She now divides her time between the hospital and a new dermatology clinic based at Norwich Community Hospital, where she works alongside two GPs with a special interest in dermatology.

Suitable patients are now referred directly to the dermatology clinic from GP surgeries throughout Norwich. If necessary, patients may be referred for further investigation or secondary care at NNUH.

"I find patients suffering from chronic skin disease really appreciate having access to a service in their community," says Carrie. "Their appointments can be longer to allow for education and support."

Carrie qualified for her new role by undertaking a degree-level course in nurse prescribing at the UEA. Many other health professionals are now following in her footsteps, including pharmacists and, in the near future, physiotherapists from NNUH.

"The medicines and drugs that nurses can independently prescribe are restricted to a formulary governed by the National Prescribing Centre and are subject to strict protocols," says Teresa Knowles, the senior nurse in practice development at NNUH. "However, the list is growing all the time to encompass more specialties."

Consultant dermatologist Nick Levell says: "Demand for Dermatology outpatient services at NNUH has more than tripled in the last ten years, due partly to improved treatments for chronic skin conditions such as psoriasis and acne. People are no longer prepared to stay at home with these conditions - they want specialist help to manage their disease and get on with their lives.

"Cases of skin cancer are also continuing to increase, despite warnings about excessive exposure to the sun. "We have new treatments for dealing with small skin cancers, such as photodynamic therapy, and we are leading the field in nurse-led services for this type of therapy in this region. "