and she was not worthy of the title of Chief Nursing Officer, the whole profession will be better off when she is gone.

    However, that does not mean the post itself isn't important! That does not mean we should not have someone in post who leads and advances our profession and fights for us, etc.

    The fact that the position itself is being downgraded is an absolute slight on the profession as a whole and just shows what exactly the powers that be thinks of us!!! It's a joke!!

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  • I think this goes to show how much respect there is for the profession.
    But why is that so?
    I think that is one question each Nurse needs to ask him/herself.

    In my view, I think the adage 'If you act like a door mat, don't be surprised when people wipe their feet on you' is so fitting for this profession.
    For too long Nurses have acted like doormats, and that combined with their hapless, clueless, patronising leaders has served as the nail on the coffin.

    No one respects the Nursing profession, and this will never change until Nurses start demanding respect, fair pay, and good working conditions, in addition to holding their leaders and their unions accountable.

    Only in Nursing do you have members who continue to pay a monthly fee to Unions which do not uphold their interests.

    Would you continue to pay money for a bad service elsewhere? Why does it happen in this profession? It would be funny if it weren't serious.

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  • tinkerbell

    why is this government giving nurses such a pasting when it is us who work on the frontline providing the service to the patients. Could it be they want us to throw our hands up in despair and walk out the door and then they can do what they like with the NHS? Get rid of the old die hards? If they keep our profession in a 'constant state of fear' over job security, pay cuts, etc., then we are more pliable, divide and conquer .It seems they want us to be thankful for any crumb they throw our way, be grateful that we have a job. Yes I am grateful that i have a job, can pay my way, but I also work bloody hard for the wage that I earn. To keep reminding me to be grateful is becoming a bit tedious to say the least. Whose arse should i be kissing to keep my job? (if i had the time to kiss corporate arse whilst at work). To downgrade nursing input at the top level really speaks volumes doesn't it about what this government really think of nursing as a profession. I think they still view us a 'gin swigging old prostitutes' Where's my bottle of gin gone?

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  • I have no problem with this, as l feel in this day and age, it is difficult to find a nursing figurehead who has got the bottle to comand the respect of the profession.

    In my dealings with Trusts, l have yet to find a senior nurse manager who is even prepared to accept any personal responsibilities for the decisions that they take and hide behind either a panel or Trust as a whole.

    Unfortunately times have sadly changed when nurse managers were true leaders of nursing. Today it seems that it is about survival and if that is the case, then we are not worthy of the status that goes with the title Chief Nursing Officer.

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  • this downgrade will do nothing for the reputation of the profession and just demonstrates the attitude of the government, managers, administrators, employers and other involved organisations and the public towards it.

    why can't the profession's leaders and representatives from all levels of nursing sit down with the politicians and those concerned and find out what they really want from nurses in every detail from A to Z and nurses tell them what services they offer and have the potential to offer from A to Z and what realistic resources from A to Z they require to carry out their work to provide care for all who need it at an acceptable standard. it seems that it is only in this way with clear communications and understanding between the profession and the government and all those involved in its management than any further headway can be made instead of just hearing all these snippets of news which are fed to us periodically.

    Isn't this what modern technology and open communications and working together in partnership to achieve the common goals of the highest standards of care is all about?

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  • This is a smack on the face of Nurses. What are our leaders saying about this? Was there any consultation about downgrading this post. I think it is time for us to stand up for ourselves. It is clear the current governement has no regard for Nursing. They will not want regulation of Advance Practice because they are happy for use to be seen as cleaners, they are trying to stop non medical prescribing, delegeting all powers to GPs, they are downgrading Chief Nursing Officer ... what next? I smell something funny!

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  • michael stone

    'Anonymous | 9-Aug-2011 1:41 pm

    I have no problem with this, as l feel in this day and age, it is difficult to find a nursing figurehead who has got the bottle to comand the respect of the profession.'

    I am not a nurse, but I see absolutely no reason why nurses and doctors should not be represented at the same level on these things. But my 'gut instinct' is a combination of what the poster said above, which I think was 'would the person represent us' and also do you all speak loudly enough in the right places - to have an effect, you need to challenge the people you disagree with: which is a bit different from 'talking amongst yourselves'.

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  • as I said above we need to discover their motives. I have not seen any opinion from the RCN on this yet? do you have any info?

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