Nursing needs policy, it provides the context to our practice, roles, knowledge and frames our patients' day to day lives. This article defines what we mean by policy and what influences its development. With the use of health policy examples the implications for nursing are explained and ideas on how policy is implemented in practice set out. As health is a devolved issue policy comparisons are made between the four regions of the UK. Finally, the implications of current policy change on nursing roles and skill mix shows how future developments in our professional are being directed.