Today, we are continually being asked to prove our worth, demonstrate effectiveness, and present outcomes which may or may not determine payment. However, at times it’s like we are living in the middle of Heisenberg’s uncertainty principle; the more precisely you measure one quantity, the less precisely you can know another associated quantity; for example, both healing (a) and well-being (b) may be quantities we measure as outcome indicators in wound management. However, if we are being asked to focus on measure (a), which is a likely request from a commissioner, are we in danger of being unable to measure (b), which is probably more important to the patient?

So in order to remove any uncertainty, community nurses must face such challenges head-on and work with commissioners to ensure a patient-centred outcome rather than a resource-centred one. In this article, we look at the role of Clinical Commissioning Groups and hear from both the Chief Operating Officer and the Executive Nurse.

The NHS reforms brought about by the Health and Social Care Act 2012 are being embedded, but the pace and complexity of nursing work continues. In this article, Dr David Foster, Deputy Director of Nursing and Midwifery Advisor, Department of Health, outlines how he and his colleagues support the work you are doing.