There must be a registered nurse on the board of every GP led commissioning consortia, the government has said in its revised health reform plans – marking a victory for the Nursing Times’ Seat on the Board campaign.
The government has today announced the amendments it will make to the Health and Social Care Bill, following the “listening exercise” sparked by concerns from clinicians about the proposed reforms.
The move to require consortia – which will now be known as clinical commission groups – to have at least one registered nurse on their board, or governing body, was called for by Nursing Times and a range of other influential bodies, including the Royal College of Nursing.
A government document summarising the changes to the bill states: “Commissioning consortia will continue to be groups of GP practices, but we will make a number of changes to provide greater assurance that commissioning will involve patients, carers and the public and a wide range of doctors, nurses and other health and care professionals.
“To reflect this stronger emphasis on wider professional involvement in commissioning decisions, we intend to use the term ‘clinical commissioning group’ to describe these local NHS organisations.”
The document adds: “We do not intend to prescribe in detail the wider professional membership of the governing body [of the commissioning group], but it will have to include at least one registered nurse and one doctor who is a secondary care specialist.
“They must have no conflict of interest in relation to the clinical commissioning group’s responsibilities, eg must not be employed by a local provider.”
Boards will also have to include two lay members.
The government’s announcement overrules recommendations published yesterday by the Future Forum – a group of around 40 clinicians and other healthcare representatives set up by the government to inform changes to the bill – that said consortia should not be compelled to have nurses on their boards.
However, the government has accepted other recommendations made by the forum on wider clinical involvement and advice in the commissioning of NHS services.
The revised reform plans say that clinical networks, such as those that exist for cancer, will be expanded to cover more specialised areas and be given a “stronger role in commissioning”, in support of local clinical commissioning groups and the new overarching national body the NHS Commissioning Board.
Additionally, ministers want nurses and a range of other health professionals to form “clinical senates”. They will have a major say in whether a commissioning group should be allowed to form in a certain area and will also advise commissioning groups on whether their plans and strategies are sound.
The government document states: “We will enable doctors, nurses and other professionals to come together in ‘clinical senates’ to give expert advice, which we expect clinical commissioning groups to follow, on how to make patient care fit together seamlessly in each area of the country.
“Clinical senates will have a formal role in the authorisation of clinical commissioning groups. In addition they will have a key role in advising the NHS Commissioning Board on whether commissioning plans are clinically robust and on major service changes.”
Announcing the changes to the reforms at Guy’s Hospital in London today, prime minister David Cameron said: “We have listened, we have learned, and we are improving our plans for the NHS.”
He added: “The fundamentals of our plans – more control for patients, more power to doctors and nurses, and less bureaucracy in the NHS – are as strong today as they have ever been. But the detail of how we are going to make this all work has really changed as a direct result of this consultation.”
Nursing Times launched its Seat on the Board campaign in December 2010, calling for it to be made a requirement for consortia to have a nurse on their board.
The campaign was launched in response to concerns that the nursing profession would lack sufficient influence over future NHS funding decisions made by the GP led consortia which are due to take over from primary care trusts in 2013.
Over a 1,000 people have signed a petition supporting the campaign.
Royal College of Nursing chief executive and general secretary Peter Carter welcomed the government’s pledge that nurses would have a guaranteed place on commissioning boards.
He said: “The RCN has been saying from the outset that nurses have an unparalleled range of skills and experience to enable them to improve health care at every level, and we are very pleased that the government has recognised the difference this will make to patients.”
However, he added that while “many of our concerns have clearly been taken on board… there is a great deal more to do”, highlighting the pressure on frontline jobs.
“These reforms have to be absolutely right if the NHS is to face the challenges ahead, especially at a time when the service has been tasked with saving up to £4bn per year,” he said.
Unison general secretary Dave Prentis reiterated his union’s position that the Health Bill was beyond repair and should go back to the drawing board.
He said: “The government is creating a Frankenstein Bill that should be thrown out now. The fact that the government is accepting the bulk of the Future Forum’s recommendations, simply underlines just how damaging the Health and Social Care Bill was and is to the NHS.”