The roles of gerontological nurse specialist and gerontological nurse practitioner are well established in America and Canada. In the UK gerontological specialist nursing is still at the evolutionary stage. Irene Schofield argues that concerns of older people, changes in healthcare and developments in nursing mean there is a need for specialist nursing roles with older people and that lessons can be learnt from overseas

The NHS is in continuous flux due in part to rapid scientific and medical advance, a shortage of doctors and a requirement to cut down their working hours. The Patient’s Charter required health services to seek ways of providing services which are more patient-focused and sensitive to individual needs. Nurses - who have a holistic preparation - are well placed to provide this. The Health of the Nation (1992) and more recent policies to improve public health will create more opportunities for health promotion roles for nurses.