Breast Care Nurses

One of the things I've noticed since I've been on this forum are various discussions about Breast Care Nurses - who has one, what do they do, whether they're helpful or not, how to access one... etc, etc.  It all seems like a great idea and the couple I have met seem very nice but the actual application of the service on the whole seems to be rather slipshod.  The ones I met in hospital when I had surgery were helpful at the time and rang once when I got home to check that I was okay but I was very surprised to find out months later, that they were meant to be my nurses on a continuing basis.  I have not developed any relationship with them and, unless I end up back at that hospital, I feel I am unlikely to.  I read people's posts saying how fantastic their bc nurses are and I also read posts asking how to access such a service.  Absolutely not knocking the nurses, but wonder why it's such a hit and miss thing.