In this article, the author outlines the factors which will influence the development of dermatology nursing services in the future. Nurses must be correctly prepared to develop the necessary new roles and how this could be achieved is discussed

Dermatology care in the UK has been subject to the effects of the healthcare reforms of the past several years. The government White Paper ‘Working for Patients’ (1989) introduced the internal market, with its purchaser-provider split, into the NHS. Commissioning authorities were established to purchase healthcare for their local area (NHSME 1990). Hospitals and community health services were converted into self- governing trusts to become providers of healthcare. Additionally, GPs who provide the primary care became both providers of primary medical care and purchasers of secondary care. In some areas the GPs became fundholders, allowing them to commission secondary care directly from the providers.