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Keywords:

  • hospitals;
  • matrons;
  • National Health Service;
  • senior nurses

Aim  The aim of this paper was to examine the consequences of the lack of a formal role for nurses within the administrative structure of the NHS between 1948 and 1966.

Background  UK health policy since 1997 has emphasized the need to re-create the NHS as a modern, dependable service, with clinicians leading the changes. Over the same period, restructuring of the bodies that determine the planning and provision of NHS services has resulted in fewer places for nurses on key decision-making bodies.

Evaluation  Exclusion from formal decision-making roles in the health committees of the NHS during its first two decades considerably limited the influence that nurses could exert over their own work and the circumstances in which they performed their duties.

Key issues  Nurses should recognize the importance of involving themselves in the politics of health and of health service delivery.

Conclusions  Nurses are unlikely to be able to deliver the changes in healthcare that current Department of Health policy anticipates without access to political and economic, as well as clinical, influence in the NHS.

Implications for nursing management  Nursing leaders should continually press the Department of Health to guarantee places for nurses at all levels of decision-making in the NHS and seek assurances that further restructuring will not result in further losses.