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Reform slowdown could stop erosion of nurse influence

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Further political pressure on government plans for a comprehensive transfer of NHS decision making powers to GP led consortia could help salvage the formal role of nurses in commissioning.

The government is reviewing health secretary Andrew Lansley’s Health and Social Care Bill and “substantive” changes have been promised.

Liberal Democrats and senior national NHS managers are understood to be pushing for “clusters” of primary care trusts to be kept for the foreseeable future, instead of being abolished in April 2013 as originally planned.

The clusters, which are to comprise two or more PCTs with shared management teams, have to be in place by next month. NHS chief executive Sir David Nicholson has already instructed them to have a nurse director on their shared executive boards.

In contrast the GP dominated commissioning consortia, which were due to completely replace PCTs and are currently not required to have a nurse on their board, may now be introduced more slowly – or even only where GPs are particularly keen to set them up.

However, health minister Anne Milton was warned by senior nurses in March that the NHS was already “haemorrhaging” nursing leaders from PCTs due to government targets on management cuts in the run up to the transition to GP consortia.

Speaking last week at a meeting of the National Association of Primary Care, health secretary Andrew Lansley continued his recent efforts to make the commissioning reforms sound inclusive of professions other than just GPs.

He told a mostly GP audience: “Let’s make no bones about it this is a straightforward intention on my part that we have clinical leadership, not just general practitioners but right across the service – doctors and nurses – who are going to be in charge of the service they deliver to patients.”

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