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Pressure builds on government over nursing involvement in reforms


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.

Sign our petition today to ensure nurses have a seat on consortia boards! Follow @Aseatontheboard on twitter follow for all the latest campaign news!


Readers' comments (5)

  • What do you reckon Mike?


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  • I agree with the last comment . Nurses should Strike to save the NHS. The government has no respect for nurses or the public who depend on the NHS as a front line service. A few token positions in the GP consortia, as a bribe. is not gonna cut it.


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  • Anonymous | 12-Apr-2011 3:41 pm: I fear striking alone will not cut it any more. Striking and negotiating and asking and pleading, it will never be enough.

    We should not be asking can we sit on the top table with the almighty GP's, we should be on there in equal numbers without question!

    We should not be asking to be part of the new NHS, we should be demanding our role in running it and we should be incensed that we even have to do so in the first place!!!! As I have said many times before, there IS no NHS or ANY care system without us!

    So yes, striking is a great first step in the right direction, but we need more than that now. It is time our profession stood up for itself. It is time we stopped allowing anyone to make us second fiddle in a health care system we all believe in. It is time we stopped simply accepting low respect, low status, threats to our pay, conditions, livelihoods and professions.

    We all need to stand up and fight now. Just look at what is happening now that the unions are finally starting to get a bit of a backbone. The slightest HINT of action from our profession and we have them worried. The government and the trusts are already back peddling and backing down, they are trying to save face whilst trying not to show how worried they have become. They are afraid that they have awoken the dragon, to coin a phrase, so I say it is time to press that advantage and show them that the dragon has awoken and they can no longer get away with treating our profession as second class citizens. If we all stand up and start fighting now, they don't stand a chance, and more importantly, they will now that in the future, they mess with our profession at their own peril.

    But if we don't, if we fail to act, if we don't stand up to the plate now, our profession, and the NHS, is doomed.

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  • Well said Mike!

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  • They have got us scared, very scared to do anything. On one hand we are offered academic recognition, on the other job cuts, what do you go for?

    I really believe whatever we do is too little. too late. Chip away, chip away to beyond recognition of what the NHS stands for, or did.

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