Every ICB must retain nursing expertise, RCN says

The RCN is warning that cuts to Integrated Care Boards (ICBs) will result in reductions in care services, put patients at risk and undermine the 10-Year Health Plan for England. We’re also demanding that every ICB retain a Chief Nursing Officer (CNO).

Earlier this year, the Westminster government announced a requirement for ICBs – the bodies responsible for funding and planning local services – to reduce their running costs by 50%. It also announced that NHS England would merge with the Department for Health and Social Care, leading to a 50% reduction in staff. In a report, the RCN highlights a range of actions for the government to take to protect nursing functions and to ensure patient safety isn’t compromised by these system changes.

There are thousands of registered nurses and other nursing staff employed within commissioning bodies, leading and contributing to vital functions. Each of the 42 ICBs currently has a CNO.

We believe that many of these roles could be at risk, with no guarantee that ICBs will have a nursing leader going forward. These roles are vital in providing unique clinical, public health, and safety oversight, sharing strategic advice and insight from the diverse breadth of the nursing workforce.

In the foreword of our report, Patricia Marquis, Executive Director of RCN England, said: “It is vital that no ICB moves forward without a CNO. These strategic leaders are essential to shaping key decisions relating to patient safety, service configuration and cost-effectiveness.

“We also need to ensure that nursing functions are protected from the impact of cost-saving measures and reforms. It is unacceptable that so many nursing staff do not have clarity about the future of their jobs so many months after the announcements were made.” 

Our analysis finds that patient safety would be compromised if any nursing roles or functions were to be lost, including the CNOs. We believe it’s vital to have executive-level nurse leadership to help translate this insight and activity into strategic directions.

• Read our full report

We also believe that the pace of change is too rapid for meaningful engagement from nursing staff, meaning that decisions are likely to be made without thorough impact assessments.

In the context of the NHS 10-Year Health Plan for England, we’re concerned that there is a disconnect between ambition and implementation. Nursing staff are key to facilitating transformative system change, working in partnership and safeguarding quality of care.

ICB leaders, supported by the NHS England transition board, must ensure that nursing roles are not lost under the guise of cost-saving.

“The RCN will continue to advocate for the importance of these roles, while also supporting nursing staff to stand up for their own valuable contributions in local planning discussions. We cannot let the government’s focus on fast-paced reform and cost-saving put patient safety at risk,” Patricia said.