OBJECTIVE: This paper focuses on the policy context for the deployment of nurses in advanced roles, with particular reference to Portugal. The health sector in Portugal, as in all countries, is labour intensive, and the scope to utilise nurses in more advanced roles is currently being debated. METHODS: Mixed methods were used: an analysis of international data on the nursing workforce; an analysis of documents and media articles; interviews with key-informants; an online survey of managers, and a technical workshop with key-informants. CONCLUSIONS: The limited evidence base on nurses in advanced roles in Portugal is a constraint on progress, but it is not an excuse for inaction. Further research in Portugal on health professionals in innovative roles would assist in informing policy direction. There is the need to move forward with a fully informed policy dialogue, taking account of the current political, economic and health service realities of Portugal.