The service involves a 24 hour cardiology assessment provision to the Emergency Department (ED), Acute Medical Unit (AMU) and Ambulance services provided by fully trained cardiac nurse practitioners. Initially 6 senior cardiac nurses were recruited to help run the service smoothly, with the nurses receiving formal health assessment training ( in conjunction with Keele University) and an subsequent 18 month cardiology specific training program, leading to a post graduate diploma in Cardiology (British Cardiovascular Society recognised).