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We would echo Wendy Fairhurst's frustration with the lack of consensus definition of a ‘nurse practitioner’, and the myriad different qualifications and levels of experience which (generally self-styled) nurse practitioners variously demonstrate. Indeed, this issue caused the first author (ME) some initial confusion when this study was conceived. Space precluded a detailed description of the qualifications and experience of the single nurse practitioner (CB) employed in our study, and the lack of any established criteria essentially meant that, for us to offer a definition of nurse practitioner as Fairhust suggests, would involve listing CB's entire four-page CV — which further reinforces Fairhurst's point (a CV is however, available on request). Nurse practitioners find themselves in a situation analogous to that of GPs, and their predecessors the surgeon-apothecaries, in the first half of the 18th century: facing competition from less qualified and less experienced colleagues who were entitled, under the ‘laissez-faire’ politics of the day, to bill themselves as professional equals. Half a century of lobbying and the formation of many GP associations (mostly short-lived, although one survives today as the British Medical Association) culminated in the Medical Act of 1858, establishing unified standards of training and qualifications for all doctors. We hope that it will not take another 50 years to establish a similarly unified and recognised curriculum for nurse practitioner training.