Some may believe asking experienced nurses to join commissioning consortia is a step too far, but surely it is a major risk not to include nurses in commissioning
Last week’s announcement that the progress of the health bill is to be delayed by one month and an advisory panel is to be formed is a welcome one. But nurses must play an important role in this panel. Nurses and nursing have a key role in both commissioning and delivering healthcare. Our skill set is vast and multifaceted - clinical knowledge and its application to care, clinical expertise, leadership, ensuring quality and patient safety are all part of the nurse’s role.
One question most commissioning consortia will be asking is: should this skill set be embedded into the new commissioning model?
Many members of multiprofessional teams are well placed to influence and jointly lead commissioning because of the very nature of their work. Nurses work with people from the start of their lives to the end - we establish strong therapeutic relationships with service users and their supporters. These provide insights into and an understanding of the needs of the individuals and their communities.
We navigate complex health and social care systems and understand how they operate. Nurses lead and influence at levels from delivering care to being part of an executive board.
Like GPs, nurses understand the needs of patients as a whole. Frequently, the nurse is the person who the patient and their supporters confide in and look to for help.
Consider the skills and knowledge of an experienced nurse and how they use these to improve health outcomes and the person’s experience of care. For example, an older person’s specialist nurse can make sense of not only the comorbidities but also the hopes, desires and aspirations of the person and how this affects their day-to-day living and independence.
Advocacy and liaison with other professionals and agencies are all key. Nurses with an active role in commissioning mean better informed, holistic approaches to the delivery of healthcare services.
Some may believe asking experienced nurses to join commissioning consortia is a step too far. After all, where does it say other professional groups should be included?
Others feel nurses can add value to decision-making and planning, because of the nature of therapeutic relationships along with their depth of knowledge and understanding of the needs of local populations.
Nurses are well placed to lead on quality, pathway redesign and the QIPP agenda. Our clinical knowledge and ability to make sense of complex situations means we can interpret and translate meaning into reality, the outcome being better care for patients.
With this wide range of skills, surely it is a major risk not to include nurses in commissioning?
If commissioning consortia do not give experienced nurses and other clinicians the opportunity to influence and jointly lead commissioning through collaborative decision-making and working, they risk losing a wealth of knowledge and expertise. A multiprofessional approach to developing consortia is yet to be established.
Experience suggests if consortia follow a unidisciplinary path or a tick-box approach to involving nurses, their unique skills set will remain untapped. The challenge for consortia is to look to the new NHS, consider what experienced nurses can offer and remember they are a vital part of the future.
Jonathan Webster is assistant director, quality and clinical performance, Bexley Care Trust, and honorary senior research fellow, Christ Church Canterbury University
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