Health secretary Andrew Lansley has given concessions to British nurses, but
the Royal College of Nursing (RCN) has demanded more action, not merely
placating words from the system. A recent announcement from Lansley altered the
language on NHS reforms and is now more ?inclusive? of nursing.
Nursing Times sponsored a petition sent to Lansley, saying that nurses and
midwives should be actively involved in the new commissioning consortia and
represented on all boards. Nursing Times believes that nurses have previously
been disenfranchised from commissioning services, which is not befitting the
single largest healthcare profession. The Nursing Times noted that nurses have
the greatest amount of direct patient contact, and share unique insight into the
complex interplay of social, financial, and environmental factors and their
effects on health and well-being. Nurses, then, must have their voices heard.
Lansley?s statement to the Commons on April 4 responded to the increasing
political struggle with the pace at which the Health and Social Care Bill was
moving through parliament. The health secretary announced a pause in the bill?s
introduction, and during his statement, Lansley referred to ?doctors and nurses?
rather than just ?doctors,? which has been viewed as a conscious move away from
focusing the reforms largely on the role of GPs and becoming more inclusive of
health care?s front line of workers: nurses.
In his statement, Lansley said he wanted to create a service ?where the power to
deliver is in the hands of local doctors, nurses, health professionals and local
communities?.
The Royal College of Nursing and other organizations have been applying pressure
on legislators for the official recognition of the importance nurses and other
health care professionals in the new GP led consortia that will assume the
responsibility of making most spending decisions from primary care trusts.
Howard Catton, RCN head of policy development, was the one to describe Lansley?s
new language about reforms as ?now inclusive? of nursing. He reported to the
Nursing Times that he believes the health secretary recognized that nursing
could make an important ?contribution at the top table? of commissioning
consortia.
Catton added, however, that this new recognition needs to be backed up by
action. Catton echoed the call by the Nursing Times? Seat on the Board campaign
to require a nurse to sit on the board of every consortia.
Catton said, ?His [Lansley?s] language is now inclusive. He talks nursing very
well, but what we now need to see is that translated into a requirement to have
nursing seat on the board [of GP consortia].?
Catton called for practical movement on this issue. ?Nurses will want to see
pragmatism,? he said. ?If we don?t, it could create even more difficulties [for
the reforms].?
There were also calls for reform from the MPs from the influential commons
health select committee, which wants the bill to be amended so that it is
compulsory for GP consortia to include a nurse on their board.
The following petition was issued by Nursing Times to Lansley:
?We the undersigned believe that as nurses play a crucial role in the provision
of patient care, the profession must be represented in commissioning consortia.
?We want those bodies that have begun issuing guidelines to consortia - the BMA,
the RCGP, the National Association of Primary Care and the NHS Alliance - to
state clearly that a nurse should be on the board, and we would ask for your
support in this aim by issuing this advice to them.
?Nurses don't just deserve to be on the board because of their number, but
because of their unique experience in the NHS. They have a different focus from
GPs, with a strong emphasis on patient care and quality of patient experience,
and are the only profession who deliver holistic patient care, working to meet
all the needs of individual patients rather than focusing on a narrowly defined
aspect of those needs. Because nurses see patients in many different situations
along the care pathway, and have a round the clock presence for many, they have
insight to share that can significantly improve patient treatment outcomes.
?With their heavy workload and limited consultation time GPs must focus largely
on patients' medical needs or refer them on to specialist practitioners. They
cannot be expected to step back and consider the impact of social, economic and
environmental factors, and there is a real danger that they will not have the
perspective to ensure that service commissioning takes account of these.
Ignoring nurses' contribution would seriously impact on patient safety and their
quality of care, as well as the efficiency of the NHS. Therefore we urge you to
involve nurses to ensure that those services being commissioned are designed to
reflect the complex relationships between individuals' health and other wide
ranging aspects of their lives.?