Why nurses’ voices must be heard in clinical commissioning groups

The purpose of clinical commissioning groups (CCGs) is to work with both patients and healthcare professionals and in partnership with local communities and local authorities to ensure that people receive the best care possible. It stands to reason that nurses should be a part of this. 

In primary care, nurses and healthcare assistants are heavily involved in patient care and, as a result, have an excellent understanding of how services are delivered and the needs and concerns of patients, their relatives and carers. And as nurses working in clinical practice are at the grass roots of the services, they will also have firsthand experience of the frustrations and problems that they face as clinicians.

Chief Nursing Officer, Jane Cummings promotes the “six Cs” of nursing. She emphasises open and honest communication and the courage of nurses and healthcare assistants to speak out regarding care and to be able to critically appraise services. Nurses and healthcare assistants build a rapport with people through open and honest communication and therefore can seek the views of individuals regarding their care. It is this information that can shape the future delivery of care, and nurse involvement in clinical commissioning offers a valuable opportunity to positively influence that change. 

Portsmouth City CCG
Portsmouth City CCG provides an example of how nurse involvement has helped to shape and improve care and health outcomes. We are privileged to have the input of two nurses with very different roles that complement each other. Our main nurse is the governing board nurse, Dr Julie Cullen. Julie is an excellent nurse and university lecturer with several years’ experience championing nurse leadership for the benefit of patient care. She has a wealth of knowledge of strategic working and sits on the board to ensure that patient care is at the heart of all decision making. 

My role within the CCG is as a clinician and practice nurse representative. I am the voice of the practice nurses and seek feedback from practice nurses through the Professional Practice Nurse Forum, other networks and education events. My role is widely known by all the nurses through my professional networks and is supported by practice managers. I am closely linked with the board nurse and am encouraged by her to share ideas, initiatives and concerns from nurses and patients. Our board nurse is also our link into the corporate side of clinical commissioning and will keep us informed of national and local changes. 

How nurse involvement in CCGs has improved diabetes care
Portsmouth City CCG listened to nurses’ suggestions for a diabetes specialist service in order to avoid hospital admissions. In general practice the workload is huge and practice nurses are expected to deliver more specialist services than ever before. The CCG recognised that practice nurses need to be excellent generalists as they are central to holistic care. Therefore, the CCG commissioned the diabetes team to provide a specialist community service and we now have two part-time DSNs who work with the practice nurses to support them with complex diabetes care, such as starting insulin. These DSNs, Gwen Hall and Allison Tier, are accessible and approachable and feedback from practice nurses is outstanding; the nurses feel valued, supported and are building the confidence and competence to deliver expert care.

This is just one example of the initiatives relating to nursing services and patient care and highlights the importance of nurse and healthcare assistant involvement in commissioning. Nursing and healthcare assistant input can influence change that will result in a highly skilled and supported workforce, which in turn, will lead to improvements in patient care.

CCGs across the country will improve services and quality care if nurses’ input is valued, so let’s make sure our voices are heard!