Demands made on the health service have increased over recent years. This is most acutely felt in emergency care. Emergency dpartment nurses have had a huge impact on care delivery, some would argue that this is attributable to the motivation and concern for patient care. Others might say that it is in response to the reduction in junior doctors hours. I would suggest that it is a combination of both, in conjunction with the political driving force of the government targets. The health service is developing at such a pace it is sometimes difficult to keep up. This was illustrated at a conference recently by a piece of on screen animation whereby an airplane, which represented the NHS, was flying along while still being built!

The desire to provide a better service for patients has brought opportunities for the development of nurse led services such as minor injury units, walk in centres, and NHS Direct, …