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DH moves to avoid CCG board nurses being token gesture


Clinical commissioning groups have been told by the Department of Health to appoint experienced nurse leaders to their boards in an apparent attempt to head off attempts by GPs to view the position as a token gesture.

CCGs will take over the majority of NHS spending from April next year and will be led by GPs. Following calls from Nursing Times and the Royal College of Nursing, the government has said each group must have at least one nurse sitting on its board.

However, the RCN has warned that CCGs have seen choosing relatively inexperienced and unqualified nurses, for example someone working at one of their practices.

Nursing Times has seen Department of Health guidance, sent to primary care trusts in recent weeks, stipulating minimum requirements for the nurse on the board.

It said these nurses must have “a high level of professional expertise and knowledge; [being] competent, confident and willing to give an independent strategic clinical view”. They must also “be able to bring detailed insights… into discussions regarding service re-design, clinical pathways and system reform”.

It addition, it said nurses on the board must “be highly regarded as a clinical leader, probably across more than one clinical discipline and/or specialty”, which appears to exclude less experienced nurses that have only worked in primary care.

Meanwhile, the Greater Manchester PCT cluster has developed a job description for nurses on the board of CCGs which sets an even higher bar. It said they must have “high-level awareness of ‘board-level’ working” and leadership and governance skills, noting that the role was a “senior clinical leadership position that will hold executive accountability”.

Greater Manchester chief nurse Hilary Garratt told Nursing Times the cluster wanted to ensure the nurses had “board level competencies”.

She said she wanted assurance they were ready to lead oversight of care quality in their area and build relationships beyond the CCG. She said: “They need to be acting and working in the community of nursing leaders, and need to deliver and work alongside the local commissioning board lead nurse.”

The cluster has also offered to lead the appointment process for nurses alongside GPs. The offer has been taken up by the majority of the cluster’s 12 CCGs.

Cluster chief executive Mike Burrows said CCGs would be expected to deal with serious safety and quality issues in their area. He said: “The nurse will have responsibility for how we tackle the quality issues.”


Readers' comments (6)

  • Albert's Mum

    If, and this was supposedly a concession after concerns were expressed, the CCG must include a nurse, a hospital doctor and 2 laymen, then unless those 4 people are truly independent from, and outside the influence of, any GPs whose practices are being served by the CCG, there is almost no point in requiring that those 4 people are on the CCG.

    Currently, those 4 people are being reduced to tokens. They should be there, to exercise what I would describe as independent power, from their own perspectives. Such as, keeping the GPs 'honest' !

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  • Shoki | 7-Mar-2012 9:52 am

    Well said. Honesty how refreshing that would be.

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  • Please could the editor provide the link to the job description, referenced in the article. It is not available through the link provided.

    Many thanks

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  • Tiger Girl

    Anonymous | 7-Mar-2012 10:51 am

    Shoki | 7-Mar-2012 9:52 am

    The way this Bill was being sold to the public and to many NHS staff - moving decision-making closer to GPs and patients - implied that relatively small groups of GPs, who understood the needs of the patients in their own locality, would club together to make better decisions about what secondary services to commission.

    Cynics, considered that it was about removing any future blame for reduced services from the Health Secretary and Goverment, and putting that blame onto GPs.

    But these CCGs now seem to be not local at all, and are comparable in size to the PCTs they are replacing - the details of the Bill, are not at all like the thing the public was being sold. It is also hideously confused and complicated, and has many more bad points than good points - it should be chucked out, but it looks as if it will be enacted, unfortunately ! I would quite like a conversation with Cameron, having previously placed my fangs around his neck, to concentrate his thinking and to try and promote some honest replies to my questions !

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  • Heather Henry

    It seems to me that what is needed is to be able to demonstrate the nursing contribution first hand. Recently I did a training session for PNs and incidentally a PCT commissioner and a Chief operating officer for a CCG turned up. I asked them to help me facilitate some group work involving nurses writing of a fictional service specification for a new community respiratory service. This enabled them to see for themselves some of the ideas that nurses were coming up with. After that they told me that they realised the value of nursing and were considering how they might form a local nursing 'reference group'.
    The issue of the experience of the nurses on the CCG board however is a very moot point. It seemed obvious to me that those practice nurses were very unfamiliar with anything other than general practice and it is then that we would press our point home to CCG leads that any CCG nurse should have experience of a range of clinical disciplines and at a strategic level.
    Having worked with GPs for most of my career, I understand that they dont actually know what they are looking for, rather than ignoring it, so they need to experience it for themselves.

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  • Dr Why ?

    Heather Henry | 9-Mar-2012 10:58 am

    'The issue of the experience of the nurses on the CCG board however is a very moot point.'

    The CCBs are supposed to be different from the CCGs - as originally outlines, the CCGs (the GPs) were supposed to identify what services woudl need to be purchased for their patients, and the associated CCBs would then do that purchasing of secondary services, for the underlaying CCG. Lots of discussion at GP practice elvel, to identify what services need to be purchased, would appear therefore to be necessary prior to any CCB involvement: and the actual CCBs, seem to need purchasing skills, and not the primarily clinical skills that GPs and nurses primarily possess.

    Who actually does what, is a major problem for this Bill !

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