Alongside plans to abolish NHS England, the government announced a requirement for ICBs to reduce their running costs by 50%. The RCN is warning that this could result in the loss of senior nursing leaders with vast clinical experience that is central to protecting public health.

In a report, the RCN is calling for there to be a chief nursing officer in every ICB to provide crucial strategic leadership and for no nursing roles to be cut without thorough assessment of the impact on patient safety, care quality and equality.

The pace of change across ICBs is too fast, the RCN says, with no opportunity for meaningful consultation with local health leaders and nursing staff, resulting in a lack of sufficient information to guarantee that patient safety will not be compromised as a result of the reforms.

The RCN says it does not have confidence that either the UK Government, NHS England, or ICBs have fully appreciated the scale of risk, nor have they taken adequate steps to protect the public from the impact of the cuts.

In addition, the current reforms are also leading to considerable anger among staff, with many feeling their skills have been ignored in the plans. Many are deeply concerned about the lack of clarity about the future of their jobs, even months after the initial announcement, says the RCN.

At a time of transformation as outlined in the 10-Year Health Plan, including plans for introducing a ‘neighbourhood health service' model, nurses are warning that cuts in ICBs will leave local health services with a deficit in expert knowledge required to plan and fund services.

The RCN is now calling for a renewed conversation with government on the cuts to ICBs and the direct involvement of nursing staff in plans for the future of local health services. There must also be time to provide greater clarity to staff and work to ensure that the cost of reform will not be paid by a fall in health and care standards.

Executive director of RCN England, Patricia Marquis, said: ‘Nursing staff in ICBs have led the way in planning and commissioning local health care. They are not only central to the safe delivery of services for patients, but also in designing the services of the future. At a time of huge transformation, their expertise is priceless and we cannot afford to lose them in a cost-cutting exercise.

'We need nurses influencing the health care in every ICB and that must include a chief nurse with a seat at the top table. Leaving those with clinical expertise and local knowledge out of discussions devalues the profession and risks the successful delivery of the ten-year plan for the NHS.'