This paper describes the development of the Clinical Skills Matrix, a consensus document designed to underpin clinical skills teaching in the Skills Centre at St Bartholomew's Hospital in London. It provides a framework for students, teachers and clinical staff, identifying the skills needed and the level of competence expected in each skill. The matrix shows that there are many similarities in the clinical skills required of medical and nursing students, particularly communication skills, and highlights opportunities for joint teaching. Interestingly, development of the matrix has shown that nurses do not have a monopoly on caring skills, neither do doctors on technical skills.