Few doubt that time spent working overseas offers benefits to the individual concerned: our feature this week tells of people returning with new skills, greater self-reliance, reinvigorated and with a better all-round sense of themselves and their job (see cover feature, pages 24-27).

But what of the NHS? The departure of a senior manager can be disruptive and brings uncertainty to any organisation. There may be doubts about whether they will return and concern about how they will fit back in if they do. It is not surprising that a service under pressure has reservations.

Yet there are benefits to the NHS, and it would be a missed opportunity if those who have made a long-term commitment to the health service were denied the chance to discover fresh insights into their work. What we need is a reassertion by the NHS Executive of Ken Jarrold's 1995 Executive Letter, and real, practical support for health service employers attempting to cope with the consequences of that.