The Labour Court recommended that the arrangements for Out of Hours Nurse Managers take effect from 7 January 2004, resolving the remaining dispute between the HSE and the Irish Nurses Organisation. The recommendation was signed on 21 November 2008. The union had sought retrospection to November 2001, saying the nurse managers had not contributed to the delay. The HSE pointed to the implementation of other parts of the claim from 1 December 2006 and the costs associated with upgrading 30 posts.