There are fears nurses’ fledgling role in NHS commissioning could be sidelined by moves to put GPs in charge.
Health secretary Andrew Lansley is planning to move responsibility for commissioning services from primary care trusts to groups of GPs by 2012.
Before the election, now health minister Anne Milton told Nursing Times nurses would also have a “crucial role” in commissioning, with GPs potentially “devolving” responsibilities to them.
But the Department of Health has yet to confirm whether or how that will happen.
Royal College of Nursing policy director Howard Catton said the college was clear “commissioning needs to be multiprofessional” but the government’s language had so far focused on GPs.
Mr Catton said improving care while keeping costs down in coming years would rely on areas with heavy nursing involvement – such as long term condition management, prevention and better coordination between hospitals, community services and social care.
He said: “These are all areas that nurses are intimately involved in and are critical to the success of.
“Nurses have great reach into the communities where they live and work. If you are commissioning services your starting point needs to be an understanding of the community.”
Jan Proctor-King, cardiovascular tutor at the primary care training centre in Bradford, and Primary Care Cardiovascular Society board member, said that in practice the extent of nurse involvement was likely to be down to the “local initiative” of GPs.
She also warned breaking commissioning down into small groups could put at risk areas where the “big picture” was important, such cardiovascular services which are currently planned through regional networks.
However, Ms Procter-King said GPs would be looking for efficient models of care and would not be afraid to scrap poor ones – which was both a “threat and an opportunity” for nurses.
She said: “GPs are going to look very much at keeping people out of hospital. Nurse led models that can show people they keep people out of hospital will have opportunities to develop and expand.
“Just having services and particular kinds of nurses because we have always had them won’t be enough to keep them. GPs will be prepared to make difficult decisions.”