Nurses are set to play the key role in shaping future changes in the NHS, their leader has predicted.
Nurses are taking on new roles
Dr Beverly Malone, secretary general of the Royal College of Nursing, said nurses were in a strong position to drive through reform.
However, she said it was vital that more people became nurses.
Speaking at the RCN annual conference in Harrogate, she said at present newly trained UK nurses were outnumbered by foreign recruits.
Dr Malone said nurses were taking on new responsibilities - and had the backing of the public to do so.
The reduction in junior doctors' working hours and the implementation of the Working Time Directive were also having an impact on the way nurses work, she said.
But there were still improvements to be made to ensure staff were deployed in a way that provided patients with the best possible care.
Dr Malone said: "We want a future where nursing reaches its full potential in providing quality of care to patients.
"This is not about being a mini-doctor. This is about being a maxi-nurse.
"We know what a fine job our medical colleagues do and we know we need more
"These new developments are about making the maximum use of nursing for the
benefit of patients."
Dr Malone emphasised the importance of the Agenda for Change initiative, which aims to make pay, career and working conditions more equitable for all nurses.
Currently, the NHS has 11 different sets of pay terms and conditions for different groups of staff.
This means a nurse could be doing a job which requires similar knowledge and skills as other NHS staff members, but their pay, terms and conditions are different.
Dr Malone said it was vital that recruitment and retention was properly addressed - and that stability was brought to the nursing labour market.
Despite efforts in recent years, this was still an issue giving serious cause for concern.
She said: "One in four nurses is aged fifty years or over and eligible to retire in the next five years. People are coming into nursing - but dropping out at rates up to 20%.
"We have reached a position where international nurses registering in the UK are outnumbering nurses qualifying in the UK.
"It is a priority to modernise pay and careers for the NHS staff who work together to care for patients.
"We have to ensure that the funding for Agenda for Change is as secure and well identified as the funding for other pay initiatives such as the new general practice and consultant contracts."
Agenda for change has been piloted in four Scottish project sites and 12 English 'early implementer' trusts.
It is set to be rolled out nationally on October 1. After this date there will be a six month period for staff to move over to the new system.