A case study analysis of a trust hospital piloting patient-focused care (PFC) on two wards was undertaken with a view to determining the education and training needs of registered nurses. The impact of PFC on the roles of the nurses was examined and nurses’ perceptions of their training needs, and the extent to which these have been met was explored. The competency model which has been operationalized to meet the training needs was also determined. Twenty-three members of staff were interviewed including members of the project team, care leaders (registered nurses), managers and trainers, and various documents were examined. Multi-skilling of staff has so far been limited to nurses. The cross-training programme developed, which is far from complete, is based on a model of competence which focuses on specific task skills. It is suggested that an ‘output’ model of competence which focuses on the whole work role may be more appropriate for qualified nurses vested with the co-ordination of care in accordance with multi-disciplinary protocols. In addition, given that a whole range of ‘soft skills’ are needed to manage the changing role boundaries, Spencer's model of competency is also an appropriate model to adopt for the identification of superior performance from both care leaders and clinical managers. Implications for both pre- and post-registration education and training are highlighted. Inadequate resourcing is currently a major weakness which could jeopardize the entire project which otherwise is viewed very favourably by the majority of those who participated in this study.