'Setting up clinical nurse specialist services: what does our research tell us?'

Over the past 50 years life expectancy in Britain has increased substantially, resulting in an increasing number of elderly people with long term conditions (Rosengren, 2012). Over the same timeframe we have seen the advent of cardiac care units, thrombolysis and more recently primary angioplasty for acute ST-segment elevation myocardial infarction (Walker et al, 2012). This has increased survival rates but there are potentially more elderly patients with complex cardiac disease including atrial fibrillation (Jernberg et al, 2011). The subsequent development of sub-specialties in heart disease has in turn given rise to the highly skilled clinical nurse specialist (CNS) role in areas including heart failure and arrhythmia management (Department of Health (DH), 2000a; DH, 2000b; DH, 2000c).