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Call for CNO to return to department of health amid new organisational shake-up

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Calls for the most senior nursing role in England to be based at the heart of government have been reignited by revelations about the latest restructuring of national arms’-length bodies.

National body Health Education England and system regulator NHS Improvement are to begin working collaboratively on workforce planning, it has been revealed.

“We need nurse leadership at the heart of government”

Donna Kinnair

Under the new system, Health Education England will require sign-off from NHS Improvement on strategies before being rubberstamped by health and social care secretary, Matt Hancock.

However, Health Education England highlighted that it will remain formally accountable to Mr Hancock. “This will ensure that workforce plans are more closely aligned with NHS service plans,” leaders have said.

Earlier this year, it was revealed that NHS England and NHS Improvement would start working in partnership – and that the next chief nursing officer for England appointed after Professor Jane Cummings steps down in December will be responsible for both agencies, as reported by Nursing Times.

Professor Cummings is based at NHS England only. The upcoming merger of the roles is the latest change to the positioning of the CNO and the leadership structure of nursing at national level in England.

The CNO role had formerly been based at the Department of Health and Social Care (DHSC). Some in the profession, including the Royal College of Nursing, have repeatedly questioned the value of moving the CNO out of the department.

The high profile Francis report into Mid Staffordshire NHS Foundation Trust, published in 2013, also said “effectiveness of the newly positioned office” of CNO should be kept under review.

In contrast to England, Wales, Scotland and Northern Ireland have so far all retained a single chief nursing officer post based with their government health departments.

Responding to the latest organisational shake-up, Dame Donna Kinnair, acting chief executive and general secretary of the RCN, welcomed the opportunities the move brought to fix nurse workforce issues but raised concerns about the “potential loss of another senior nursing voice”.

Dame Donna reiterated calls for a return of a CNO at the DHSC. She said: “This is a chance for the government to finally tackle the single biggest issue facing the NHS, and create a credible workforce strategy driven by the needs of patients in England, not efficiency savings.

Donna Kinnair

Dame Donna Kinnair

Donna Kinnair

“Investment in nursing and higher education should be a priority, with a plan underpinned by legislation that holds decision makers accountable for nurse staffing for safe and effective care,” she said.

“But at a time when nurse leadership has never been more vital, we are concerned at the potential loss of another senior nursing voice,” she said. “We need nurse leadership at the heart of government, with a chief nursing officer back in the DHSC.”

Health Education England confirmed to Nursing Times that the role of its chief nurse, Lisa Bayliss-Pratt, “remains unchanged”.

A spokeswoman said: “The important thing here for our staff and partners we work with to understand is that our day-to-day work will not be affected.

“These current changes are about improving how organisations support each other to fulfil their objectives to deliver the workforce the NHS needs now and in the future not to merge functions or leadership roles,” she said.

As part of the new joint working arrangements between NHS Improvement and NHS England, a shared “chief people officer” post has been created to provide a cohesive approach to recruiting, retaining, deploying and developing the current health service workforce.

It was announced today that the NHS Leadership Academy, which runs staff leadership and management programmes, would transfer from Health Education England to the new NHS Improvement and NHS England “people function” from 1 April 2019.

“A strong workforce is critical to the future of the NHS”

Ian Dalton

Health Education England will also “identify opportunities” to align with the new integrated regional teams between NHS Improvement and NHS England.

The changes come as part of commitments made in a draft workforce strategy published last year – called Facing the Facts, Shaping the Future – to review national organisational roles and responsibilities to improve workforce planning.

Ian Cumming, chief executive of Health Education England, welcomed the changes and said closer alignment between service, financial and workforce planning was “essential”.

“At national, regional and local level NHS must have confidence that our organisations are working together on workforce challenges to support both day to day delivery and the long-term plan,” he added.

Ian Dalton, chief executive of NHS Improvement, said: “A strong workforce is critical to the future of the NHS. By integrating the work of Health Education England with NHS Improvement, we will develop a more coherent approach to workforce development across the NHS.”

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