In response to Obrey Alexis, while I agree that there is a shortage of front-line nursing staff, it is important to understand that not all trusts are employing nurse consultants as 'mini-medical consultants or consultants' handmaidens'.

In fact, the overriding principle behind the introduction of nurse consultants was to keep good clinical nurses at the front line.

The Health Service Circular (1999/217) clearly spells out that 'where posts are structured to include technical or clinical interventions normally undertaken by medical staff, these narrow responsibilities should not be the principal element of the post. They should be included only where they are clearly an integral part of, and contribute to, the fundamental core of the nursing function'.

Where trusts have appointed nurse consultants to perform medical roles, they are missing the point, and the nurses undertaking these roles are wasting a valuable opportunity for the nursing profession.

Maggie Crowe Consultant nurse Cancer services Royal United Hospital Bath