Opinion  

And the report has, largely, been warmly welcomed. There is much to endorse and applaud in its emphasis on prevention as well as cure, quality as well as finance, staff as well as patients.

The QNI was particularly pleased to see the emphasis on innovation. We have been supporting nurses' projects, all based on good ideas for improving care, for many years. To have regional funds and responsibilities to encourage and support innovation is a great step forward.

Too often nurses who want to make changes find themselves unsupported, or pulled in different directions by the competing demands of their day to day work and their project. Yet if these innovators didn't pursue their ideas, persevere in the face of opposition, and insist on completing their projects, how would new ideas that benefit patients ever take root?

Similarly, the QNI has been providing information and contacts for nurses considering involvement with social enterprises. The interest in our QNI Briefing on social enterprise, and the conference we ran in late 2006, showed that many nurses are aware of this form of business as a potential vehicle for NHS provider services.

But there have been some significant obstacles to nurses' participation in these enterprises, not least the need to leave behind the familiar and valuable NHS terms and conditions of employment, including access to the NHS pension. Now that the Next Stage Review has promised to make the pension portable to social enterprises, we may see a resurgence of interest in them. Certainly, the government's ambitions for new types of provider organisation, employing community nurses to deliver services outside of hospitals, remain unchanged.

This is an encouraging time for nurses in primary care who want to try new things, improve the way patients are cared for, and at the same time, feel properly supported to do these things. Of course, words are one thing, and implementation another. We should all be lobbying now for these opportunities to appear in our locality.

- Rosemary Cook, director, Queen's Nursing Institute