Working with nurses on their role at board level, I ask them whether they are responsible for nurses as well as nursing.

Most have replied - with some condescension for my old-fashioned views - that they are head of nursing but not nurses. In view of your features, it may be time to reassess whether patients would be better served if nurses returned to being in charge not only of nursing practice but the development of nurses themselves.

Andrew Wall Visiting senior fellow Health services management centre Birmingham University