Primary care and community nurses with the skills and interest in commissioning are said to be "thin on the ground" as a survey shows only 2.5% are a member of a clinical commissioning group (CCG).
A whopping 97.5% of the 550 nurses responding to Management in Practice's sister title Nursing in Practice's now annual survey said they were not on a CCG board.
Of those nurses not involved with their local CCG, almost half (44.3) were unable to give a reason for their lack of input.
Worryingly, almost one in ten (9.8%) said they were not involved with their local CCG for fear they will not be heard to able to make a difference.
Others said they simply don't have the time to dedicate to a CCG role (17.4%), do not agree with the government's reforms (6.8%) or had another reason (21.7%).
Rebecca Cheatle, Primary Care Advisor for the Royal College of Nursing, said it is "awful" that such a low number of primary care and community nurses are involved in CCGs.
She vowed to do all she can to make sure there is much stronger nursing input into clinical commissioning.
Dr Mike Dixon, Chair of the NHS Alliance and clinical commissioning champion, said he is not surprised by the survey findings, believing more frontline nurses will shun commissioning roles than frontline GPs in favour of the day job.
However, he urged nurses interested in becoming involved in CCGs to "raise their hands" and show their "added value" to the new commissioning structure.
"The involvement of frontline nurses [in CCGs] will be variable, and the degree to which frontline nurses want to be involved in commissioning will be less than frontline GPs," he said.
"Nurses with the skills and interest in commissioning are relatively thin on the ground and any that do want to be involved should very much put up their hands to ensure nurses have a voice locally.
"It is much more important for nurses to show their added value than demand a seat at the table.
"No CCG is going to be able to succeed without good nursing input."
Dame Barbara Hakin, National Director of Commissioning Development at the NHS Commissioning Board, said there is a "massive role" for nurses in commissioning.
"We have always made it clear that all nurses in primary care need to be involved [in commissioning] as well as all clinicians," she said,
"There is a massive role for nurses in commissioning and CCGs need to show they are taking advantage of their workforce and the knowledge they have."
Their disengagement may be explained by an perceived lack of respect from government ministers.
The Nursing in Practice survey found three-quarters of primary care and community nurses feel respected by the government.