Clinician-led commissioning

From April 2013, clinical commissioning groups (CCGs) will take over full responsibility from PCTs, commissioning the majority of NHS services for their patients, including elective hospital care, rehabilitative care, urgent and emergency care, most community health services, plus mental health and learning disability services.

These influential new organisations are designed to put clinicians at the forefront of decision-making enabling collaborative, bottom-up approaches to designing local services; however concerns remain that they could simply replicate their PCT predecessors.

There are also fears that boards will be GP-dominated, overlooking the vital contribution nurses make to primary and community-based care. Indeed, government guidance states that CCG boards must not recruit a local practice nurse as their 'executive nurse' but must look further afield in order to avoid a 'conflicts of interest'. They can, however, recruit local nurses to other board positions or seek input from grassroots nurses, on a formal or informal basis.