The “critical” role of the nurse on the clinical commissioning group governing body has “evolved significantly” over time, according to a briefing paper.
Such nurses bring a “unique patient-focused whole-team perspective” to decision-making on NHS commissioning, which helps deliver improved outcomes for patients and local populations, it said.
The report noted that the term “commissioning nurse” now applied to two distinct groups – the independent registered nurse on the CCG governing body and executive nurses involved in the group’s daily activity and running.
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Under its Seat on the Board campaign, Nursing Times helped ensure that CCGs were required to have least one registered nurse on their or governing body.
The government announced the requirement in June 2011 as part of amendments to the Health and Social Care Bill, following a “listening exercise” sparked by concerns from clinicians about its reforms.
The new report, published today by NHS Clinical Commissioners, an independent body representing 91% of CCGs, highlighted the positive impact and changing role of “commissioning nurses” via a series of case studies.
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It said the role had changed since CCGs were created in April 2013 and was “far removed from that originally envisioned” in many places, with more power to make a difference for local populations.
According to the report, many CCGs were now employing full-time chief or executive nurses with responsibility for the day-to-day running of an element of the organisation, usually quality, which went far beyond the legal requirement for a registered nurse to sit on their governing body.
“This report highlights what a positive role nurses can have in CCGs”
Where this change had occurred, it noted that some CCGs had subsequently introduced one or more further registered nurses on the governing body in the independent role to support the more embedded executive nurse.
The NHSCC said the report was intended to “showcase the positive impact” that commissioning nurses were making, such as reducing rates of smoking in pregnancy, providing a voice for practice nurses and leading local service development.
Other benefits included providing a valuable voice for the patient while at the same time giving a critical clinical perspective.
The briefing paper – titled The role of the nurse on the CCG governing body (see attched PDF below) – noted that the NHSCC’s Nurses’ Forum undertook a membership survey in October last year to better understand current responsibilities of CCG nurses.
Of the 41 respondents, 84% were a member of the quality committee, while 42% were also its chair.
In addition, 71% were members of the primary care committee, 58% were members of the performance committee, 38% of the audit committee and 26% of the remuneration committee
Meanwhile, other nurses were members of committees on prioritisation, end-of-life care, workforce and education, and also chaired ad hoc committees with a specific nursing perspective, such as serious incidents and provider quality.
The forum said it intended for the briefing paper to help both CCGs and national organisations to make sure that they were “getting the most value” from the role of commissioning nurses.
Commissioning nurse role has ‘evolved significantly’
The report recommended providing CCG nurses with support and development, opportunities to meet regularly with staff at all levels in their area to accurately represent their views in commissioning decisions and setting them realistic expectations as to what should be delivered.
Dr Amanda Doyle, NHSCC co-chair and chief clinical officer of Blackpool CCG, said: “Nurses on a CCG governing body are immensely important, playing a key role in driving the delivery of high-quality services, as well as acting as local leaders of the nursing profession.
“They provide a unique patient viewpoint, while also bringing strategic clinical and practical insight into board level decision-making about how services can work better together for the benefit of their local people,” she said.
Jane Cummings, chief nursing officer for England, said the report “rightly highlights the valuable work” of CCG nurses and their key role in improving care through commissioning.
“There are increasing opportunities for nurses to progress in leadership roles,” she said. “This report highlights what a positive role nurses can have in CCGs.”
“More consistency about the authority and nurse influence in key decision making is vital”
Kathryn Yates, the Royal College of Nursing’s professional lead for primary and community care, said she was “encouraged but not surprised” to see CCG nurses making “such a meaningful difference”.
However, the college, which also campaigned for the nursing voice to be required on CCGs, warned that the positive examples highlighted in the report were not necessarily representative of the whole country.
Ms Yates said: “More consistency is needed to ensure that all areas can match the practice in the best, which seem to be places where senior nurses have been fully involved and is working at a high level to use their expertise and set a direction for the CCG, alongside medical and lay colleagues.
“What is clear from this report is that this is not the case everywhere, and indeed it is difficult to establish what arrangements are in place on all boards,” she said.
“Where the nurse role is tokenistic, it is difficult to get the same level of advice and guidance, so more consistency about the authority and nurse influence in key decision making is vital to improve care,” she added.