Nursing has moved a significant step closer to winning the battle for formal involvement in future NHS decision making this week, after strong signals the government will change its mind about GP domination of commissioning.
Prime minister David Cameron has put on hold previous plans to hand NHS spending decisions to GP-led commissioning consortia – with no formal requirement to include nurses or other professions – following strong opposition from organisations including the Royal College of Nursing.
Nursing Times is currently campaigning to get a nurse on the board of every GP consortium – the new bodies that will take over from primary care trusts.
Mr Cameron last week launched a review of the government’s NHS reform proposals, which he described as a “listening exercise”.
It followed an announcement by health secretary Andrew Lansley that there would be a “pause” on the passage of the Health and Social Care Bill through parliament in order to listen to concerns from health professionals.
The review will be carried out by a panel of around 50 senior clinicians and managers who will consult with NHS staff, the public and relevant organisations, before suggesting changes to the bill. One of those understood to be leading the process is Julie Moore, a former nurse and now chief executive of University Hospital Birmingham Foundation Trust.
The group, named the NHS Future Forum, will be chaired by former Royal College of GPs chair Steve Field. Most members have yet to be announced.
Speaking to Nursing Times last week, Professor Field said nurses and other professions must be involved in commissioning. He said: “I have always said you cannot do this without high quality nurses, managers and specialists involved.”
He highlighted that the review was restricted to “improving” the current proposals, rather than scrapping them. But he said: “I want to hear ideas about how clinicians should be engaged in order to get them to own [the policy]. We want people on board. Clearly at the moment many people feel they are not.
“I want to help in whatever way I can to hear concerns and help the politicians address them.”
Professor Field said review members would be, “going out and listening to people who are working in the NHS, together with patients and the public”. He said they also needed to involve organisations – such as the RCN – which have been highly critical of elements of the plans.
He said: “We will want to engage with various organisations and I am sure they will want to engage with us. The message is ‘the door is open.’”
The review is expected to make recommendations for changes to the bill in June, which the government will be under pressure to accept.
Last week also saw public support for nurses to have a statutory role in commissioning services build with politicians from all major political parties giving their backing.
Conservative MP Stephen Dorrell, the influential chair of the Commons health select committee and former health secretary, called in a report for it to be mandatory for consortia boards to include “representatives of nurses and of secondary care doctors”.
Shadow health minister John Healey also said a commitment to involve nurses and other health professionals in consortia was essential if the reforms were to win Labour backing.
Speaking to Nursing Times at the Unison annual health conference last week, Mr Healey said he had an issue with “only GPs doing commissioning”.
He said: “Clearly nurses have expertise to offer the planning and commissioning of services. We have seen over the last decade nurses playing a bigger and bigger role, both as effective nurse managers and as specialists.
“In the future we should see nurses play a bigger, not a smaller part, in the way we run health services.”
Earlier this month, Dame Donna Kinnair, director of commissioning and nursing at NHS Southwark, warned health minister Anne Milton that some GPs were excluding nurses from being involved in consortia.
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