Clinical commissioning: the nurse's role.

The move to place clinicians at the centre of healthcare commissioning has been an integral aspect of reforms to health and social care in England. This article outlines the background to clinical commissioning and considers the roles and responsibilities of clinical commissioning groups (CCGs) and the nurses working in them. One CCG is used as an example to illustrate how policy has been put into practice.

New responsibilities in purchasing and developing services.

The role of nursing in the NHS commissioning structure in England is developing. Since April 2013 more than 200 clinical commissioning groups (CCGs), which comprise all GP practices in the locality, have taken on responsibility for health budgets in their areas. This article describes the challenges ahead and nurses' responsibilities in CCGs when working with local citizens and across the health and social care system to assure the delivery of high quality, safe services.

Practice question.

As a nurse practitioner for older people I spent many years responding to requests for home visits to nursing and residential home residents. Now I respond to requests from intermediate care and community hospitals. Regardless of who employs the health professional or what their role is, it is essential that we all work together to ensure the best outcome for the patient.

Practice question.

The Deprivation of Liberty Safeguards (DoLS) have been part of the legal framework for the care of people lacking capacity since 2009. Yet there remains a great deal of misunderstanding and fear about the practical application of this part of the Mental Capacity Act 2005.

Dignified care.

Do not forget the person: this is the central message of a new dignity campaign by the British Geriatrics Society (BGS), aimed at reminding all those working with older people of the basic principles of dignified care.

Ask the experts.

Patient information needs to be shared within and between NHS organisations. Information technology (IT) systems can achieve this when developed in an integrated way.

Neglect is not a cut and dried issue.

There are obviously situations where the development of a pressure injury is caused by neglect and/or poor practice; however, with the increasing number of individuals living with significant frailty and disability in the community, there are circumstances in which an injury can occur due to uncorrectable pathological processes.

On the campaign trail.

My concern about the present dignity campaign is that it is minimising the complexity of the problem, and frontline staff are suffering the backlash for everything that is wrong in the system without a genuine review of why there is such a problem in the first place.