This study, through extensive research methods, utilising a variety of data collection tools, has examined the clinical outcomes of clinical specialists and advanced practitioners in Ireland. This study has demonstrated conclusively that care provided by clinical specialists and advanced practitioners improves patient/client outcomes, is safe, acceptable and cost-neutral. Nursing and midwifery care is provided in a complex changing environment and it is critically important that resources are utilised in a cost-effective, strategic manner. The study shows the potential of clinical specialists and advanced practitioners to support implementation of health policy, meet the changing health needs of the population, address patient expectations, contribute to service reconfiguration and provide nursing and midwifery leadership for the introduction of care models and care programmes into the HSE and, potentially, other health services. Clinical specialists and advanced practitioners support a safe environment for patients by increasing the use of evidence-based clinical guidelines. Their overall positive effect on patient/client care, other staff and the health services in general is very apparent. Given these considerable benefits, and the fact that the economic analysis did not demonstrate a difference in costs between services with clinical specialists/advanced practitioners and the comparison sites, there is a strong case for introducing more clinical specialists and advanced practitioners. This Final Report and a Summary Report are available to download from our website: www.ncnm.ie