Nurse-led initiatives
The Government paper Making; a Difference (Department of
Health (DoH), 1999) advocated nurses extend their skills and
knowledge and adopt different w^ays of working, and strongly
supported the development of nurse-led initiatives. The NHS
Plan (DoH, 2000) highlights the challenges that lie ahead and
promotes nurses as change agents to improve service and deliver
a more patient-centred service. Another significant driver for
changing current practices is the implementation of the
European working time directive (DoH, 2003).The reduction in
junior doctors' working hours may have a significant impactservice delivery. A review undertaken by Richardson and
Cunliffe (2003) to identify the accelerated development of nurseled
services, highlighted a number of influences, ranging from
NHS policy, practice environment, to local need 'service gap'.
The author recognized that a service gap was compromising
patient care and a solution was sought to rectify the problem