Governing body nurses' experiences of clinical commissioning groups: an observational study of two clinical commissioning groups in England

Clinical commissioning groups (CCGs) were set up under the Health & Social Care Act (2012) in England to commission healthcare services for local communities. Governing body nurses (GBNs) provide nursing leadership to commissioning services on CCGs. Little is known about how nurses function on clinical commissioning groups. We conducted observations of seven formal meetings, three informal observation sessions, and seven interviews from January 2015 to July 2015 in two CCGs in the South of England. Implicit in the GBN role is the enduring and contested assumption that nurses embody the values of caring, perception and compassion. This assumption undermines the authority of nurses in multidisciplinary teams where authority is traditionally clinically based. Newly emerging public management roles - such as those within CCGs - are not based on clinical knowledge and scope of practice. The type of leadership promoted by new public management prizes governance over clinically based authority. The authority of GBNs is contested by members of the CCG and external stakeholders irrespective of whether it is aligned with clinical knowledge and practice or with new forms of management, as both disregard the type of expertise nurses in commissioning embody