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CCG roles should be 'for experienced commissioners'

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Clinical commissioning group (CCG) boards should appoint nurses with proven commissioning experience to ensure their input is effective, according to RCN general secretary Dr Peter Carter.

Dr Carter said some nurses being appointed to boards were 'good people' but warned they were 'not the people who will bring real added value to the complex issue of commissioning'.

'Commissioning is very, very difficult, and the average nurse, however how well intended, just won't have the experience,' he explained.

RCN guidance states that the CCG lead nurse should have 'significant experience and understanding of the whole health and social care system', adding that 'ideally it will be a full time post'.

However, GP and DoH National Clinical Commissioning Network lead Dr James Kingsland said he was 'very concerned' about Dr Carter's remarks, claiming they demonstrated a lack of understanding of the aims of the commissioning reforms.

'Saying that nurses don't understand commissioning is misleading,' he said. 'Some might not be conscious of it, but they are commissioning every day when the prescribe, or choose a wound dressing, or treat a diabetes patient.

'For me, the nurse on the board has to be someone in clinical practice, who sees what is going on day to day. It doesn't have to be a practice nurse, it could be a district nurse or a health visitor.'

Dr Kingsland said having nurses working full-time in commissioning ran the risk of recreating PCTs, which would 'completely miss the point' of introducing CCGs.

'I'd say a practice nurse who is a real expert in understanding the delivery of care, who of course has to learn some new commissioning skills, is more important and relevant than a nurse who decided to leave practice, and go into management, and learn management speak. That is the old world.'

The DoH maintains it is up to individual CCGs to decide how they recruit a nurse to their board, as it is dependent on local circumstances.

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