Ten hot topics requiring further ‘clarification, understanding and debate' were published by the commission earlier this month.

They include a call to ‘address the current confusion relating to roles and titles among nurses and midwives to make it clearer for service users'.

They also set out plans for nurses ‘taking responsibility and being held to account for quality and safety in patient care'.

Norfolk nurse practitioner and former RCN Nurse Practitioner Association chair Benny Harston, welcomed the list of topics.

‘We do have to clarify who is responsible and whether they have autonomy,' she said. ‘We work outside traditional boundaries so much that we need to clarify roles not covered by our original registration.'

She welcomed the emphasis on nurses leading services and taking more responsibility. She argued that it could help reverse the ‘Teflon effect' created by a culture in which nurses pass on some things they could do themselves because some tasks are not seen as within their remit.

But she said it was ‘easy to come up with ideas', but harder to implement them. She said the NHS spends too much on ‘tiers and tiers of management' but often fails to implement change.

Read the full version of this story in this week's Independent Nurse dated 19 October