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'Nurse involvement in decision making must be formalised'


Nursing Times’ practice editor, Ann Shuttleworth, argues that nurses may be better placed than GPs to manage commissioning

It can’t have escaped your attention that there is a certain amount of disquiet about the NHS reforms. In fact it is difficult to find much in the way of supportive comment that does not come directly from the government – howls of protests have come from healthcare professionals, the organisations that represent them and what seems like an ever-growing list of other respected individuals and institutions.

A seat on the board campaign

  • Mission:To ensure nurses are actively involved in the new commissioning consortia and represented on all boards.
  • How do I sign?Click here and add your name today.
  • Signatures to date: 801

Nurses have many good reasons to be concerned about the changes, both on behalf of their patients and for reasons of self-interest. Can the government guarantee patient care will not suffer? And what about nurses’ careers and job stability? Who knows – maybe in five years we’ll be wondering what all the fuss was about.

But whether you support or oppose the reforms, it’s vital that – assuming they make it through parliament – the NHS is given the best chance of making them work.

One of the biggest – and to my mind most worrying – changes planned is GP commissioning. Setting aside whether it makes sense for 80% of the NHS budget to be controlled at local levels, my main worry is that as it stands, GPs could be making funding decisions without referring to any other professionals.

“But whether you support or oppose the reforms, it’s vital that – assuming they make it through parliament – the NHS is given the best chance of making them work.”

Of course it is likely that most GP consortiums will adopt a far more collaborative approach and include a range of healthcare professionals in the decision-making process. But the point is, they don’t have to – and even if only a tiny minority decide to go it alone, their patients will suffer.

As the only healthcare profession with a holistic view of patients’ needs it’s arguable that nurses are actually better placed than GPs to be put in charge of commissioning. That’s why we’ve set up our A Seat on the Board campaign to ensure that each consortium has at least one nurse board member. It’s not enough for them to talk about “involving other professions where necessary” – nurse involvement in decision making must be formalised.

We’re in it for the long haul– we have until 2013-14, when GP commissioning goes fully operational, to push, prod and yes, even plead, with individual consortiums and the organisations representing and advising them to guarantee real involvement for nurses.

So whether you support the NHS reforms or not, help us to make sure the nursing profession has real involvement in deciding the future of NHS care by signing our petition.


Readers' comments (3)

  • Really i say we should be even more radical andbring legal action against GP consortia that deny us out rightful and legitimate place - ahead of the medical community.

    As Aneurin Bevan pointed out, the only way to entice the medical profession into the NHS was to 'stuff their mouths with gold', as in pay them over the odds for .... let's face it average work.

    Whilst nursing has slumbered on for four decades assuming some husband figure was taking care of the professions interests and finances other professions that have far less responsibility, interaction and liability have sped light years into the future where now a dietician, a physio and an OT can earn more than me despite having practically no involvement beyond their narrow job descriptions.

    Despite the presence of these three groups malnourished patients: my fault
    patients declining mobility wise - my fault,
    patients unable to do ADL's, my fault.

    and these 'therapists' also think they have the ability to command me to do things - which they do not.

    We need more of a wake up than this, because there is no weaker profession that nursing - but 60% of it is self harm and the rest is just stupidity/foolishness/naievity.

    Get radical people because every other group except us will get something out of the ConDems ruination of the NHS, but hey it does seem that nurses enjoy (in that sick way) being over the barrel.

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  • Maybe the comment below in today's Bloomberg Business Weeek applies to nurses and the NHS Reforms as well. However, I am still optimistic, maybe naively so, that any reforms will pull the health services in Britain into the 21st century and give all its citizens equitable and high quality care!

    (and I am glad that he has seen the good sense in listening and backtracked on the sale of forrests - and this is what should be done with all proposals which affect so many individuals)

    Cameron Drops Forest Sale Plan in Biggest U-Turn of Premiership
    February 17, 2011, 8:05 AM EST
    By Kitty Donaldson

    '“If you launch a consultation and you get a very strong, clear response it’s the right thing to do in government to be a listening government,” Cameron told reporters in east London today'

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  • Absolutely agree with JJJez here. It is now the 21st Century, we are no longer handmaidens with no education or clue. Physicians are not the be all and end all of medical care. Nurses are now as highly qualified, many with degrees, Masters and even Doctorates of their own. It is Nurses who have the most direct patient contact. We are the ones who give the most care. We are the ones who should be in control! It is as simple as that!

    Oh, and just 469 signatures? Pathetic! I think this profession is beyond hope, I reallly do. We could use our strength and take control of the NHS alongside physicians, drive forward best practice for our patients and create the NHS we all want to work in! But most Nurses are too apathetic or afraid to rock the boat!

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