Cross-boundary working: a macro-political analysis of the impact on professional roles

This paper reviews the policy developments impacting on professional roles and boundaries in health and social care. A macro-political analysis is used to offer a challenging critique to many of the assumptions associated with cross-boundary working. It explores issues such as: whether or not new nursing roles are truly being developed to meet need; the myths and realities of interprofessional working; how competence can be assured; the need for new forms of professional regulation; the implications for professional education of initiatives such as national occupational standards and shared learning; planning the future health care workforce; and the need for rigorous and robust evaluation of service and role developments. Through this exploration the likely consequences of political and professional initiatives for both cross-boundary working and the profession of nursing itself are illuminated.