title: Struggle to be heard in the new health service.
abstract: On April 1, major NHS reform in England will see the introduction of a system that puts NHS spending in the hands of clinicians. This article, the first in a series, outlines the new commissioning organisations and details the progress made in Cumbria, where nurses play a leading role on the clinical commissioning group.
authors.forename: Daloni
authors.initials: D
authors.lastname: Carlisle
mesh_terms: D018166:Health Care Reform; D006301:Health Services Needs and Demand; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom