The priority for clinical commissioners is to ensure that the services we commission are high-quality and safe for our patients and populations.
The responsibility for this often rests with the executive nurse, who provides checks and balances on the decision-making process and acts as a conduit for longer-term monitoring of quality and delivery across the system.
We contribute to the conversations on financial challenges, ensuring that the impact of these on the quality and access to services – and patient experience – is recognised and properly understood by other members of the governing body.
One of the fundamental skills of nursing is communicating effectively with a wide range of patients and colleagues and in many different settings.
Our enhanced communication skills mean we can build strong links with the numerous stakeholders, including hospital and community providers, general practice, care homes and the voluntary sector.
Because of this, executive commissioning nurses are instrumental in driving cross-organisational relationships to facilitate planning and delivering health and care across a local area.
Executive nurses have accumulated a breadth of clinical knowledge and experience throughout their careers, which means that they are able to make sure that commissioning decisions remain grounded in what matters to patients and will be in their best interest.
“Whether their background is operational, managerial or in commissioning, executive nurses understand the complexities of the system”
In my area, East Sussex, we begin every clinical commissioning group governing body meeting with a patient story, led by the commissioning nurses, which grounds us in real-life experiences and keeps our patients as the focus of our decision-making process.
Whether their background is operational, managerial or in commissioning, executive nurses understand the complexities of the system, where different parts interoperate and where there are opportunities to maximise the use of finite resources across the region.
This will be increasingly important as the system continues to evolve; commissioning nurses must be at the heart of system leadership, and it is essential that other leaders in the system value them, as well as providing opportunities for development.
Executive nurses provide a voice in commissioning decision-making for the largest profession within the NHS. Increasingly systems are seeking to design pathways of care for patients, which maximise the potential of a multidisciplinary team and deliver improved patient outcomes throughout that. The input of executive nurses is vital to ensure that nurses’ clinical capabilities are understood by clinical commissioning bodies and that their skills are maximised.
As well as a voice, commissioning nurses are natural leaders of the profession in local areas. Some members of the wider nursing community may not always have the established support network that those working in larger organisations have access to.
Executive nurses lead on professional development, succession planning and development of the future model for general practice nurses in local areas ensuring that this is coherent with the wider local strategy. They are able to impart learning from the national to local level, as well as showcasing successful and innovative local work on national platforms.
It is clear from talking to our members that the breadth of experience executive commissioning nurses bring to the table, as well as their strong relationships and ability to see the system as a whole, makes them an invaluable and irreplaceable contributor to strategic clinical commissioning.
“As we move towards place-based models of care, it’s clear that a command-and-control relationship between commissioners and providers won’t cut it”
It is important that as nurses, we see ourselves in this way too, and challenge ourselves and our colleagues to have honest conversations about how different approaches can help to improve services and outcomes for our local populations.
As we move towards place-based models of care, it’s clear that a command-and-control relationship between commissioners and providers won’t cut it.
Nurses already possess the skills to build alliances and collaborate effectively across organisations, thus sharing local risks and burdens.
As the NHS looks towards its next 70 years, now is the time to embed commissioning nurse leadership within the strategic and integrated systems to maximise value and improve outcomes for our populations.
Allison Cannon is chief nurse and director of quality, East Surrey and Sussex Clinical Commissioning Groups