§ Mr. David Nicholson
To ask the Secretary of State for Health what data he has collated concerning the increase in the number of posts of(a) matron and (b) director of nursing services in NHS hospitals; what supervising duties such posts carry; and what guidance his Department has given regarding numbers, duties, or good practice as regards such posts. 
§ Mr. Horam
[pursuant to his reply 10 March, column 97]: I am now able to provide additional information. The full reply is as follows:1040W
National health service hospital and community health service—HCHS—staff are not classified by job title, but by the job they do. At September 1995 there were 4,280 whole-time equivalent nurse managers employed by the NHS HCHS in England. These are staff who are required to hold a statutory nursing, midwifery or health visiting qualification to do their job, but who have management responsibilities and have little or no direct clinical involvement. Consequently, staff holding the job titles "Matron" and "Director of Nursing" may be included in these figures, along with other staff with different job titles but whose jobs meet the same criteria.
In the past, staff were classified by national pay scales, some of which are specifically designated for matrons, including deputies and assistants, and directors of nursing. Up until 1994 the Department of Health's non-medical work force census recorded the number of staff on these pay scales, but because of the introduction of clinical grading, the reclassification of some senior nurses onto general and senior manager pay scales and the introduction of local terms and conditions, this information does not accurately identify trends in the numbers of matrons and directors of nursing.
The responsibility for determining the most appropriate form of nurse management and advice lies with the individual national health service employer concerned. The National Health Service Trusts (Membership and Procedure) regulations 1990 state that the executive directors of an NHS trust shall include a registered nurse or registered midwife, except in the case of a trust which does not provide services directly to patients or a trust whose principle function is to provide ambulance or patient transport services. The NHS executive has published two documents that identify the existing roles of trust nurse executive directors: "One year on—The Nurse Executive Director Post" and "Sharpening the Focus: The roles and perceptions of nursing in NHS Trusts". Copies are available in the Library.