AIM: This paper describes how an acute teaching trust established the role of Senior Nurses (Modern Matrons) and an audit that was undertaken 12 months after they were appointed to evaluate the role. BACKGROUND: The concept of the Modern Matron was introduced in 2000 and all trusts had to implement the role by April 2002. METHODS: The audit comprised: measurement of progress against agreed corporate objectives and questionnaires to all senior nurses and a range of trust staff staff. RESULTS: The following themes were identified: Senior Nurse post, patient care, infection control and leadership. Senior nurses were found to be satisfied with their role and the preparation for and understanding of their role seemed to be successful. There were many improvements such as a reduction in drug errors, complaints and MRSA bacteriaemias. CONCLUSIONS: Implementation of the Modern Matron role has been successful and made improvements in patient care.