Concerns that partnership in care was not really working brought about the need to establish new documentation. A written management plan of care which actively involves the child and family to identify the partnership in care component is essential. Integration of medical and nursing history forms the basic assessment for a jointly managed plan of care. A major culture change needed to be managed to ensure more purposeful and effective communication within the nursing team. The balance of power for nursing care delivery has shifted away from the children's nurse towards the child/parent/carer. The Blackburn PINC model has provided the structures to ensure partnership in care is a reality. Ongoing development and evaluation in response to nursing and parent comments ensures that the process is responsive to current needs.