The RCN has asked health secretary Andrew Lansley to ensure nurses gain seats on the governing bodies of clinical commissioning groups (CCGs).
RCN general secretary Dr Peter Carter warned the government's pledge that every CCG board would include a nurse was not currently being honoured.
'There is a disconnect between Whitehall, and what is happening on the ground,' said Dr Carter.
Mr Lansley acknowledged there were insufficient numbers of nurse-led CCGs at present and added he hoped there would soon be more.
The RCN and Mr Lansley have backed IN's 'No Tokenism' campaign, calling for genuine nurse influence in clinical commissioning.