The purpose of this study was to explore the previously little researched area of the implementation of the Named Nurse Standard in hospital settings. The Standard formed part of the Government's programme of health service reforms that aimed to enhance the patient experience by having an identified nurse in charge of their care from admission to discharge. Quantitative and qualitative methods were used to identify whether nursing work was organised to facilitate the named nurse concept and the patient's perception of who delivered their care. A case study approach in surgical wards in two NHS trusts enabled comparison of clinical settings with a high adherence to the Standard's criteria and wards with a low adherence. The areas selected for comparison were the methods of organising nursing work, nurses' perceptions of the Named Nurse Standard and the patient's experience of the named nurse role. The results show that, although levels of patient satisfaction were high, this was not associated with care from a named nurse. There was no significant difference between the methods of organising nursing work on the wards in the two adherence categories. Furthermore, the Named Nurse Standard was not fully implemented on any of the wards sampled. The main recommendation of this study is that innovations in nursing practice should be evaluated in a pilot study before being introduced nationally. Areas recommended for future research in the organisation of nursing work include day case units and discharge planning.