The MIU is a good idea, but in many areas it has been a disappointment in the hope that it would reduce the work load of main A & E. MIU should have a supervising consultant to encourage and educate ENPs in the unit. There has to be valid protocols in place. Once a week, one 4 hour session - middle grade supervision will be educational to both parties. As the name implies, it is a minor injuries unit and patients presenting with problems other than minor trauma, minor illness should be refered to the local A & E. Also there is a risk of Gps abusing the system. These little hiccups have been encountered and should pose as no surprise to those who are trying to start a similar unit.