Do governing body and CSU nurses on clinical commissioning groups really lead a nursing agenda? Findings from a 2015 Survey of the Commissioning Nurse Leaders' Network Membership.

AIMS: This paper reports the findings from a 2015 survey of the Commissioning Nurse Leaders' Network. Our aim was to understand how governing body nurses perceive their influence and leadership on clinical commissioning groups. METHODS: An online survey method was used with a census sample of 238 governing body nurses and nurses working in Commissioning Support Units, who were members of the Commissioning Nurse Leaders' Network. The response rate was 40.7% (n = 97). RESULTS: While most governing body nurses felt confident in their leadership role, this was less so for non-executive governing body nurses. Nurses in Commissioning Support Units were much less positive than governing body nurses about their influence on clinical commissioning groups. CONCLUSION: Governing body nurses were satisfied with their impact on clinical commissioning groups and so could be said to be leading a nursing agenda but this evidence is limited to their own perceptions and more objective or diverse measures of impact are needed. The purpose of such roles to 'represent nursing, and ensure the patient voice is heard' may be a flawed aspiration, conflating nursing leadership and patient voice. IMPLICATIONS FOR NURSING MANAGEMENT: This is the first study to explore explicitly the differences between executive and non-executive governing body nurses and nurses working in commissioning support units. Achieving clinical commissioning groups' goals, including developing and embedding nursing leadership roles in clinical commissioning groups, may be threatened if the contributions of governing body nurses, and other nurses supporting clinical commissioning groups, go unrecognised within the profession, or if general practitioners or other clinical commissioning group executive members dominate decision-making on clinical commissioning groups.

Good care cannot help all.

Thank you for the thoughtful article 'Nurse backs challenge to law on assisted dying' (analysis, 26 July). It was well balanced, but I feel I must challenge some statements in it.

Obesity plan is misdirected.

The government's new obesity strategy not only fails to challenge the big food companies who profit from childhood obesity, it has shifted responsibility to health visitors who are already dealing with an impossible workload.

Nurses' experiences of clinical commissioning group boards.

Aim To explore the experience of governing body nurses appointed to clinical commissioning group (CCG) boards; how they perform their responsibilities; and their perceived effectiveness in ensuring safe, patient-centred care and the factors that influence their effectiveness. Method This was a small pilot study using a mixed methods approach. There were four phases of the study: literature review, qualitative data collection (interviews), quantitative data collection (survey), and final data analysis. Findings In the early stages of the formation of CCGs, few governing body nurses had relevant experience to meet the needs of a strategic role, and many of these nurses had no proper job description, too little time to carry out their responsibilities, little management support, and unequal access to training, development, formal support or supervision compared to GP colleagues. Two working patterns or models of work of governing body nurses emerged: the full-time integrated executive statutory role and the part-time non-executive statutory role. Quality and quality assurance were the most frequently cited roles or responsibilities of governing body nurses in CCGs, and their highest priority was to improve the population's health. Conclusion The role of governing body nurse has emerged at a time of organisational change, and following extensive criticism of nursing and nurses in the media. Nurses' roles and experiences are affected by these contextual events and by the emerging structures and diversity of CCGs. Further research is required into the leadership role of governing body nurses, succession planning, and the effectiveness of their relationships with other senior nurses.

Are senior nurses on Clinical Commissioning Groups in England inadvertently supporting the devaluation of their profession?: A critical integrative review of the literature.

In this study, we discuss the role of senior nurses who sit on clinical commissioning groups that now plan and procure most health services in England. These nurses are expected to bring a nursing view to all aspects of clinical commissioning group business. The role is a senior level appointment and requires experience of strategic commissioning. However, little is known about how nurses function in these roles. Following Barrientos' methodology, published policy and literature were analysed to investigate these roles and National Health Service England's claim that nursing can influence and advance a nursing perspective in clinical commissioning groups. Drawing on work by Berg, Barry and Chandler on 'new public management', we discuss how nurses on clinical commissioning groups work at the alignment of the interests of biomedicine and managerialism. We propose that the way this nursing role is being implemented might paradoxically offer further evidence of the devaluing of nursing rather than the emergence of a strong professional nursing voice at the level of strategic commissioning.

Junior doctors are now in the same boat as nurses regarding pay.

It was great to see so much support for junior doctors among nurses at Barts Health NHS Trust in London (analysis November 18). But where is the RCN in supporting the junior doctors?

Fighting the good fight from Lambeth to Cambridgeshire.

Please join us for the next meeting of Lambeth Keep Our NHS Public on Thursday November 21, from 7pm at the Duke of Cambridge, 74 Lansdowne Way, London SW8 2DR. For further details, email lambethkonp@gmail.com.

NHS pensions are in jeopardy for many if health bill is passed.

I am pleased that the RCN is opposing the health and social care bill ( news January 25 ) and I hope this will make a big contribution towards its demise. It would be less damaging to drop the legislation, difficult though this might be, than to go on with this dog's breakfast of a bill.

Capability assessments record shames paralympics sponsor.

It was shocking to read how work capability assessments by private company Atos Healthcare are leading to many nurses with disabilities being denied Employment and Support Allowance (news August 22).

Debate on assisted suicide needs up-to-date information.

Stephen Wright's (reflections May 11) bases his 'slippery slope' argument about assisted suicide and euthanasia on Dutch figures from the early 1990s. He mistakenly says that the law to regulate euthanasia and assisted suicide preceded these figures.

Honour a patient's request to die without judgement.

Nurses who hear a patient asking for assisted dying should really listen. It is wrong to ignore an authentic request, or dismiss it with 'you don't really mean that'.