The government, currently driving the controversial Health and Social Care Bill through Parliament, says nurses can be on the boards of clinical commissioning boards (CCGs), which are replacing PCTs. However, Unite, which embraces the CPHVA, along with other health unions, says nurses should be on these boards.
Changes are taking place in how the NHS is managed before legislation has received Royal Assent - a strangely undemocratic process. It is disappointing how few practitioners feel engaged, a feeling borne out by the members we speak to up and down the country.
In some areas, we have heard that staff are actively discouraged from involvement with CCG boards. There is a lack of opportunities for nurses to observe and learn how boards function and how changes are affecting services. There are not enough examples of good practice with the accompanying involvement and inclusion. Without these building bricks in place, there is a real risk that the potential impact of services won't be fully understood by commissioners..
We are in year two of the health visitor implementation plan, where proper commissioning structures are vital, if we are to have an impact on the health of communities.
Staff should ask managers about what is being commissioned - all too often, conversations are about what is not being commissioned. Commissioners will need to meet with the clinical workforce to discover the true picture on the frontline.
However, it is good to see just over a third surveyed by Independent Nurse intend to become commissioners or to influence commissioning. The goal should be for health visitors and nurses to overcome barriers, real and imagined, and make their voices loudly heard on these new boards.
Nurses are at the epicentre of patient care - they should also be at the heart of the commissioning process. These two aims are not mutually exclusive.