The publication of the new government’s White Paper Equity and Excellence: Liberating the NHS (Department of Health [DH], 2010a) heralds significant change for the NHS and, indeed, other providers of health services. It sets out an agenda which puts patients and the public first and focuses on achieving health outcomes that are among the best in the world. Of course there is a lot of detail to go along with these two ambitions, but as matters of principle they are exactly what we as nurses strive to achieve: we have always held patients’ needs as central to our values and want to do our best for them.