Increasingly within the UK, issues related to bed availability can lead to ENT patients receiving care away from previously well-established specialist wards. This is a cause for concern in many institutions and the authors looked to assess this. They demonstrated nurses working on a dedicated ENT ward have an average higher score in a test of ENT related knowledge than nurses working on generic surgical wards. This difference was statistically significant and persists despite banding or training. Ensuring patient safety is a key priority in healthcare and evaluating ward competency is a valuable exercise. Certain aspects of nursing specialisation would appear self evident yet articles such as this allow departments to justify their position.