The majority of the cutting edge GP commissioning consortia are in favour of having nurses on their boards, Nursing Times has found.
The views of the “pathfinder” consortia announced by the government last week give strong backing to Nursing Times’ A Seat on the Board campaign.
We felt strongly that it was critical to have nurses and other health professionals involved in the development of our plan for the future
The pathfinders have been set up to inform the government’s plan to hand the bulk of decision making on NHS spending to GP consortia in April 2013.
However, many have not yet recruited any nurses, and have only GPs on their boards at present.
Nursing Times spoke to 13 of the 54 pathfinders. Twelve said they supported the need for nursing representation, and five already had at least one nurse on the board.
The Langbaurgh Consortium, which covers 16 practices in Redcar and Cleveland in the north east of England, has nurse practitioners as well as GPs, practice managers and pharmacists on its board.
Ali Tahmassebi, the current chair of the consortium, which is planning to hold elections for the post in the near future, supported the Nursing Times campaign.
He said the consortium planned to focus on improving productivity, and “no one knows better about the waste that’s going on than the people who carry out the services”.
Principia, a social enterprise and pathfinder consortium in Nottinghamshire, has three nurses on its board. Clinical lead Jeremy Griffiths, a GP at Ludlow Hill Surgery, said all consortia boards should have nurse involvement.
He said: “All [health professions and patients] need to be connected as strongly as is feasible. All are therefore represented at the top of the company, to provide dynamic leadership to those they can influence most, namely their colleagues.”
Dudley GP Commissioning Consortium also has a nurse on its board. Its lead GP David Hegarty said the practice nurse was already “intrinsically involved in commissioning”, and had been chosen by her local practices to represent them on the board.
He said: “We absolutely feel nurse representation adds value.”
Jonathan Bates, interim GP lead of The Sutton Consortium in south London similarly said: “We felt strongly that it was critical to have nurses and other health professionals involved in the development of our plan for the future.”
He added nurses were essential to the success of GP practice, not least because they carried out a large part of the care covered by the quality and outcomes framework, which rewards GPs with bonuses for meeting certain process and outcome targets.
However, not all pathfinders have nurses on their board. Nene Commissioning, a consortium of 76 practices that covers more than 500,000 people in Northamptonshire, has an all GP board.
Chair and GP Darin Seiger said the consortium had “good levels of engagement” with nurses but broadening the board to nurses, or any secondary care clinicians, was “a step too far at the moment”.
Seven of the 13 consortia which spoke to Nursing Times said that, although they supported the need for nurses on their board, they were not developed to the stage where they had appointed one, or were waiting for government guidance.
Despite these early signs of GP interest in giving nurses a significant role, Johnny Marshall, chair of the National Association of Primary Care, rejected some senior nurses’ calls to make nurse involvement a legal requirement.
Dr Marshall said: “What can sometimes happen is things like this are translated into structural arrangements, such as a seat on the board, and that isn’t necessarily the best way of doing it. That may be the traditional way of doing things, but we’re keen for people to perhaps think in a more transformational way.”
But Unison head of nursing Gail Adams said nurses on consortia boards was “not an option”.
“It is something we think is fundamental. The quality of services can be much better improved if they are commissioned in a multiprofessional way.”