COMMISSIONING
Howard Catton, the Royal College of Nursing’s Head of Policy and International, speaks to NHE about the concept and practice of clinician-led commissioning.
mid dismissive talk in some quar- ters about the Government’s health reforms being “watered down”, for nurses the changes marked something of a victory, with the shifting emphasis from purely GP- led commissioning to the more inclusive Clinical Commissioning Groups and ‘clini- cal senates’.
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The RCN’s Howard Catton, the organisa- tion’s head of policy and international, told NHE it was a victory for patients, it was not about nurses’ egos.
He said: “We are pleased with the proposed changes to the Bill. The important starting point for me is that we’re very aware that there are a lots of people who are not sure about this; they’re not sure about designat- ing nurses on commissioning boards for secondary care.
“People should be there because they’ve got the right skills for them to undertake those roles. I actually don’t disagree with people who say that we need the people with the right skills, but I do disagree with the con- clusion that therefore putting a nurse in there is tokenistic.”
Transforming models of care
He continued: “You have to look at future care demands: what we are going to be fac-
22 | national health executive Jul/Aug 11
The debate is not a completely theoretical one, of course: plenty of commissioning groups exist already, and the RCN has been
ing in terms of an ageing population and the increase in people who are suffering from long-term conditions, often multiple conditions as well. Nursing care and sup- port is going to be absolutely crucial to meeting those future healthcare demands.
“That is the key driver, the key reason why commissioning consortia need to have nurses on the board, because they are go- ing to be commissioning for an ageing pop- ulation with long-term chronic conditions, with patients needing more care and sup- port at home.
“Patients will need support to make more decisions about their own care, their own future, their own management and their own treatment. Nurses and nursing will play an absolutely crucial role in meeting those care demands. So, the reason why we argued and we lobbied as hard as we did to get nursing on the boards was absolutely driven by what we believe future patient needs are going to be. Without that nurs- ing contribution at board level, I think the ambitions of commissioning would be frus- trated.”
Evidence so far
monitoring “very carefully” the experiences of the Pathfi nders.
Catton said: “Just before the NHS Future Forum’s fi nal report and the Government’s response, we put out our own information on what we were fi nding in relation to nurs- ing involvement as far as Pathfi nders were concerned.
“There was no specifi c requirement for nursing involvement, and it was diffi cult to fi nd out what was going on; few of the Pathfi nders groups came back to us, so we were aware that only about a third, at that time, were actively involving nurses and looking at having nursing at the top.
“What that said to us was, and the concern it created for us, was that if we were to leave it to entirely local voluntary decisions and arrangements, it might not happen, to be frank.”
Currently the Health & Social Care Bill does not specifi cally legislate for nurses on every local commissioning board – al- though it has been revealed that one of the fi ve executive board directors on the na- tional NHS Commissioning Board will be a nursing director, alongside ‘professional leads’, who will be doctors and nurses.
Catton said he expected that in practice,
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