Setting up a new service begins with identifying patient needs at both a local and national level, with the goal of producing higher quality and more sustainable services, improved health outcomes, reduced health inequalities and better models of care. Aims and objectives of the new service need to be clearly laid out early on, with the support and input from all stakeholders to ensure its wider acceptance and long-term success. Building a business case is vital in explaining why the new service Is needed and should be clinically-led, underpinned by clear clinical evidence base and national standards. The scale of service, financial implications, organisations involved and geographical focus should be carefully described. Commissioners, patients, public and staff should be engaged throughout the process to ensure full support of the clinical community. Implementation of the new service must take into account service access, scope of referrals, staffing, training needs, location, facilities, health informatics, use of current resources, sustainability, publicity, patient safety and clinical governance issues. Key areas of continuing professional development, training, education and ongoing service expansion need regular and frequent review. Evaluation and improvement of the new service are both vital, measuring its ongoing effectiveness and evolving the service in line with current guidelines and best practice. Communication of the new service to others, its successes and challenges, should be disseminated at both a local and national level, to enable improved quality of patient services offered across the wider healthcare system and encourage others to use similar models in their own scope of practice.