Your feature 'Careers without tiers' (page 30, 22 June) states that Manchester University's school of nursing, midwifery and health was the first in the country to develop a course for nurses to expand their role and become surgeons' assistants.

Norfolk and Norwich Health Care trust began exploring the possibilities of developing an accredited in-house programme at degree level for surgical assistants in 1995. The first nurses completed their training in 1996.

Carol Edwards Head of nursing practice/education and development Norfolk & Norwich Health Care trust