CCG governing boards may not include local councillors and must include one secondary care nurse, the NHS Commissioning Board has said.
The new policy tightens the previous ruling that CCG boards had to include one nurse – many CCGs had planned to give the place to a practice nurse.
The nurse must not work for a major provider contracted by the CCG – which has raised concerns about finding suitable people.
Councillors are also excluded by the new governance regulations for CCG boards, to be published in July.
Both decisions reflect tensions between the need to avoid conflicts of interest and the need to bring together the most relevant stakeholders.
The statement on nurse members follows concerns raised by the RCN and others that a practice nurse might be inexperienced and, at worst, a ‘token’ appointment.
Dame Barbara Hakin, National Director of Commissioning Development, said it was important for a nurse to bring a “different perspective” from that of primary care.
As the number of people on a CCG board is unlimited, practice nurses could also be appointed.
The prescribed nurse and acute care medic on the board must not be employed by major local service providers to the CCG.
According to Nursing Times, this means many CCGs may struggle to find suitable people.
Similarly, the exclusion of local councillors will weaken engagement between the NHS and social care.
However, the BMA has confirmed that CCG boards will include GPs: a proposed GP boycott of CCGs was rejected by its Annual Representatives Meeting.