This article outlines the health needs of older nursing home residents and identifies the case for the role of an older people's specialist nurse within a multidisciplinary care homes support team (CHST). This model has been successfully introduced in the London boroughs of Lambeth, Southwark and Lewisham as a response to the profile of local health need among care home residents and changes in national policy such as the introduction of NHS-funding nursing care. The structure of the CHST is described, and the older people's specialist nurse is discussed in detail. The emergent role of the older people's specialist nurse as key to managing the interface between the nursing homes and primary care is highlighted as a key benefit of this unique role.