To deal with the shortage of doctors the government has delegated roles of assessing and treating patients to nurses in some situations. The next logical step, says the government, is to delegate some nursing roles to "nursing associates". The need to provide healthcare to an ever increasing number of patients with limited resource may necessarily reduce patient access to doctors. Without very careful implementation this will inevitably lead to an increase in missed diagnoses, injury to patients and medical negligence claims. The experience of unqualified staff dealing with emergency calls to the NHS 111 line proves that there is no substitute for clinical training and experience in making the right decision and giving the right advice. It is crucuial the NHS ensure there is always a properly qualified clinician available and willing to be called to examine the patient. This is accepted by healthcare providers however in a busy clinical setting such a resource is rarely consistently available as waiting times in A&E departments demonstrate. The fear is that the increasing use of less qualified staff reduces the safety of healthcare provision as experienced qualified staff are not available to offer immediate reassurance and supervision.