An exodus of senior nurses from key local NHS commissioning roles is taking place, which threatens to create a leadership vacuum, Nursing Times has been warned.
In the north east, the Royal College of Nursing said all 12 primary care trust nursing directors had left their organisations since PCTs’ abolition in 2013 was announced in July, as part of the government’s NHS reform agenda.
RCN representative Glenn Turp said most had either left for another job or taken retirement. Nursing Times has also seen evidence that PCTs in other regions are losing their nursing directors.
RCN policy director Howard Catton warned the pattern was reflected nationally. He said: “We have become increasingly aware of PCT nurse directors who are moving on, and others who are looking for other opportunities.”
Concerns have consistently been raised over recent months that key staff would choose to leave PCTs during the transition to the new system of GP consortia as a result of uncertainty over their future.
The situation has been compounded by PCTs merging into “clusters”, following a dictat to cut management costs. The government has said each one must have a nurse director but there are expected to be about 50 clusters nationally – about a third of the current number of PCTs and far fewer than the predicted 250 GP consortia.
Mr Catton said the loss of PCT nursing directors was “a predictable consequence of the fact we’ve not got a clear, or formal, indication of the requirements about involving nursing in commissioning in the future”.
He said the government’s current proposal – that commissioning consortia be required to take advice from other professionals – could be interpreted in various ways as to when involving nurses was appropriate.
Health secretary Andrew Lansley last week told Nursing Times he would like to see nurses sitting on GP consortia boards, but maintained that he would not make it mandatory.
But Mr Catton said: “[This] is only advisory and it needs to be strengthened. It is worrying we are losing the knowledge and experience [of the individuals] and cannot get it back quickly. It is critical, particularly in developing nurse-led services and integrated care.”
He added: “Losing that could undermine some of the service changes we need for the future.”
Mr Catton said another concern during the upheaval was the lack of nurse commissioners to “ensure robust and high quality care, and hold people to account” for it during the transition period.
The government confirmed last week that nurse involvement in its reforms at a national level would be overseen by chief nursing officer Dame Christine Beasley until October, which will include a senior nurse sitting on the NHS Commissioning Board.
It remains unclear how many other nurses the board will employ, either at national or regional levels.
Despite the loss of PCT nurse directors in the north east, a spokeswoman for the strategic health authority NHS North East said it still intended to meet the government’s requirement to have one for each of its four PCT clusters.
She said: “Up until now PCTs in the north east have had either a director or an associate director of nursing providing advice to their boards. We are reviewing the position to ensure compliance [with the guidance on clusters].”
Last month, an investigation by Nursing Times found hospital trusts had identified significant gaps in nurse leadership in the acute sector.