It is the responsibility of primary care trusts and strategic health authorities to analyse their local situation and develop plans, in liaison with their local national health service trusts and primary care providers, to deliver high quality NHS services and take action to recruit the appropriate staff required to deliver these services. We understand that the current levels of recruitment of health visitors, nursery nurses, support workers and midwives are in line with work force plans designed to ensure that high-quality services and patient care will continue in Hertfordshire.